Flotillin 1 is differentially expressed in human epithelial ovarian tumors

Although Flotillin 1 (FLOT1) is highly expressed in various human cancers, its relationship with ovarian cancer (OC) remains unknown. This study determines FLOT1 expression in human ovarian tumors and examines its effect on OC   cell proliferation. FLOT1 protein expression was assessed in a tissue microarray by immunohistochemical staining. We found that 81.48% malignant and 50% borderline tumors were FLOT1 protein-positive, whereas benign tumors and normal ovarian tissues were negative. The staining was strongest in serous malignant tumor and transitional cell carcinoma and weakest in mucinous tumor. Differentially expressed FLOT1 in freshly isolated serous tumors was confirmed by Western blot and we then evaluated FLOT1 expression association with OC patients' clinical characteristics. Histological typing established that FLOT1 protein expression was significantly associated with serous tumor (P Keywords: cell proliferation, epithelial ovarian cancer, FLOT1, miRNA, therapeutic target, tumorigenesis.

Claudin-7 (CLDN7) is overexpressed in gastric cancer and promotes gastric cancer cell proliferation, invasion and maintains mesenchymal state

Gastric cancer (GC) ranks as the fourth most common cancer worldwide and is among the most aggressive types of cancer. Claudin-7 (CLDN7) has been found to be aberrantly expressed in some types of cancers. However, the expression and role of CLDN7 on gastric cancer (GC) remain largely unknown. In this study, we have performed the largest expression analysis study to date of CLDN7 in 113 pairs of human GC tissues and non-tumorous adjacent tissues. We found CLDN7 expression is significantly elevated in GC tissues, and the overexpression of CLDN7 is closely related to lymph node metastasis. Furthermore, we observed that CLDN7 executes an oncogenic function, promoting cancer cell proliferation, invasion, and epithelial-mesenchymal transition in GC. Given this oncogenic role of CLDN7 in GC formation and progression, CLDN7 may have an indispensable potential for future anti-metastatic and therapeutic applications.

Plasma C-type lectin-like receptor 2 as a predictor of death and vascular events in patients with acute ischemic stroke

BACKGROUND AND PURPOSE

C-type lectin-like receptor 2 (CLEC-2) has prominent involvement in platelet activation, which is increased in coronary heart disease and acute ischaemic stroke (AIS) and is associated with stroke progression and stroke prognosis. Here, the aim was to examine the prognostic value of CLEC-2 in death and vascular event recurrence in AIS patients.

METHODS

In all, 352 patients with AIS were studied prospectively. All patients were followed up for 1 year. Death for all vascular events and a combination of death and vascular diseases (recurrent stroke, myocardial infarction, hospitalized and treated angina, hospitalized and treated peripheral arterial disease) were recorded.

RESULTS

During 1 year of follow-up, 46 patients (14.2%) experienced death or combined end-points (23 death and 46 combined end-points). Plasma CLEC-2 (pCLEC-2) was significantly associated with an increased risk of death and combined events of death and vascular diseases after adjusting for age, sex, history of hypertension, diabetes mellitus and coronary artery disease, and National Institutes of Health Stroke Scale scores. Each 1 SD higher log-transformed pCLEC-2 was associated with a 4.27-fold (hazard ratio 4.27, 95% confidence interval 1.71-10.65) increased risk for death and a 2.42-fold increased risk for combined end-points (hazard ratio 2.42, 95% confidence interval 1.52-3.86). The optimal cut-off point of pCLEC-2 for predicting death was 184.38 pg/ml.

CONCLUSIONS

Higher pCLEC-2 levels at admission were associated with increased risk of death and combined events of death and vascular diseases in patients with AIS, which indicated that pCLEC-2 is an important prognostic factor for AIS.

[Clonal evolution and clinical significance of trisomy 8 in acquired bone marrow failure]

Objective: To analyze clonal evolution and clinical significance of trisomy 8 in patients with acquired bone marrow failure. Methods: The clinical data of 63 patients with acquired bone marrow failure accompanied with isolated trisomy 8 (+8) from June 2011 to September 2018 were analyzed retrospectively, the clonal evolution patterns and relationship with immmunosuppressive therapy were summarized. Results: Totally 24 male and 39 female patients were enrolled, including 39 patients with aplastic anemia (AA) and 24 patients with relatively low-risk myelodysplastic syndrome (MDS) . Mean size of+8 clone in MDS patients[65% (15%-100%) ]was higher than that of AA patients[25% (4.8%-100%) , z=3.48, P=0.001]. The patients were was divided into three groups (<30%, 30%-<50%,and ≥50%) according to the proportion of+8 clone. There was significant difference among the three groups between AA[<30%:55.6% (20/36) ; 30-50%: 22.2% (8/36) ; ≥50%22.2% (8/36) ]and MDS patients[<30%:19.0% (4/21) ; 30%-<50%:19.0% (4/21) ; ≥50%61.9% (13/21) ] (P=0.007) . The proportion of AA patients with+8 clone <30% was significantly higher than that of MDS patients (P=0.002) ; and the proportion of AA patients with+8 clone ≥50%was significantly lower than that of MDS patients (P=0.002) . The median age of AA and MDS patients was respectively 28 (7-61) years old and 48.5 (16-72) years old. Moreover, there was no correlation between age and+8 clone size in AA or MDS (r(s)=0.109, P=0.125; r(s)=-0.022, P=0.924, respectively) . There was statistical difference in total iron binding capacity, transferrin and erythropoietin between high and low clone group of AA patients (P=0.016, P=0.046, P=0.012, respectively) , but no significant difference in MDS patients. The immunosuppressive therapy (IST) efficacy of AA and MDS patients was respectively 66.7% and 43.8% (P=0.125) . Comparing with initial clone size (27.3%) , the +8 clone size (45%) of AA patients was increased 1-2 year after IST, but no statistical difference (z=0.83, P=0.272) . Consistently, there was no significant change between initial clone size (72.5%) and 1-2 year clone size (70.5%) after IST in MDS patients. There was no significant difference in IST efficient rate between +8 clone size expansion and decline group of in AA patients at 0.5-<1, 1-2 and>2 years after IST. We found four dynamic evolution patterns of +8 clone, which were clone persistence (45%) , clone disappearance (30%) , clone emergence (10%) and clone recurrence (15%) . Conclusions: AA patients had a low clone burden, while MDS patients had a high burden of +8 clone. The +8 clone of AA patients didn't significantly expanded after IST, and the changes of +8 clone also had no effect on IST response.

