An increasing number of studies in recent years have focused on the association between female endometrial microbiota and fertility.Once the endometrial microflora microecology is unbalanced,it will cause a series of endometrial lesions,thereby destroying endometrial receptivity,affecting embryo implantation,resulting in embryo implantation or implantation failure.Among them,the most concerned is the positive significance of lactobacillus-led microbiota on reproductive outcome.Although the relationship between endometrial microbiota and reproductive outcome has not reached a consensus,most studies recognize the positive impact of lactobacillus-led microbiota on reproductive outcome.In this review,the relationship between lactobacillus-dominated microbiota and reproductive outcome is reviewed.

Objective:To explore mechanism of long non-coding RNA maternally expressed gene 8(LncRNA MEG8)mediates immune escape in colorectal cancer(CRC)cells by regulating MICA/B via targeting miR-15a-5p.Methods:RT-qPCR and Western blot were used to detect expressions of MEG8,miR-15a-5p,MICA,MICB,NKG2D protein in CRC tissue and cell lines;dual luciferase experiment was used to verify regulatory relationship of MEG8 on miR-15a-5p;NC,MEG8,miR-NC and miR-15a-5p were respectively or co-transfected into SW480 and SW620 cells by liposome transfection,and recorded as NC group,MEG8 group,MEG8+miR-NC group,MEG8+miR-15a-5p group;NK cells were cocultured with SW480 and SW620 cells respectively;ELISA was used to detect TNF-α and IFN-γ levels in coculture medium;CCK-8,EdU staining,Transwell assay were used to detect cell prolifera-tion,migration and invasion ability;RT-qPCR and Western blot were used to detect MEG8,miR-15a-5p,MICA,MICB,NKG2D protein levels in cells.Results:Compared with adjacent cancer tissues or normal colon epithelial cells,MEG8,MICA,MICB,NKG2D mRNA and protein levels in CRC tissues and cell lines were decreased,while miR-15a-5p level was increased(P<0.05).MEG8 targeting regulated miR-15a-5p.In cocultivation system,compared with NC group,MICA,MICB,NKG2D protein levels,TNF-α,IFN-γ levels in cocultured supernatant in MEG8 group were significantly increased,after 1 d,2 d,and 3 d of cell culture,OD value,EdU positive rate,number of migrating and invading cells were significantly decreased(P<0.05);overexpression of miR-15a-5p could partially reverse effects of overexpression of MEG8 on MICA,MICB,NKG2D,TNF-α,IFN-γ levels in cells,prolifera-tion,invasion and metastasis ability(P<0.05).Conclusion:MEG8 promotes NK cell activity and inhibits CRC cell immune escape by regulating MICA and MICB expressions via targeting miR-15a-5p.

NKILA is a kind of newly-discovered lncRNA whose expression is aberrant in diverse malignant tumors. The existing researches have confirmed that NKILA participates in the occurrence and development of tumors mainly by regulating the NF-κB signaling pathway, and has significance to the cancer diagnosis, treatment and prognostic evaluation of patients. This article reviews the abnormal expressions and biological effects of NKILA, and the up- and down-stream mechanisms of NKILA regulating malignant biological behavior in different cancers.

