Purpose: Neoadjuvant therapy modality can increase the operability rate and mitigate pathological risks in locally advanced cervical cancer, but treatment response varies widely. It remains unclear whether genetic alterations correlate with the response to neoadjuvant therapy and disease-free survival (DFS) in locally advanced cervical cancer. Materials and Methods: A total of 62 locally advanced cervical cancer (stage IB-IIA) patients who received neoadjuvant chemoradiation plus radical hysterectomy were retrospectively analyzed. Patients’ tumor biopsy samples were comprehensively profiled using targeted next generation sequencing. Pathologic response to neoadjuvant treatment and DFS were evaluated against the association with genomic traits. Results: Genetic alterations of PIK3CA were most frequent (37%), comparable to that of Caucasian populations from The Cancer Genome Atlas. The mutation frequency of genes including TERT, POLD1, NOS2, and FGFR3 was significantly higher in Chinese patients whereas RPTOR, EGFR, and TP53 were underrepresented in comparison to Caucasians. Germline mutations were identified in 21% (13/62) of the cohort and more than half (57%) had mutations in DNA damage repair genes, including BRCA1/2, TP53 and PALB2. Importantly, high tumor mutation burden, TP53 polymorphism (rs1042522), and KEAP1 mutations were found to be associated with poor pathologic response to neoadjuvant chemoradiation treatment. KEAP1 mutations, PIK3CA-SOX2 co-amplification, TERC copy number gain, and TYMS polymorphism correlated with an increased risk of disease relapse. Conclusion We report the genomic profile of locally advanced cervical cancer patients and the distinction between Asian and Caucasian cohorts. Our findings highlight genomic traits associated with unfavorable neoadjuvant chemoradiation response and a higher risk of early disease recurrence.

OBJECTIVE: To explore the MRI findings of os acromiale and to analyze the relationship between os acromiale and the supraspinatus and infraspinatus injury. METHODS: From January 2010 to August 2020, 21 patients with os acromiale (os arcomiale group) were compared with 21 subjects with no evidence of os acromiale (no os arcomiale group). There were 14 males and 7 females in the os arcomiate group, aged from 29 to 77 years old, mean aged (55.5±11.5) years old. While in the control group, there were 10 males and 11 females in no os arcomiale group, aged from 31 to 70 years old, mean aged (51.1±10.0) years old. The os acromiales were classified as edematous os acromiale or non-edematous os acromiale based on whether the presence of marrow edema, and as displaced os acromiale or non-displaced os acromiale based on whether the presence of displacement of the os acromiale. The MRI features of os acromiale were analyzed. Statistical analyses were performed to identify the differences between the os arcomiale group and no os arcomiale group regarding rotator cuff tear, supraspinatus and infraspinatus injury. Differences in the supraspinatus and infraspinatus tear between the edematous and non-edematous os acromiale group, the displaced and non-displaced os acromiale group, the displaced os acromiale and no os arcomiale group were also assessed. RESULTS: On MRI, all the 21 os acromiales appeared as a triangular or irregular bone fragment of the distal acromion, and forms a pseudo-acromioclavicular joint with the acromion. Eleven cases were edematous os acromiale, 11 cases were displaced os acromiale. In the os arcomiale group, 17 had supraspinatus tear, 1 had supraspinatus tendinitis, 11 had infraspinatus tear, and 4 had infraspinatus tendinitis. In the no os arcomiale group, 11 had supraspinatus tear, 2 had supraspinatus tendinitis, 5 had infraspinatus tear, and 1 had infraspinatus tendinitis. No statistically significant difference between the os arcomiale group and no os arcomiale group regarding the rotator cuff tear, supraspinatus and infraspinatus injury (P>0.05). In the 11 cases of edematous os arcomiale, 10 had supraspinatus tear and 7 had infraspinatus tear. In the 10 cases of non-edematous os acromiale, 7 had supraspinatus tear and 4 had infraspinatus tear. No statistically significant difference was noted between the edematous os acromiale and non-edematous os acromiale in terms of supraspinatus and infraspinatus tear (P>0.05). In the 11 cases of displaced os acromiale, 11 had supraspinatus tear and 9 had infraspinatus tear. In the 10 cases of non-displaced os acromiale, 6 had supraspinatus tear and 2 had infraspinatus tear. In the no os arcomiale group, 11 had supraspinatus tear and 5 had infraspinatus tear. There was a statistically significant increases in the prevalence of supraspinatus and infraspinatus tear in the displaced os acromiale group compared with non-displaced os acromiale group, the displaced os acromiale group and no os arcomiale group(P<0.05). CONCLUSION Shoulder MRI can very well depict os acromiale and can reveal associated abnormalities such as adjacent bone marrow edema, displaced deformity, and rotator cuff tear, and it can be used to assess the stability of the os acromiale. The presence of os acromiale may not increase the risk of supraspinatus and infraspinatus tear significantly. However, the presence of displaced os acromiale is at greater risk of supraspinatus and infraspinatus tear.
Acromion/diagnostic imaging* ; Adult ; Aged ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Rotator Cuff ; Rotator Cuff Injuries/diagnostic imaging* ; Shoulder