Prenatal Exposure to the Great Chinese Famine and Risk of Intracerebral Hemorrhage in Mid-life: Prospective Cohort Study (P18-064-19)

Objectives

The “Developmental Origins of Health and Disease” hypothesis suggests that adversity in early life, particularly in utero, affects health status later in life. We thus investigated whether prenatal exposure to the Great Chinese famine 1959–1961 was associated with risk of intracerebral hemorrhage (ICH) in adulthood.

Methods

Included were 97,399 participants of the Kailuan Study, who were free of stroke, myocardial infarction, or cancer at baseline (2006). Incident ICH cases were confirmed by medical record review. The cox proportional hazards model was used to calculate the hazard ratio (HR) and 95% confidence interval (95%CI) for ICH, according to prenatal famine exposure status.

Results

During a median 9.0 years of follow-up (2006–2015), 724 incident intracerebral hemorrhage cases were identified. After adjustment for potential confounders, the hazard ratio (HR) of intracerebral hemorrhage was 1.49 (95%CI: 1.01 to 2.19) for prenatal famine exposed individuals versus individuals born between 1956–1958 and not exposed in utero. When exposure to famine and severity of famine were examined jointly, the adjusted HR was 2.81(95% CI: 1.11 to 7.13) for prenatal exposure to severe famine and 1.81 (95%CI: 1.16 to 2.82) for prenatal exposure to less-severe famine, relative to those without prenatal exposure to famine at all (born between 1956 and 1958). The associations between prenatal exposure and ICH risk were more pronounced in individuals who were overweight or hypertensive, compared to normal weight and non-hypertensives, respectively (P interaction < 0.05 for both).

Conclusions

Individuals with prenatal exposure to famine, especially exposed to severe famine, were more likely to suffer from intracerebral hemorrhage in midlife, highlighting the role of nutritional factors in susceptibility to this severe cerebral condition.

Funding Sources

This research is supported by the start-up grant from the college of health and human development and the department of nutritional sciences, Penn State University and the Institute for CyberScience Seed Grant Program, Penn State University.

Supporting Tables, Images and/or Graphs

Spiral Steel Wire Based Fiber-Shaped Stretchable and Tailorable Triboelectric Nanogenerator for Wearable Power Source and Active Gesture Sensor

Continuous deforming always leads to the performance degradation of a flexible triboelectric nanogenerator due to the Young's modulus mismatch of different functional layers. In this work, we fabricated a fiber-shaped stretchable and tailorable triboelectric nanogenerator (FST-TENG) based on the geometric construction of a steel wire as electrode and ingenious selection of silicone rubber as triboelectric layer. Owing to the great robustness and continuous conductivity, the FST-TENGs demonstrate high stability, stretchability, and even tailorability. For a single device with ~ 6 cm in length and ~ 3 mm in diameter, the open-circuit voltage of ~ 59.7 V, transferred charge of ~ 23.7 nC, short-circuit current of ~ 2.67 μA and average power of ~ 2.13 μW can be obtained at 2.5 Hz. By knitting several FST-TENGs to be a fabric or a bracelet, it enables to harvest human motion energy and then to drive a wearable electronic device. Finally, it can also be woven on dorsum of glove to monitor the movements of gesture, which can recognize every single finger, different bending angle, and numbers of bent finger by analyzing voltage signals.

Increased Phosphatidylserine on Blood Cells in Oral Squamous Cell Carcinoma

The specific function of phosphatidylserine (PS) in the context of the development of a hypercoagulable state among individuals with oral squamous cell carcinoma (OSCC) is uncertain. The goal of this study was therefore to assess the exposure of PS on microparticles (MPs) as well as on endothelial and blood cells and to assess procoagulant activity (PCA) as a function of the stage of OSCC progression. We recruited patients with OSCC (n = 63) as well as healthy controls (n = 26) to participate in this study. PS exposure was then assessed via confocal microscopy and flow cytometry, revealing that patients with stage III/IV OSCC exhibited higher frequencies of PS-exposing blood cells, MPs, and serum-cultured endothelial cells (ECs) than did patients with stage I/II OSCC or healthy controls. When we conducted functional coagulation assays, we discovered that PS⁺ blood cells, MPs, and serum-cultured ECs from patients with stage III/IV OSCC mediated more rapid coagulation and more substantial production of FXa, thrombin, and fibrin as compared with controls. When samples were treated with the PS antagonist lactadherin, this resulted in an 80% disruption of PCA. Strikingly, when pre- and postoperative samples were compared from patients with stage III/IV OSCC undergoing resective surgery, PCA was significantly reduced in the postoperative samples. After stimulating ECs with inflammatory cytokines, we found by confocal microscopy that they expose PS on their cell membranes, thus generating FVa and FXa binding sites and mediating the formation of fibrin. Together our findings provide evidence that PS⁺ blood cells and MPs are important mediators of the development of a hypercoagulable and prothrombotic state among individuals afflicted by advanced-stage OSCC. As such, a PS blockade may be a viable therapeutic strategy for treating such patients.

A liquid PEDOT:PSS electrode-based stretchable triboelectric nanogenerator for a portable self-charging power source

The rapid development of wearable electronics has led to an enormous demand for power sources that are wearable, small-scale, flexible and compatible. In this work, poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS) as the liquid electrode and silicone rubber as the triboelectric/encapsulation layer were introduced to design a stretchable PEDOT:PSS liquid electrode-based triboelectric nanogenerator (PL-TENG). The elastic silicone rubber and PEDOT:PSS liquid electrode with a special macromolecular structure endowed PL-TENG with extraordinary flexibility and conductivity simultaneously. Working under the single-electrode mode with different motion frequencies from 0.5 to 2.5 Hz, PL-TENG generated open-circuit voltage of 265 V, short-circuit current of 24.9 μA and short-circuit charge quantity of 85 nC. The output performances still maintained the original values after washing in saline, storing for one month and stretching 10 000 times. At the same time, PL-TENG could also produce stable electrical outputs even when deformed into a variety of shapes including stretching in different directions, bending and twisting. All of these features demonstrated the excellent resistance of PL-TENG to sweat, time and deformation. When attached to a human body, PL-TENG could provide a sufficiently stable power output to drive wearable electronics sustainably.