Objective: To investigate smoking cessation behaviors and factors influencing it among adult community smokers in Beijing. Methods: This was a cross-sectional epidemiological study. A questionnaire survey was administered among community smokers over 18 years old, in which information on basic demographics, tobacco use, attempts to quit smoking, tobacco-related awareness, and environmental assessment of smoking cessation support were collected. Descriptive analysis was conducted on the basic information, smoking situation, and demand for smoking cessation intervention of the respondents. Two tests were used to examine the quitting attempts of respondents. Tobacco attempts was found to be correlated with socio-demographic indicators, and factors such as tobacco use, awareness of tobacco-related issues, and the smoking cessation support environment. Dual logistic regression was used to further explore the dependence of identified factors and attempted smoking cessation behavior. Results: A total of 449 respondents were enrolled in this study, 410 of them were men (91.3%). Among the respondents, 272 people (60.6%) had tried to quit smoking and 177 people (39.4%) did not try to quit smoking. Monthly income level, tobacco-related awareness, degree of surrounding people supporting smoking cessation, whether medical treatment was sought in the previous year, number of visits, whether to persuade medical staff to quit smoking in the past year, and whether smoking was given up in the past year were the identified factors. These seven factors, such as whether they have been asked about smoking, are the influencing factors in trying to quit smoking（P<0.05）. Under the logistic regression model, monthly income level (OR=1.271, 95%CI:1.081-1.493), the support of people around them to quit smoking (OR=1.251, 95%CI:1.035-1.512), and the suggestion of medical personnel in the past year (OR=2.382, 95%CI: 1.054-5.381) were found to encourage attempts to quit smoking. Conclusion Factors such as health status, environmental support, hazard perception, and economic level influence attempts to quit smoking. Lack of self-determination and other people's influence are the main reasons for failing to quit smoking. Taking community places as the basic unit of intervention combined with professional guidance of smoking cessation clinic doctors and forming an online comprehensive linkage smoking cessation hospital community intervention model is an innovative way to optimize the management of tobacco dependence.

BACKGROUND: Cardiac valve replacement provides an effective therapeutic means for valvular heart disease. Compared with thoracotomy surgery, interventional treatment, typified by transcatheter aortic valve implantation, has the advantages of minor trauma and rapid recovery. At present, the transcatheter aortic valve replacement is rarely applied in clinical practice. Existing studies mainly focus on the changes of physiological conditions after surgery, while little is reported on the transcatheter aortic valve models. OBJECTIVE: To explore the deformation and stress distribution features of the transcatheter aortic valve, and to verify its working performance. METHODS: The finite element geometric model and mathematical model of the aortic valve, including the aortic valve, blood vessel wall, blood and stent, were established. The fluid structure interaction analysis was carried out by the immersion boundary method, and the effective orifice area index was calculated to verify the performance of the model. RESULTS AND CONCLUSION: During the course of blood shock, the valve leaflets were curl, and the maximum deformation occurred at 1/4 and 3/4 of the valve leaflet free edge. The largest equivalent stress of the aortic valve model was on the stent, but it is almost unformed. The stress concentration of the valve leaflets was located at the curved site of the free edge and the suture points of the leaflets and stents, where a damage easily occurred. The dynamic flow experiments show that the process of the simulation model deformation and effective orifice area index are close to the experimental results. Therefore, the simulation model is reasonable and effective.

Objective To understand the current situation of health education contents as well as the differences in their requirements between clinical medical students and clinicians,and to provide reference for the optimization of health education curricula for medical students.Methods A stratified sampling method was adopted to select 511 medical students (303 females and 208 males) from a medical university,and the survey results of 436 clinicians (144 females and 292 males) were taken as reference.Differences in the degrees of need between clinical medical students and clinicians were compared by chi-square tests.Results There were statistical differences in needs between clinical medical students and clinicians regarding drug compliance,smoking cessation intervention,balanced diet,application of Chinese traditional rehabilitation medicine,mobile health technology education,exercise rehabilitation guidance,and theory of health promotion (P＜0.01).With regard to drug compliance,smoking cessation intervention,and exercise rehabilitation guidance,the proportions of clinical medical students' needs were just 87.1％,82.2％,and 81.2％,respectively,but for clinicians the proportions reached up to 96.3％,93.8％,and 92.8％,respectively.Whereas,there were no statistical differences for mental stress management,chronic infectious disease health education,and acute infectious disease health education (P＞0.05).Conclusion There is still a big gap between medical students and clinical doctors when it comes to the knowledge of chronic disease management and healthy lifestyles;clinical medical students have not yet realized the importance of such knowledge and skills.Therefore,the strengthening of course construction for clinical medical students is suggested.

