METHODS: Rat BMSCs were isolated, cultured and identified. The time-dependent expressions of TSP-2 and Sox9 in BMSCs under a dynamic mechanical pressure of 0–120 kPa at 0.1 Hz for 1 h were tested by qPCR and Western blotting. The role of TSP-2 in chondrogenic differentiation of BMSCs under mechanical pressure was validated by using small interfering RNA. The impact of TSP-2 and mechanical pressure on chondrogenesis were detected and the downstream signaling molecules were explored using Western blotting. RESULTS: Mechanical pressure stimulation of 0–120 kPa for 1 h significantly upregulated the expression of TSP-2 in BMSCs. The expression of the chondrogenesis markers Sox9, Aggrecan, and Col-II were all upregulated under dynamic mechanical pressure or TSP-2 stimulation. Additional exogenous TSP-2 may potentiate the chondrogenic effect of mechanical stimulation. After knock down TSP-2, the upregulation of Sox9, Aggrecan and Col-II under mechanical pressure was inhibited. The NF-jB signaling pathway responded to both dynamic pressure and TSP-2 stimulation, and the cartilage-promoting effect was blocked by an NF-jB signaling inhibitor. CONCLUSION TSP-2 plays an essential role in the chondrogenic differentiation of BMSCs under mechanical pressure. NF-jB signaling is involved in the mechano-chemical coupling of TSP-2 and mechanical pressure for the chondrogenic differentiation of BMSCs.

Objective:To analyze the risk factors for the most common adverse events, i.e. abdominal pain and distension in sedation-free colonoscopy.Methods:This was a multicenter clinical study, in which clinical data of patients including outpatients and inpatients who underwent selective sedation-free colonoscopy at six gastrointestinal endoscopy centers from July 2017 to December 2019 were collected, including patients' general information, complicating diseases, examination time, examination results, and occurrence of adverse events of abdominal pain and distension. Univariate and multivariate logistic regression was performed to analyze the risk factors for adverse events of abdominal pain and distension during sedation-free colonoscopy.Results:A total of 2 394 patients underwent sedation-free colonoscopy, among whom 690 (28.8%) suffered from abdominal pain, and 1 151 (48.1%) experienced abdominal distension. The results of multivariate logistic analysis showed that overweight ( OR=1.33, 95% CI:1.09-1.62, P=0.005), obesity ( OR=1.55, 95% CI:1.14-2.11, P=0.005) and combination of hypertension ( OR=1.58, 95% CI:1.23-2.02, P<0.001) were independent risk factors for abdominal pain during sedation-free colonoscopy, and overweight ( OR=1.40, 95% CI:1.17-1.68, P<0.001) and combination of hypertension ( OR=1.39,95% CI:1.10-1.76, P=0.006) were independent risk factors for abdominal distension during sedation-free colonoscopy. Conclusion:Obesity, overweight and combination of hypertension are independent risk factors for abdominal pain, and overweight and combination of hypertension are independent risk factors for abdominal distension during sedation-free colonoscopy.

Objective:To investigate the in vitro anti-cancer effect of Vinorelbine (NVB) combined with adriamycin (PLD) on human breast cancer MCF-7 cells and related mechanisms.Methods:The effects of NVB and PLD alone or in combination on the proliferation of breast cancer cells were detected by CCK-8 experiment. Flow cytometry was used to detect cell apoptosis and changes in reactive oxygen species (ROS) levels. Western blot experiment was carried out to detect protein expression.Results:The results of CCK-8 showed that compared with the blank control group, the inhibition rates of the vinorelbine treatment group, the adriamycin treatment group and the combined treatment group were 27.6%, 31.2% and 65.4%, compared with the NVB group and PLD group, the difference between the combined treatment group was statistically significant ( P=0.005 vs 0.001) . The results of flow cytometry showed that the proportion of apoptotic cells in each group was 3.54%, 16.95%, 15.01% and 32.24%, compared with the NVB group and PLD group, the difference between the combined treatment group was statistically significant ( P=0.006 vs 0.005) . The levels of reactive oxygen species in each group were 1, 1.03, 1.06 and 1.57, compared with the NVB group and PLD group, the difference between the combined treatment group was statistically significant ( P=0.008 vs 0.007) . Western blot results showed that the expression of p-ERK and p-STAT3 decreased after the combination of NVB and PLD, which inhibited the ERK/STAT3 signaling pathway. Conclusions:The combination of NVB and PLD can promote the apoptosis of breast cancer cells and inhibit the proliferation of breast cancer cells with high efficiency and low toxicity. Its mechanism of action may be related to the up-regulation of ROS levels in cells, thereby inhibiting the activation of the ERK/STAT3 pathway.