Osteoprotegerin mediate RANK/RANKL signaling inhibition eases asthma inflammatory reaction by affecting the survival and function of dendritic cells

INTRODUCTION

Asthma is a chronic inflammatory, heterogeneous airway disease affecting millions of people around the world. Dendritic cells (DCs) are considered the most important antigen-presenting cell in asthma airway inflammatory reaction. But whether osteoprotegerin (OPG) mediate RANK/RANKL signaling inhibition influences asthma development by affecting the survival and function of DCs remains unclear. In this study, we assessed the effects of OPG on DCs and asthma.

MATERIAL AND METHODS

BALB/c mice immunized with ovalbumin (OVA) were challenged thrice with an aerosol of OVA every second day for eight days. Dexamethasone (1.0mg/kg) or OPG (50μg/kg) was administered intraperitoneally to OVA-immunized BALB/c mice on day 24 once a day for nine days. Mice were analyzed for effects of OPG on asthma, inflammatory cell infiltration and cytokine levels in lung tissue. The expression of RANK and β-actin was detected by Western Blot. DCs were isolated from mouse bone morrow. Cell survival was assessed by cell counting. The content of IL-12 was detected by ELISA.

RESULTS

Results showed that OVA increased the number of inflammatory factors in BALF, elevated lung inflammation scores in mice. OPG reversed the alterations induced by OVA in the asthmatic mice. OPG inhibited the survival and function of DC via inhibition of RANK/RANKL signaling.

CONCLUSIONS

This research proved inhibition of RANK/RANKL signaling by OPG could ease the inflammatory reaction in asthma, providing new evidence for the application of OPG on asthma.

[A retrospective analysis of 12 cases of primary thyroid lymphoma]

OBJECTIVE

To discuss the clinical characteristics and diagnostic and therapeutic considerations of primary thyroid lymphoma (PTL) by reviewing PTL cases.

METHODS

In the study, 12 cases of PTL diagnosed and treated in Peking University First Hospital between January 1995 and September 2015 were identified. The clinical characteristics, management experiences and prognosis of these cases were reviewed retrospectively.

RESULTS

A total of 12 PTL patients (four males and eight females) were collected, with an average age of 63 years (42 to 81 years) at the time of diagnosis. The average time to clarify diagnosis was 5 months (0.5 to 24 months). Eleven patients presented with a rapidly growing neck mass and visited surgical department, except one complained of coughing and suffocated. Seven patients were hypothyroid, and four were euthyroid at the time of diagnosis. In sonography of 11 cases, nine showed bilateral nodules, with an average diameter of 3.87 cm. Pathologic diagnosis of non-Hodgkin's lymphoma was confirmed in all the 12 cases by means of partial thyroidectomy (four) or core needle biopsy (eight). The pathological subtypes were diffuse large B cell lymphoma in nine patients, mucosa-associated lymphoid tissue lymphoma (MALToma) in two, and small B cell lymphoma in the other one patient. Five patients were concomitant with Hashimoto's thyroiditis. Eleven patients received chemotherapy. Only one patient did not have any further treatment after operation due to an inertia type of tumor. The median overall survival time was 24 months (1-117 months), three patients died. Among the patients who survived, seven completed chemotherapy without disease progression, one MALToma case did not receive chemotherapy after thyroidectomy but was still alive with PTL, and one patient just finished his second course of chemotherapy.

CONCLUSION

The diagnosis of PTL should be considered when dealing with rapidly growing goiters in elder female Hashimoto's thyroiditis patients whose B ultrasound indicates hypoechogenicity in thyroid nodules or parenchyma, especially with lymphadenopathy and tracheal compressions. Timely use of coreneedle biopsy on suspicious cases can avoid unnecessary surgical trauma, and chemotherapy is the main treatment.

Abstract P3-07-07: Withdrawn

This abstract was withdrawn by the authors.

Citation Format: Jiang Y-Z, Ma D, Suo C, Shi J, Xue M, Stover DG, Verschraegen C, Kaklamani V, Wang P, Shi L, Huang W, Shao Z-M. Withdrawn [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-07-07.

Abstract P3-01-18: In vivo isolation of circulating tumour cells using CellCollector and detection of gene mutations in different metastasis organ sites in breast cancer

Introduction: Metastasis is thought to result from tumour cell entry into the circulation and migration to distant organs, where the mutation landscape of metastatic breast cancer (MBC) may shift and vary. The genotypic features of circulating tumour cells (CTCs) typically differ from those of primary breast cancer (BC) cells. Gene mutation analysis of CTCs in MBC may benefit patients by identifying those amenable to specific therapies. Currently, CTCs are primarily isolated in vitro from small volumes of blood. The aim of this study was to isolate CTCs in vivo using CellCollector and screen for specific gene mutations in cells from different metastasis organ sites and molecular subtypes in MBC patients.

Methods: In this study, we used a novel technology, CellCollector, to collect peripheral CTCs. Thirty MBC patients were enrolled, and 17 were analysed with next-generation sequencing (NGS) methods. Clinical characteristics were analysed along with CTC enumeration and detection rates. Whole-genome amplification (WGA) was used to amplify the CTC genomic DNA of 127 genes.

Results: We isolated CTCs in vivo from 20 of 30 MBC patients (66.7%), with a median and mean (range) of 2 (0-15) CTCs. In non-cancer patients, no CTCs were detected. We analysed CTC enumeration and the detection rate in different clinical characteristic subgroups. We found that in their corresponding subgroups, patients younger than 45 years old, with brain metastasis, with three or more metastasis organ sites, or with HER2-positive subtypes had the highest CTC medians and means.As far as clinical characteristics were concerned, the number of CTCs seemed correlated with more advanced clinical characteristics. In the one metastasis organ, two metastasis organs and three or more metastasis organs subgroups, the CTC detection rates were 38.5% (5/13), 77.8% (7/9), and 100.0% (8/8), respectively. The CTC detection rate correlated with the number of metastasis organs; patients with more metastasis organ sites had higher CTC detection rates. We also found that different metastasis organs and molecular subtypes contain high-frequency mutation genes, and also contain unique gene mutations.