Objective To explore the value of controlled decompression under intracranial pressure monitoring in craniotomy of patients with severe cerebral hemorrhage.Methods One hundred and six patients with severe cerebral hemorrhage,admitted to our hospital from January 2015 to July 2018,were prospectively enrolled.These patients were divided into control group (n=5 l) and treatment group (n=55) according to their families' wishes.The patients in the control group were treated with traditional craniotomy and hematoma removal;the patients in the treatment group were treated with controlled decompression combined with craniotomy and hematoma clearance under intracranial pressure monitoring,and intracranial pressure monitoring and management were carried out after operation.The rate of bone flap acceptance during operation,incidences of complications such as re-bleeding,scalp exudation,intracranial infection and cerebral infarction after operation,rate of re-operation and Glasgow outcome scale scores 6 months after injury were compared and analyzed between the two groups.Results Five patients had midway withdrawal (2 from the control group and 3 from the treatment group),and 101 patients (49 from the control group and 52 from the treatment group) were included in the statistical analysis.The rate of bone flap acceptance in the treatment group (69.2％) was significantly higher than that in the control group (24.5％,P＜0.05).The incidences of complications such as bleeding,scalp exudation,intracranial infection and cerebral infarction (11.5％,7.7％,3.8％,and 13.5％) were significantly lower than those in the control group (30.6％,22.4％,16.3％,and 34.7％,P＜0.05).The re-operation rate (3.8％) was significantly lower than that in the control group (16.3％,P＜0.05).Good recovery rate in the treatment group (76.9％) was significantly higher than that in the control group (55.1％,P＜0.05).The mortality rate (7.7％) was significantly lower than that of the control group (22.4％,P＜0.05).Conclusion For patients with severe cerebral hemorrhage,controlled decompression under intracranial pressure monitoring combined with craniotomy and hematoma removal can significantly improve the rate of bone flap acceptance,reduce the rate of second-stage cranioplasty,reduce the incidence of complications and re-operation rate,and more effectively improve the quality of life and prognosis of patients.

Objective To observe the effect of enriched environment (EE) on the pain threshold and depression like behavior in mice with chronic constriction injury (CCI) and the underly ing mechanism.Methods Sixty C57/BL6 mice were equally randomized into five groups:sham operation group (group Sham),CCI+standard environment(SE) group (group CS),CCI+EE group (group CE),CCI+EE+temozolomide group (group CET),CCI+EE+lipopolysaccharide group (group CEL).The paw withdraw threshold (PWT),paw withdraw latency,forced swim test (FST)and sucrose preference test (SPT) were evaluated,after the operation,meanwhile the hippocampal bromodeoxyuridine (Brdu),ki67 and doublecortin (ICX) positive cells,tumor necrosis factor-α (TNF-α) and interleukin-1β(IL-1β) were determined.Results Compared with group Sham,the PWT,PWL,sucrose consumption and Brdu,Ki67,DCX positive cells were significantly decreased,the immobility time and levels of TNF-α and IL-1β were obviously increased in group CS (P＜0.05).Compared with group CE,the PWT,PWL,sucrose consumption and Brdu,Ki67,DCX positive cells were significantly decreased in groups CS and CEL.The immobility time was obviously increased in groups CS,CET and CEL,moreover,the levels of TNF-α and IL-1β were significantly increased in groups CS and CEL (P＜0.05).Conclusion EE can improve the neuropathic pain,depression-like behavior and neural regeneration in mice with CCI.The inhibition of neural regeneration can block EE-induced improvement of depression-like behavior,but does not affect the pain threshold in mice with CCI.The augmentation of central inflammation can attenuate EE-induced improvement of pain threshold and depression-like behavior in mice with CCI.