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Chinese Pancreatic Surgery Association, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Group of Pancreatic Surgery, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Group of Pancreatic Surgery, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.

OBJECTIVE: To investigate the effect of Pim1 expression up-regulation on cell proliferation, apoptosis, chemotaxis and angiogenesis in acute myeloid leukemia (AML) cell line U937, and to explore the possible molecular mechanism involved, finally to estimate the Pim1 expression in primary AML cells. METHODS: GFP-tagged plasmid for Pim1 overexpression and an empty vector plasmid were constructed, and then a stable Pim1 expressed U937 cell line and a control virus-infected U937 cell line were established by a lentiviral vector system. After confirming Pim1 overexpression in U937 cells, proliferation and apoptosis are determined by CCK-8 Kit and flow cytometry respectively. Transwell chemotaxis assay was used to measure the effect of Pim1 overexpression on AML cells. Flow cytometry and confocal microscopy were applied to detect the influence of Pim1 overexpression on phosphorylated CXCR4 (pCXCR4) and its location. Real-time fluorescence quantitative PCR (qPCR) was used to detect the expression of angiogenesis and adhesion related genes in AML primary cells. RESULTS: The lentivirus-infected AML cell line with Pim1 overex-pression and the control virusinfected AML cell line were established successfully. The Pim1 overexpression could enhance the proliferation and inhibit the cell apoptosis, moreover accompnied with the increasing expression of cyclin D1, phosphorylated BAD (pBAD) and pCXCR4. After SDF-1 α stimuli, Pim1 overexpression induced AML cell chemotaxis accompanied with p-CXCR4 expression and calcium influx increment. Pim1 overexpression has no effect on angiogenesis. Pim1 mRNA expression was significantly higher in AML patients than the healthy people. CONCLUSION Pim1 plays an important role in the pathogenesis of AML, which not only promotes AML cell proliferation and inhibition of apoptosis, but also enhances the chemotactic ability of leukemia cells, which closely relates with Pim1 phosphorylation of CXCR4 and the increase of intracellular calcium ion influx signals.
Apoptosis ; Cell Proliferation ; Humans ; Leukemia, Myeloid, Acute ; genetics ; Proto-Oncogene Proteins c-pim-1 ; genetics ; Signal Transduction ; U937 Cells

AIM:To investigate the effect of 27nt-microRNA (27nt-miRNA) on the expression of smooth muscle 22α protein (SM22α) and the cell viability, migration and phenotypic changes of vascular smooth muscle cells (VSMCs).METHODS:The highly expression plasmids of 27nt-miRNA, and anti-27nt-miRNA and negative control plasmids were constructed, packaged with lentivirus and transfected into the rat primary VSMCs.Platelet-derived growth factor BB (PDGF-BB) was added to induce VSMCs phenotype conversion.The cell viability was measured by MTT assay.The migration ability was detected by scratch assay.The mRNA and protein expression of SM22αwas determined by RT-PCR, immunocytochemical staining and Western blot.RESULTS:Compared with normal group, the cell viability in PDGF-BB group was increased (P<0.05) , the migration ability was increased (P<0.05) and the expression of SM22αat mRNA and protein level was decreased (P<0.05).Compared with negative control lentiviral group, the cell viability in 27ntmiRNA over-expression group was decreased (P<0.05) , the migration ability was decreased (P<0.05) , and the mRNA and protein expression of SM22αwas increased (P<0.05).While in anti-27nt-miRNA group, the cell viability was increased (P<0.05) , the migration ability was increased (P<0.05) , and the mRNA and protein expression of SM22αwas decreased (P<0.05).CONCLUSION:27nt-miRNA significantly increases the expression of SM22α, while inhibits the viability and migration ability of VSMCs, and inhibits its phenotypic shift from contractile to synthetic.