Conclusions: In MBC, CellCollector can be used to collect intact CTCs, from which we can obtain gene mutation information. Different metastasis organs and molecular subtypes may have corresponding unique mutations, which may provide a basis for future gene therapy.

CTCs enumeration data and correlations to clinicopathologic characteristicsPatients' characteristics CTCs enumeration  RangemedianmeanTotal0-1522Age (years)   &lt;450-422≥45 and &lt;600-1512≥600-212Metastatic location   Brain0-1556Lung+liver0-712Bone+local recurrence0-411Number of metastatic locations   10-40120-15133-41-723Molecular subtypes   Luminal A000Luminal B0-511HER2 positive0-1523Triple negative0-712HER2, human epidermal growth factor receptor 2

Citation Format: Geng C, Li S, Yang S, Shi J, Ding Y, Gao W, Cheng M, Sun Y, Xie Y, Sang M. In vivo isolation of circulating tumour cells using CellCollector and detection of gene mutations in different metastasis organ sites in breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-01-18.

[Outcomes of splenectomy in relapsed/refractory autoimmune hemolytic anemia]

Objective: To evaluate the outcomes of splenectomy in the treatment of relapsed/refractory autoimmune hemolytic anemia (AIHA). Methods: Retrospective analysis was performed in 30 cases with relapsed/refractory AIHA who were treated with splenectomy in our hospital. The pre- and post-operative blood routine indexes and responses were followed up. Results: Among the 30 relapsed/refractory AIHA patients, 20 were pure AIHA (including 13 patients with warm antibody AIHA, 2 with warm-cold double antibody AIHA and 5 with Coombs negative AIHA) and 10 were Evans syndrome. The short-term response was evaluated 10-14 days after operation, and the overall response rate (ORR) of short-term response was 90% [12 cases in complete response (CR), 6 cases in partial response (PR)] in 20 therapeutic evaluable cases. Among 13 patients with long-term follow-up data, except 3 patients with Evans syndrome died (2 cases were refractory to splenectomy, 1 case relapsed after surgery), the ORR of 10 patients with relapsed/refractory pure AIHA at 6 months and 12 months were 90% (9/10) and 70% (7/10), respectively, with a median follow-up of 14 (4-156) months. At the end of follow-up, 3 cases had maintained CR for more than 3 years. Conclusion: The short-term response of splenectomy as a second-line treatment for relapsed/refractory AIHA is satisfactory, and long-term outcome of splenectomy is up to 70% at 1 year. Approximately one-third of patients could maintain sustained remission.

[Clinical features and laboratory data analysis of decreased glycosylated hemoglobin related to hemolytic disease]

Objective: To compare the effects of different hemolytic diseases on the level of glycosylated hemoglobin (HbA(1c)) to further explore the relationship between HbA(1c) and laboratory indexes to disclose implications of HbA(1c) in hemolytic diseases. Methods: The distribution of 192 decreased HbA(1c) cases in 4 categories of hemolytic diseases was analyzed. Laboratory indexes related to hemolysis were tested and analyzed in each kind of disease, and relationship between laboratory indexes and HbA(1)c was statistically explored. Results: Diagnoses of decreased HbA(1c) cases mainly included erythrocyte membranopathies (88 cases), immunohemolytic anemia (72 cases), hemoglobinopathy (4 cases) and erythrocyte enzymopathy (5 cases). The distribution of HbA(2) and normal HbF subjects in immunohemolytic anemia and hemoglobinopathy was significantly different from those of HbA(2) and / or abnormal HbF subjects (41.7% vs 22.0%, χ(2)=5.574, P=0.018; 0.7% vs 7.3%, P=0.031). Compared with non-hemolytic disease patients, those who suffered from 4 categories of hemolytic diseases showed lower HbA(1c) level and higher reticulocyte percentage (Ret), indirect bilirubin (IBIL) and free hemoglobin (F-Hb). Different levels of Ret, reticulocyte hemoglobin content (Ret-He), mean corpuscular volume (MCV), IBIL and F-Hb among the 4 kinds of diseases were observed, but the causes of the differences were not the same. HbA(1c) was negatively correlated with other laboratory indexes in erythrocyte membranopathies and immunohemolytic anemia. Conclusions: Hemolytic disease resulted in false lower HbA(1c), but impact of difference on HbA1c between different diseases was not significant. HbA(1c) was closely connected to laboratory indexes related to hemolysis, which might have potential implications for hemolytic diseases such as erythrocyte membranopathies and immunohemolytic anemia.

[The analysis of prognosis-associated factors in adults with acute promyelocytic leukemia]

目的

探讨CD34、CD2、CD56表达和FLT3-ITD突变在成人急性早幼粒细胞白血病（APL）中的预后价值。

方法

分析2010年1月至2016年3月确诊的137例成人APL患者的免疫表型及分子学特点，探讨CD34、CD2、CD56表达及FLT3-ITD突变与初诊WBC、完全缓解率、早期死亡率、复发率、总生存（OS）率及无病生存（DFS）率的关系。

结果

①137例APL患者中，伴CD34表达者占26.3%，伴CD2表达者占25.5%，伴CD56表达者占10.2%，FLT3-ITD突变率为17.5%。CD34、CD2、CD56表达和FLT3-ITD突变在高危组患者中的发生率分别为43.2%、47.7%、18.2%和27.3%；在中/低危组患者中的发生率分别为18.3%、15.1%、6.5%和12.9%，差异均有统计学意义（χ²值分别为9.561、16.764、4.480、4.268，P值分别为0.002、<0.001、0.034、0.039）。②中位随访41个月，完全缓解率为96.9%，早期死亡率为6.6%，复发率为7.3%。与阴性者比较，伴CD34或CD2表达者的复发率增加（18.8%对3.3%，χ²=8.462，P=0.004；16.1%对4.3%，χ²=4.382，P=0.028）；伴CD56表达或FLT3-ITD突变者早期死亡率增加（21.4%对4.9%，χ²=5.610，P=0.018；16.7%对4.4%，χ²=4.833，P=0.028）。③137例患者的OS率为88.3%，DFS率为84.7%；CD34、CD56表达或FLT3-ITD突变者的OS及DFS较阴性者差（P值均<0.05）。