Objective To evaluate the clinical efficacy of prophylactic cranial irradiation (PCI) in the treatment of surgically resected small cell lung cancer (SCLC).Methods Clinical data of SCLC patients undergoing radical resection surgery in Zhejiang Cancer Hospital from 2003 to 2015 were retrospectively analyzed.According to the treatment modality,all patients were allocated into the PCI and non-PCI groups.A total of 52 patients were finally included,including 19 patients in the PCI group (5 cases of stage Ⅰ,5 stage Ⅱ and 9 stage Ⅲ) and 33 in the non-PCI group (12 cases of stage Ⅰ,5 stage Ⅱ and 16 stage Ⅲ).Kaplan-Meier method was utilized for survival analysis.Cox proportional hazards model was adopted to analyze clinical prognosis.Results The median survival time was 32.9 months in the PCI group,and 20.4 months in the non-PCI group.The 2-year overall survival rate was 72％ in the PCI group,significantly higher than 38％ in the non-PCI group (P=0.023).The median brain metastasis-free survival (BMFS) was 32.5 months in the PCI group,and 17.1 months in the non-PCI group.In the PCI group,the 2-year BMFS rate was 89％,significantly better than 53％ in the non-PCI group (P=0.026).Subgroup analysis demonstrated that PCI could confer survival benefit to patients with p-stage Ⅲ (p=0.031) rather than p-stage Ⅰ (P=0.924) and Ⅱ (P=0.094) counterparts.Multivariate analysis revealed that PCI (HR=0.330,P=0.041) was an independent prognostic factor of the overall survival.Conclusions PCI can reduce thr risk of brain metastasis rate and improve the overall survival of patients with surgically resected SCLC.

Objective: To evalate the effectiveness and suitability of a wearable health monitoring device for community-based management of hypertension. Methods: In December 2015, 400 patients with hypertension were enrolled from Beijing, Chaoyang. Subjects were divided into an experimental group (220 cases) and control group (180 cases), and baseline data were collected. The control group received follow-up with general planning while the experimental group received wearable health devices. Follow-up was performed three times using a questionnaire (April, August, and December 2016), and medical staff provided feedback and guidance. The experimental group was also classified according to risk factors and intervention measures were individually designed, and included monitor and medication compliance, self-management ability, and social support. Communication between patients and medical staff was recorded to form a case system. Evaluation indexes included accuracy and reliability, blood pressure management efficacy, behavior intervention efficacy, satisfaction, and disease burden. A t-test, non-parametric test, and chi-square test were used to compare the experimental and control groups before and after intervention. Results: At 1-year follow-up, after correcting for differences in baseline information between the two groups, statistically significant differences in numerical indexes were observed for number of visits within 1 month [1(1) vs. 1(1), Z=5.42], payment within 1 month [85(141) yuan vs. 40(70) yuan, Z=-2.66], visiting time [20(20) min vs. 20(15) min, Z=-2.82], exercise times [4.79(2.24) times/week vs. 4.09(2.00) times/week, Z=9.27], medication compliance score [7.33(5.77) vs. 8.70(5.24), Z=6.86], satisfaction [9.27(0.08) vs. 8.88(0.10), Z=11.77], diastolic pressure [(78.93±0.56) mmHg vs. (81.32±0.61)mmHg, F=8.70] (1 mmHg=0.133 kPa), and body mass index [(25.55±0.27) kg/m² vs. (27.74±0.43) kg/m², F=-2.24]. In addition, classification indexes adjusted for normalized blood pressure and habitus were different between experimental and control groups (χ²=3.89, 8.38, P≤0.05). The equipment worked well, with performance rates of over 90% (90.9%, 97.3%, and 92.7%). Conclusion The wearable health monitoring equipment showed good stability and reliability, and was able to effectively support health management in patients with hypertension in the community. At the same time, the equipment can improve healthy lifestyle compliance and awareness or self-management of blood pressure. In this manner, the burden of disease is reduced and the quality of life is improved.