The diagnosis and treatment of spontaneous rupture and massive hemorrhage of tuberous sclerosis-related renal hamartoma in a woman in the third trimester are reported. The patient was admitted at 39 weeks of gestation, with threatened labor and a history of bilateral renal hamartoma, which had been hidden. Placental abruption was considered due to persistent lumbago, abdominal pain, abdominal muscle tension, uterine tension and fetal heart rate dropping to 90 bpm, and an emergency cesarean section was performed at 39 +1 weeks. About 200 ml of bloody ascites was found in the peritoneal cavity. A live boy was delivered and no blood clot was seen in the maternal face of the placenta. After the uterine incision was closed, a huge bluish purple mass was detected on the right-side retroperitoneum and the renal angiography showed rupture and hemorrhage of a right renal hamartoma. A selective right renal artery embolization was performed. The patient recovered after the operation and was discharged seven days later required by the family. The patient was in good condition except for hematuria during a 30-day postpartum follow-up, and oral everolimus treatment and regular follow-up were continued. The newborn with a birth weight of 2 355 g was transferred to the neonatology department after birth due to severe asphyxia, and postnatal echocardiography suspected heart rhabdomyoma. The baby had one seizure but was otherwise well, and was discharged after eight days. The seizure did not recur to the neonate after discharge. Clinicians should pay attention to pregnant women with renal hamartoma. If abnormal abdominal distension, hematuria or lumbago occur during pregnancy, rupture of renal hamartoma and possible massive hemorrhage should be considered.

Objective To discuss the correlation between molecular subtypes of early stage breast cancer patients with positive sentinel lymph nodes and the metastasis of non-sentinel lymph nodes, and find out the factors predicting the metastasis of non-sentinel lymph nodes. Methods The clinical data of 124 female breast cancer patients with sentinel lymph node positive were retrospectively analyzed, and the patients were treated with axillary lymph node dissection. And the correlations were analyzed by single factor analysis and multiple factor Logistic regression analysis. Results Among the 124 patients,non-sentinel lymph node metastasis was in 45 cases (36.3%), and only sentinel lymph node positive was in 79 cases (63.7%). The single factor analysis result showed that the age≤35 years, number of sentinel lymph node positive≥2, macrometastasis of sentinel lymph node had correlation with the metastasis of non-sentinel lymph node (P<0.05 or<0.01);but the molecular type, operation method, maximum tumor diameter had no correlation with the metastasis of non-sentinel lymph node (P>0.05). The multiple factor Logistic regression analysis result showed that the number of sentinel lymph node positive and circumstance of sentinel lymph node positive lesions were the independent risk factors of the non-sentinel lymph node metastasis in patients with sentinel lymph node positive (OR = 4.589 and 2.948; P<0.01 or <0.05). Conclusions The circumstance of sentinel lymph node positive lesions and number of sentinel lymph node positive are the independent risk factors of the non-sentinel lymph node metastasis, but the molecular type is not correlated with the metastasis of non-sentinel lymph node. Predicting non-sentinel lymph node metastasis should be combined with clinical and pathological factors.

Objective The study aimed to establish a kind of simple,rapid,accurate and reliable method in order to simultaneous determine the phenobarbital,ibuprofen and nikethamide in the biomaterial. Methods The biomaterial were pre-treated with ethanol(v/v 95%)at pH 3~4 and then was extracted with ethyl acetate at pH 3~4 and 10~11,respectively. Finally,phenobarbital,ibuprofen and nikethamide in the biomaterial were simultaneous detected by GC-MS. The retention times and relevant characteristic fragment ions of the three substances in the total ion current(TIC)and the mass spectrogram could be used as the basis of qualitative analysis. Results The method was simple and easy operation. It has the characteristics of low background interference,good separation effect and fast analytical speed. The retention times of phenobarbital,ibuprofen and nikethamide were 8.472 min,7.087 min and 6.655 min,respectively. The characteristic fragment ions of phenobarbital were 204 and 232(m/z),of ibuprofen were 161 and 206(m/z),and of nikethamide were 106 and 177(m/z). Conclusion The method showed a satisfactory result that it could be applied to simultaneous determine phenobarbital,ibuprofen and nikethamide of the biomaterial for forensic toxicological analysis.

Objective To expand MSCT obseration and cognition in the ponticulus of atlas,and to improve the diagnosis for it. Methods 263 cases were collected among the patients undergone the examine of MSCT angiography in intracranial and cervical and volume rendering technique(VRT)with unenhance images,and observation and analysis was focused on the posterior arch of atlas. Results 69 cases(97 sides)were detected ponticulus in this group,including unilateral in 41 cases,bilateral in 28 cases.The simple type ponticulus were 82 sides,including the ponticulus posterior (PP)were 60 sides,the ponticulus lateralis (PL)were 1 5 sides,the ponticulus borderland (PB)were 5 sides,The ponticulus middle (PM)were 2 sides.According to the shape of the ponticulus:simple root in 43 sides,opposite beaked in 21 sides,complete type in 18 sides.The ponticulus compound (PC)were 1 5 sides.Conclusion The images of MSCT VRT can showed accurately the ponticulus of atlas,and it can provide reliable imaging evidence on its diagnosis and classification,and it can be used as an unearthly method for its examination.