结论

在成人APL患者中，CD34、CD2、CD56表达及FLT3-ITD突变是一种不良预后因素。

[Impaired hypoxic ventilatory response and related factors in Han and Uygur patients with obstructive sleep apnea-hypopnea syndrome]

Objective: To investigate the respiratory central hypoxia response and its related factors in Han and Uygur patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: One hundred and sixty six OSAHS patients were selected from Jan. 2016 to Dec. 2016 in Department of Respiratory and Critical Care Medicine, Kelamayi Central Hospital, including 69 cases of Han nationality and 97 cases of Uygur nationality. Seventy-three healthy subjects of Uygur nationality were enrolled as the control group. All of them under went sleep monitoring, nocturnal oxygen saturation (SaO(2)), pulmonary function and respiratory central hypoxia response. Results: The 3 groups were matched for age, gender, body mass index(BMI) and apnea-hypopnea index(AHI). The Uygur patients had a higher oxygen desaturation index (ODI4) [(30±22) per hour vs (18±17) per hour ] than Han patients of the same age and BMI. Compared to Han patients, Uygur patients had weaker hypoxic responsiveness [(-0.41±0.23) L·min(-1)·%(-1) vs (-0.36±0.22) L·min(-1)·%(-1,) P<0.05], and the difference still existed after adjusting for AHI [(-0.31±0.21) L·min(-1)·%(-1) vs (-0.41±0.22) L·min(-1)·%(-1,) P<0.05] in mild OSAHS, but this difference was not significant in severe OSAHS. Conclusions: The central hypoxic response in Uygur OSAHS patients was lower than that in Han OSAHS patients and normal controls.

Clinical analysis of cervical lymph node metastasis risk factors in patients with papillary thyroid microcarcinoma

PURPOSE

Lymph node metastasis (LNM) is a vital prognosis factor in patients with papillary thyroid microcarcinoma (PTMC). The study tried to identify clinicopathological factors for LNM of PTMC.

METHODS

The clinicopathological data of 1031 patients with PTMC were extracted and analyzed. Univariate and multivariate analyses were used to identify risk factors associated with cervical lymph node metastasis. ROC analysis was used to determine the ideal critical points of the sum of the maximum diameter of multifocal in a unilateral lobe.

RESULTS

The probability of LNM, central lymph node metastasis (CLNM) and lateral lymph node metastasis(LLNM)of PTMC patients were 35.6, 33.7 and 5.6%, respectively. In addition, 1.9% PTMC had LLNM only. Male, age ≤ 40 years, tumor largest diameter ≥ 5 mm, multifocal, non-uniform echoic distribution, the sum of the maximum diameter of multifocal in a unilateral lobe ≥ 8.5 mm, tumors in the lower pole location were prone to CLNM. Ultrasound mix-echo, the sum of the maximum diameter of the multifocal ≥ 10.75 mm, tumors in the upper pole location were extremely prone to LLNM. T3 were prone to LLNM or skip LLNM.

CONCLUSIONS

According to the clinicopathological characteristics of PTMC, the cervical lymph nodes should be correctly evaluated to guide the surgical treatment.

[The diagnostic framework for screening Alzheimer's disease in the Chinese population]

Criteria for diagnosis of Alzheimer's disease (AD) is not available in China. The international criteria is not a proper choice due to issues such as translation and lead to low diagnostic rate and high rate of missed diagnosis. The research group of Alzheimer's Disease Chinese (ADC) reviewed knowledge and techniques in neuropsychology, neuroimaging, molecular biology, and clinical neurology, and systematically studied the detection techniques such as memory, language, visuospatial, executive function, and medial temporal lobe visual scores on MRI, and their optimal threshold and diagnostic value for the diagnosis of AD. Through a systematic review and consensus meeting, a diagnostic framework for screening AD in the Chinese population was established. Among these methods, an operational standard for clinical pathology models increased the diagnostic sensitivity by 15%. The sensitivity and specificity of screening memory impairment increased by 18.1% and 11.6%, respectively. The sensitivity of screening medial temporal lobe atrophy increased by 24.5% and missed diagnosis was decreased by 34.5%. An operational standard for clinical biology models, incorporating the latest molecular imaging and molecular biology techniques, has enabled the early diagnosis of AD in China. The framework combines a principled diagnostic guideline with an operational screening protocol, which is applicable to all clinical settings and of great significance for the early detection, early diagnosis and early treatment of AD.

OCT4 is up-regulated by DNA hypomethylation of promoter in recurrent gliomas

OCT4, a marker of embryonic stem cells, is also a key transcription factor that plays a regulatory role in the self-renewal, proliferation and differentiation of stem cells. Previous studies showed that DNA methylation is involved in the regulation of OCT4 expression during the development and differentiation of embryonic stem cells. However, DNA methylation in the promoter region of OCT4 has not yet been discussed in human recurrent glioma. In this study, we assessed the specimens from 24 cases of recurrent glioma for OCT4 expression and methylation status, and commenced analyzing the correlation between the two by treating glioma cells with a demethylating agent in vitro. The results demonstrated that for the same cases, the expression of OCT4 in specimens of recurrent glioma was significant higher than that in primary glioma (P<0.05). DNA methylation levels in recurrent glioma decreased obviously compared with that in primary glioma (t=9.800, P=0.008). In vitro study indicated, following demethylation treatment, glioma cells had an increased OCT4 expression. These results suggest that DNA hypomethylation may be a key mechanism underlying the up-regulation of OCT4 in the recurrence of glioma, which facilitates the understanding of the role of stem cells and the exploration of novel strategies for the treatment of recurrent glioma.