Objective To explore the clinical effects of Ilizarov technology combined with closed minimally invasive osteotomy and slow tissue distraction in the treatment of complex crus malformations.Methods From June 2006 to February 2016,83 cases suffering complex crus malformations in our department were treated by Ilizarov technique combined with closed minimally invasive osteotomy and slow tissue distraction.Of whom,39 cases were traumatic bone defect,36 cases were bone osteomyelitis,8 cases were congenital pseudarthrosis of tibia.Bone defect ranged from 6 to 11 cm,with an average of 8 cm.All cases were conducted by segmental resection of bone lesions combined with closed minimally invasive osteotomy and Ilizarov technique.The functional evaluation was carried out according to the Paley evaluation criterion.Bone healing time,duration of external fixation,postoperative limb lengthening and limb function recovery were recorded.Results Eighty-three patients were followed up for 8 to 36 months,with an average of 16 months.All patients' crus malformations were completely corrected.The external fixation time was from 6 to 18 months,with an average of 10.3 months;the length of the limb lengthening was from 4.5 to 9 cm,with an average of 6.3 cm;and bone healing time was from 6 to 15 months,with an average of 9.8 months.According to the Paley evaluation criterion,53 cases were excellent,24 cases were good,6 cases were general.Conclusion Ilizarov technology combined with closed minimally invasive osteotomy and slow tissue distraction a reliable method to correct the complex deformity of the tibia and fibula.

BACKGROUNDTo study the characters of high-frequency oscillations (HFOs) in the seizure onset zones (SOZ) and the nonseizure onset zones (NSOZ) in the electrocorticography (ECoG) of patients with neocortical epilepsy.

METHODSOnly patients with neocortical epilepsy who were seizure-free after surgery as determined with ECoG were included. We selected patients with normal magnetic resonance imaging before surgery in order to avoid the influence of HFOs by other lesions. Three minutes preictal and 10 min interictal ECoG as recorded in 39 channels in the SOZ and 256 channels in the NSOZ were analyzed. Ripples and fast ripples (FRs) were analyzed by Advanced Source Analysis software (ASA, The Netherlands). Average duration of HFOs was analyzed in SOZ and NSOZ separately.

RESULTSFor ripples, the permillage time occupied by HFOs was 0.83 in NSOZ and 1.17 in SOZ during the interictal period. During preictal period, they were 2.02 in NSOZ and 7.93 in SOZ. For FRs, the permillage time occupied by HFOs was 0.02 in NSOZ and 0.42 in SOZ during the interictal period. During preictal period, they were 0.03 in NSOZ and 2 in SOZ.

CONCLUSIONSHigh-frequency oscillations are linked to SOZ in neocortical epilepsy. Our study demonstrates the prevalent occurrence of HFOs in SOZ. More and more burst of HFOs, especially FRs, means the onset of seizures.

Adolescent ; Adult ; Child ; Electrocorticography ; Electroencephalography ; Epilepsy ; physiopathology ; Female ; Humans ; Male ; Seizures ; physiopathology ; Young Adult

OBJECTIVETo investigate the viral pathogens of acute lower respiratory tract infection (ALRTI) in hospitalized children from East Guangdong Province of China and the relationship of the pathogens with age and seasons.

METHODSThe nasopharyngeal aspirates samples obtained from 345 hospitalized children with ALRTI were investigated for respiratory syncytial virus (RSV), human bocavirus (HBoV), human metapneumovirus (hMPV), influenza virus types A and B, rhinovirus, parainfluenza virus types 1 and 3 and adenovirus by PCR.

RESULTSViral pathogens were detected in 178 patients (51.6%). RSV was the most frequent (19.3%). Novel viruses hMPV (3.2%) and HBoV (3.2%) were found. A highest detection rate (61.9%) of virus was found between January to March. The infants aged 1 to 6 months showed a higher detection rate (71.3%) of virus than the other age groups. The detection rate of viral pathogens was 72.6% in children with bronchiolitis, followed by asthmatic bronchitis (70.0%) and bronchial pneumonia (44.6%).

CONCLUSIONSRSV remained the leading viral pathogens in children with ALRTI in East Guangdong of China. Novel viruses HBoV and hMPV were also important pathogens. The detection rate of viral pathogens was associated with seasonal changes and age. Different respiratory infectious diseases had different viral detection rates, with highest detection rate in bronchiolitis cases.

Acute Disease ; Adenoviridae ; isolation & purification ; Child, Hospitalized ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Metapneumovirus ; isolation & purification ; Nasopharynx ; virology ; Orthomyxoviridae ; isolation & purification ; Respiratory Syncytial Virus, Human ; isolation & purification ; Respiratory Tract Infections ; virology ; Rhinovirus ; isolation & purification ; Seasons