Objective To explore the belongingness,name and clinical significance of a sort of osteal structure variation (OSV) posterior,outboard and superior to the ditch of vertebral artery of atlas.Methods 23 cases of OSV were collected among 426 patients underwent MSCT intracranial and cervical angiography with volume rendering technique (VRT)to notice the pier point,shape and direction of protuberance,and the relation and influence to the vertebral artery.Results The incidence of OSV was 5.40%(23/426) in which 31 sides were detected,and 1 5 cases in unilateral and 8 cases in bilateral.Simple type was showed at 1 9 sides,compound type at 12 sides with other ponticulus.According to the shape of the ponticulus,simple root was seen at 1 7 sides(13 inferior root and 4 lat-erial root),opposite beaked at 5 sides,complete type at 9 sides.OSV was located at posterior,outbord and superior to the ditch of vertebral artery of atlas and closed to the vertebral artery.The vertebral artery was influenced by OSV as following:in simple OSV vertebral artery stenosis was seen at 4 sides in which unite convulsion was showed at one side;in compound OSV vertebral artery ste-nosis was seen at 5 sides,in which unite convulsion was showed at 2 sides.Conclusion OSV is similar to ponticulus posticus(PP)and ponticulus lateralis(PL),and has similarly importance clinical significance,and should belong to the ponticulus of atlas,and to be named as ponticulus borderland(PB).

Objective To explore the clinical and pathological characteristics of triple-negative breast cancer(TNBC) and to compare the response to neoadjuvant chemotherapy and survival in patients with TNBC and non-TNBC. Methods Five hundred and thirty-five patients were included in this retrospective study. 75 patients were TNBC and 460 were non-TNBC. The clinical and pathological characteristics, 5-year disease free survival (DFS) and overall survival (OS) were analyzed. 88 patients were treated with neoadjuvant chemotherapy in which 26 patients were TNBC, the other were non-TNBC. Their responses to neoadjuvant chemotherapy, and the relations of response and survival were analyzed. Results The patients with TNBC were younger than those with non-TNBC (35 vs 44), and most of the patients with TNBC were premenopausal at diagnosis (88.0 % vs 67.2 %, P =0.009). The frequency of invasive ductal carcinoma was higher in patients with TNBC than those with non-TNBC (92.0 % vs 80.4 %, P =0.020). Generally patients with TNBC had higher grade tumors (grade Ⅱ ) than patients with non-TNBC (56.0 % vs 17.2 %, P = 0.000). Lower rate of lymph node metastasis were observed in patients with TNBC than those with non-TNBC (33.3 % vs 53.9 %, P = 0.001). Patients with TNBC had worse 5-year DFS (66.67 %) and OS (80.0 %) than those with non-TNBC (74.78 %, 90.00 %). In this study. 88 patients were treated with neoadjuvant chemotherapy. The overall response rate(OR) of patients with TNBC was 88.46 %, including 65.38 % clinical complete response (cCR)and 23.08 % clinical partial response (cPR). It was significantly higher than patients with non-TNBC respectively (82.26 %, 37.10 %, 45.16 %) (P <0.05). Patients with TNBC had worse 5-year DFS (65.38 %)and OS (73.08 %) than those with non-TNBC (72.58 %, 80.65 %) (P <0.05). If cCR were achieved, patients with TNBC or with non-TNBC had similar 5-year DFS and 5-year OS (P>0.05). In contrast, TNBC patients with residual disease after neoadjuvant chemotherapy had worse 5-year DFS and OS compared with non-TNBC (P <0.05). Conclusion TNBC is common in young premenopausal women. Its main pathological style is nonspecial type of invasive ductal carcinoma with high grade, with low lymph node metastasis rate. Patients with TNBC are more sensitive to neoadjuvant chemotherapy than those with non-TNBC. Patients with TNBC have increased cCR rates compared with non-TNBC, and those with cCR have a good prognosis. TNBC patients in whom cCR are not achieved have significantly worse survival rates compared with that of non-TNBC patients.

AIM To study the protective effects of prostaglandin E 1 on hypoxia/reoxygenation injury in cultured neonatal rat myocytes. METHODS The hypoxia/reoxygenation injury model of cultured neonatal rat myocardial cells was developed. The activities of plasma superoxide dismutase (SOD) were measured by the method of xanthine oxidase and the contents of serum malonicaldehyde (MDA) were determined by the method of thiobarbituric acid. The activities of dehydrogenase in mitochondria were detected by MTT assay. The activities of LDH in culture were also evaluated. CONCLUSION PGE 1 has protective effects on the cultured neonatal rat myocardial cells injured by hypoxia/reoxygenation. The mechanisms are related to its antioxidation effects.