Severe Gastric Mycormycosis Infection Followed by Cytomegalovirus Pneumonia in a Renal Transplant Recipient: A Case Report and Concise Review of the Literature

Mucormycosis is an uncommonly encountered fungal infection in solid-organ transplantation, occurring most often gastrointestinally. The most common and fatal infectious disease is cytomegalovirus (CMV) pneumonia, which may result in acute respiratory distress syndrome (ARDS), with rapid onset. Early diagnosis, active treatment, and rational reduction of immunosuppressants are crucial for successful kidney transplantation. We performed successful treatment for both mucormycosis and CMV pneumonia and adjusted the tacrolimus dose accordingly. The case we describe was that of a 47-year-old woman with history of renal transplantation 1 month earlier. She presented with chest pain and gastrointestinal bleeding and was diagnosed with gastric mucormycosis and a secondary episode of hospital-acquired pneumonia. Preemptive therapy, which included liposomal amphotericin B and posaconazole, was adminstered when voriconazole proved to be unhelpful and before histologic reports of gastric mucormycosis. Moreover, CMV re-activation was confirmed by CMV antibody detection, and we administered gancyclovir and thymosin α1 but reduced the strength of the immunosuppressive drugs. Fourteen days after the aforementioned therapy, the patient began to recover and she was discharged on day 81 postoperatively. We conclude that preemptive treatment is critical for severe infection in renal transplant recipients, especially with the rarely seen gastric mucormycosis and with ARDS. In addition, immunoregulated agents, such as asthymosin α1, are also of great value in renal transplant recipients in the setting of opportunistic pathogen infections.

Competitive adsorption phenomenon in shale gas displacement processes

Displacement of methane (CH₄) by injection gas is regarded as an effective way to exploit shale gas and sequestrate carbon dioxide (CO₂) simultaneously. To remarkably enhance the rupture and extension of fractures, an original and comprehensive simplification for the real shale composition model is established to study the shale gas displacement by gas injection. In the present model, besides the consideration in the existence of organic matter in shale, the choice of silica as inorganic minerals is firstly taken into account considering its brittleness characteristic to meet the demand of fracture stretch. Based on the model, the displacement methane process and competitive adsorption behaviors were studied by using the grand canonical Monte Carlo (GCMC) and molecular dynamics (MD) respectively. As the results, the strong interaction between carbon dioxide and shale results in the higher efficiency of displacing methane. We also find that the optimum operating conditions for CO₂ and N₂ displacing methane are at the pore width of 30 Å, the result being slightly different from the previous studies indicating that the displacement efficiency of small pores is higher. Moreover, the displacement efficiency by using different gases can all reach higher than 50% when the injection pressure is greater than 30 MPa. It is expected that this work can reveal the mechanisms of competitive adsorption between shale gas and gases, and provide a guidance for displacement exploitation of shale gas by gas injection and sequestration of carbon dioxide.

Displacement of methane (CH₄) by injection gas is regarded as an effective way to exploit shale gas and sequestrate carbon dioxide (CO₂) simultaneously.

[Related factors and interaction on HIV/HCV co-infection of patients access to methadone maintenance treatment]

Objective: To estimate the prevalence of HIV/HCV co-infection and explore the influence factors and their interaction on HIV/HCV co-infection of patient's access to methadone maintenance treatment (MMT). Methods: A face to face interviews were conducted among 750 patients at two MMT clinics in Guangxi Zhuang Autonomous Region. The questionnaires information included demographic characteristics, HIV and HCV infection status, history of drug abuse, urine test for morphine, high risk sex behaviors, needle sharing, dropped out etc. Methods of χ(2) test one-way, multivariate logistic regression and interactions were used to analyze the related factors of HIV/HCV co-infection. Results: The study subjects included 750 participants, 18.31% (127/691) of patients were co-infected with HIV and HCV. The HIV/HCV co-infection rate in patients who shared needles with others or dropped out of treatment was 35.84% (81/226) and 19.88% (64/322) respectively, which were higher than those who have never shared needles or dropped out (9.89%, 46/465 and 17.07%, 63/369). Logistic regression analysis results showed that after adjusted for confounding factors, patients who shared needles (OR=4.50, 95%CI: 2.72-7.43) and dropped out of treatment (OR=1.71, 95%CI: 1.04-2.80) were more likely to be infected with HIV/HCV. Interaction analysis showed that sharing needles and dropping out of treatment exist additive effect on co-infection of HIV and HCV (RERI=4.21, AP=0.44, SI=1.95). Conclusions: Needle sharing and dropping out of treatment are associated with HIV/HCV co-infection. Health education, psychological counseling and other measures should be taken to reduce needle sharing and dropping out of MMT.

[Multiple factors analysis of early postpartum pelvic floor muscles injury in regenerated parturients]

Objective: To investigate the risk factors for multiparous pelvic floor muscles injury during 6-8 weeks after delivery. Method: From June 2015 to April 2017, 1917 women (1 523 primigravidas and 294 multiparas) were accepted postpartum pelvic floor function screening during 6-8 weeks after delivery in Beijing Hospital.Pelvic examination and pelvic floor muscle strength testing were carried out in these women.All the data were analyzed with multivariate logistic regression method to explore the related factors for postpartum pelvic floor muscle injury. Result: The incidence of muscle strength grades less than third grade was 63.60 % (type Ⅰ muscle fiber) and 24.83 % (type Ⅱ muscle fiber). Multivariate analysis showed that time interval, between two deliveries, less than 3 years (OR=2.16, 95%CI 1.21-3.86), and maternal BMI<18.5 (OR=3.04, 95%CI 1.10-9.30) and BMI≥28 (OR=3.04, 95%CI 1.10-9.30) before pregnancy were risk factors for postpartum injury of type Ⅰ muscle fiber. Gestational age more than 40 weeks increased the risk of damaging type Ⅱ muscle fiber (OR=2.79, 95%CI 1.156-6.76). Compared with cesarean section, vaginal delivery significantly increased the risk of injury of type Ⅰ and Ⅱ pelvic floor muscle fibers (P<0.05). Conclusion: The incidence of multiparous pelvic floor muscle injury was high in early postpartum period.Several factors are related to the pelvic floor muscle injury.Pelvic floor rehabilitation in early postpartum and maternal education may be helpful to reduce the radio of injury.

[Dementia screening and diagnostic framework in Chinese population]

There are no standard diagnostic criteria for Alzheimer's disease (AD) in China. The copied international criteria has led to a high rate of missed diagnosis due to issues such as translation and cultural discrepancy. Under the principles of semantic equivalence, content equivalence and performance equivalence, the research group of Alzheimer's Disease Chinese (ADC) adopted several effective methods, such as two-way translation, content conversion, performance evaluation, etc. to systematically study the cognitive, behavioral, functional, and general assessment techniques in dementia screening and diagnosis, as well as their screening thresholds and diagnostic values. We also established a dementia screening and assessment framework in clinical practice through systematic reviews and group consensus. It has improved the early diagnosis rate of dementia in China, been accepted by home and abroad academic institutions, which is of great significance for early diagnosis and treatment of dementia.

[Active and passive maternal smoking during pregnancy and risk of having a child with polydactyly: a case-control study]

Objective: The number of children with polydactyly is increasing. In addition to genetic factors, an influence of maternal behavior or environmental effects during pregnancy is becoming increasingly apparent. However, epidemiological data on these effects are lacking. Methods: This hospital-based, case-control study enrolled 143 infants with polydactyly and 286 controls without genetic diseases to evaluate the association between active and passive maternal smoking during pregnancy and the likelihood of giving birth to a child with polydactyly. Results: Active and passive maternal smoking during pregnancy was associated with an increased risk of giving birth to a child with polydactyly (active smoking: OR=4.74, 95%CI: 1.43-15.65, P=0.011; passive smoking: OR=2.42, 95%CI: 1.32-4.44, P=0.004). After adjusting for confounders, smoking during pregnancy remained significant influence on polydactyly (active smoking: aOR=7.27, 95%CI: 1.72-30.72, P=0.007; passive smoking: aOR=2.41, 95%CI: 1.11-5.23, P=0.026). Conclusion: Active and passive maternal smoking during pregnancy appears to be a risk factor for polydactyly in newborns.

[Relevant molecular characteristics analysis on malignant transformation of interstitial cells induced by tumor stem cells in glioma microenvironment]

Objective: A variety of interstitial cells in tumor microenvironment (TME) based on glioma stem cells(GSC) have the function to promote malignant progression of tumors, but whether these interstitial cells have already undergone malignant transformation and their related molecular characteristics are still poorly understood. Methods: Human SU3-RFP glioma stem cells (GSC) stably transfected with red fluorescent protein (RFP) and interstitial cells from enhanced green fluorescent protein (EGFP) transgenic nude mice were co-cultured in vitro. SU3-RFP cells were also inoculated in different tissues of EGFP-Balb/c nude mice. Immortal EGFP(+) cells were monocloned either from co-culture cells in vitro, or from their xenografts in vivo. These immortal EGFP(+) cells were confirmed to bear characteristics of tumor cell via chromosomal analysis and tumorigenicity assay. Related molecular phenotypes of these cells were further detected through RT-PCR, flow cytometry and immunochemistry(IHC) techniques. Results: (1) Two EGFP(+) cell lines were obtained in vitro, and 5 EGFP(+) cell lines were obtained in vivo tumorigenic experiments. Seven EGFP(+) cell lines all have characteristics of self-renewal, heteroploid of chromosomes and 100% tumorigenicity. (2) Cell surface marker analysis showed cell origin of these cell lines were macrophages (tMΦ1 and tMΦ2 ), dendritic cells (tDC1 and tDC2), fibroblasts (tFB), oligodendrocytes (tOG) and BMSC cells (tBMSC), respectively. (3)All of these seven cell lines co-expressed Sca-1 and c-myc, and have Sox-2 or Nanog expression also, which suggest that they may bear molecular characteristics of mesenchymal stem cells or pluripotent stem cells. Conclusions: (1) Tumor stromal cells in TME have undergone malignant transformation, which is related to the tissue remodeling of TME by GSCs, and not limit to the specific type of their parasitic tissues. (2) Tumor cells originated from GSC and tumor interstitial cells, respectively, are two major types of tumor cells with different origins in glioma parenchyma, can not be simply regarded as tumor heterogeneity, transformed interstitial cells of TME may have the potential to serve as new targets for target diagnosis and therapy.

Capacity of a body shape index and body roundness index to identify diabetes mellitus in Han Chinese people in Northeast China: a cross-sectional study

AIM

To assess the capacity of a body shape index and body roundness index to identify people with diabetes mellitus and those with prediabetes, and to determine whether a body shape index and/or body roundness index is superior to the traditional overall adiposity index, BMI, in Han Chinese people in Northeast China.

METHODS

A total of 15 078 participants were enrolled from Jilin province in 2012 using a multi-stage stratified random cluster sampling method. Demographic data were collected, and anthropometric indices and biochemical indices were measured. Receiver-operating characteristic curves were used to compare the validity of each anthropometric index, and the area under the receiver-operating characteristic curve was calculated for each anthropometric index.

RESULTS

Body roundness index had the highest areas under the receiver-operating curve for prediabetes, diagnosed diabetes and undiagnosed diabetes in both men and women (all P<0.01). The optimum threshold values for body roundness index for prediabetes, undiagnosed diabetes and diagnosed diabetes, respectively, were 2.8, 3.7 and 3.3 in men, and 3.4, 3.8 and 3.6 in women. The cumulative proportions of prediabetes, undiagnosed diabetes and diagnosed diabetes identified by the optimum threshold values of body roundness index were 79.2%, 67.5% and 77.0% (82.3%, 62.5% and 75.3% in men; 74.6%, 74.9% and 78.3% in women), respectively.

CONCLUSIONS

BMI, a body shape index and body roundness index may identify the presence of diabetes. Among the three anthropometric indices, BMI had the weakest association with diabetes. Body roundness index is an alternative index for assessing diabetes in Han Chinese people in Northeast China.

[Visceral parasitic migration of liver: a clinicopathologic analysis of seven cases]

Objective: To investigate the clinical, radiological and pathological features of visceral parasitic migration of the liver. Methods: Seven cases of visceral parasitic migration of liver were identified at the Affiliated Drum Tower Hospital of Medical School of Nanjing University from January 2008 to July 2017. Clinical data, enhanced CT image and pathological features were analyzed, combining with literature review. Results: There were 5 male and 2 female patients. Five patients presented with abdominal pain or discomfort as the first symptom. Two patients were admitted to the hospital for physical examination with liver nodule. Blood eosinophils were mildly to moderately increased in 4 cases. Enhanced CT showed the liver irregular beaded nodules that showed no significant enhancement of arterial phase. Mild enhancement of round lesions (ring lesion) was seen in a few cases before surgery. By histopathology, the lesions showed central geographic necrosis, surrounded by epithelioid granuloma and inflammatory cell bands. A large number of eosinophils and scattered multinucleated giant cells were found, especially at the peripheral of the lesion. Charcot-Leyden crystals were present in all case and parasitic migrans was found in one case. Conclusions: Visceral parasitic migration of liver is a rare liver disease and is easily misdiagnosed as other benign or malignant liver tumors. Combining clinical data, enhanced CT images and pathological examination can improve the preoperative and postoperative diagnosis of the disease.

Clofazimine improves clinical outcomes in multidrug-resistant tuberculosis: a randomized controlled trial

OBJECTIVES

We carried out a randomized multicentre study in China to investigate whether the clofazimine would improve the efficacy of the standardized regimen in patients with multidrug-resistant tuberculosis (MDR-TB).

METHODS

Patients with MDR-TB managed in 17 TB specialist hospitals in China between September 2009 and September 2011 were randomly assigned to the treatment groups at enrolment. In the intervention group, 100 mg clofazimine per day was added to the standardized regimen. The primary outcome was the proportion of patients with successful outcomes.

RESULTS

From the 156 patients that were screened, 74 were assigned to the control group and 66 to the clofazimine group. Of the 66 cases analysed for clinical outcome in the clofazimine group, 36 patients were cured, and seven completed treatment, yielding a favourable outcome rate of 65.1%. The proportion of patients with favourable outcomes receiving the control regimen was 47.3% (35/74), which was significantly lower than that in the clofazimine group (p 0.034, relative risk 0.661, 95% CI 0.243-0.949).

CONCLUSIONS

The addition of clofazimine to the standard regimen improved the treatment of MDR-TB.

Cell-free therapy based on adipose tissue stem cell-derived exosomes promotes wound healing via the PI3K/Akt signaling pathway

INTRODUCTION

Adipose tissue-derived stem cells (ADSCs) have been shown to enhance wound healing via their paracrine function. Exosomes, as one of the most important paracrine factors, play an essential role in this process. However, the concrete mechanisms that underlie this effect are poorly understood. In this study, we aim to explore the potential roles and molecular mechanisms of exosomes derived from ADSCs in cutaneous wound healing.

METHODS

Normal human skin fibroblasts and ADSCs were isolated from patient skin and adipose tissues. ADSCs were characterized by using flow cytometric analysis and adipogenic and osteogenic differentiation assays. Exosomes were purified from human ADSCs by differential ultracentrifugation and identified by electron microscopy, nanoparticle tracking, fluorescence confocal microscopy and western blotting. Fibroblasts were treated with different concentrations of exosomes, and the synthesis of collagen was analyzed by western blotting; the levels of growth factors were analyzed by real-time quantitative PCR (RT-PCR) and ELISA; and the proliferation and migration abilities of fibroblasts were analyzed by real-time cell analysis, CCK-8 assays and scratch assays. A mouse model with a full-thickness incision wound was used to evaluate the effect of ADSC-derived exosomes on wound healing. The level of p-Akt/Akt was analyzed by western blotting. Ly294002, a phosphatidylinositol 3-kinases (PI3K) inhibitor, was used to identify the underlying mechanisms by which ADSC-derived exosomes promote wound healing.

RESULTS

ADSC-derived exosomes were taken up by the fibroblasts, which showed significant, dose-dependent increases in cell proliferation and migration compared to the behavior of cells without exosome treatment. More importantly, both the mRNA and protein levels of type I collagen (Col 1), type III collagen (Col 3), MMP1, bFGF, and TGF-β1 were increased in fibroblasts after stimulation with exosomes. Furthermore, exosomes significantly accelerated wound healing in vivo and increased the level of p-Akt/Akt in vitro. However, Ly294002 alleviated these exosome-induced changes, suggesting that exosomes from ADSCs could promote and optimize collagen deposition in vitro and in vivo and further promote wound healing via the PI3K/Akt signaling pathway.

CONCLUSIONS

This study demonstrates that ADSC-derived exosomes can promote fibroblast proliferation and migration and optimize collagen deposition via the PI3K/Akt signaling pathway to further accelerate wound healing. Our results suggest that ADSCs likely facilitate wound healing via the release of exosomes, and the PI3K/Akt pathway may play a role in this process. Our data also suggest that the clinical application of ADSC-derived exosomes may shed new light on the use of cell-free therapy to accelerate full-thickness skin wound healing and attenuate scar formation.

Is inflammatory micronucleation the key to a successful anti-mitotic cancer drug?

Paclitaxel is a successful anti-cancer drug that kills cancer cells in two-dimensional culture through perturbation of mitosis, but whether it causes tumour regression by anti-mitotic actions is controversial. Drug candidates that specifically target mitosis, including inhibitors of kinesin-5, AurkA, AurkB and Plk1, disappointed in the clinic. Current explanations for this discrepancy include pharmacokinetic differences and hypothetical interphase actions of paclitaxel. Here, we discuss post-mitotic micronucleation as a special activity of taxanes that might explain their higher activity in solid tumours. We review data showing that cells which exit mitosis in paclitaxel are highly micronucleated and suffer post-mitotic DNA damage, and that these effects are much stronger for paclitaxel than kinesin-5 inhibitors. We propose that post-mitotic micronucleation promotes inflammatory signalling via cGAS–STING and other pathways. In tumours, this signalling may recruit cytotoxic leucocytes, damage blood vessels and prime T-cell responses, leading to whole-tumour regression. We discuss experiments that are needed to test the micronucleation hypothesis, and its implications for novel anti-mitotic targets and enhancement of taxane-based therapies.

[Similar coronal curvature may not represent the same 3-dimensional deformity in adolescent idiopathic scoliosis: a matched-pair study using EOS imaging system]

Objective: To analyze the preoperative axial plane and the surgical outcomes of the Lenke type 1A patients with adolescent idiopathic scoliosis (AIS) whose coronal curve type was matched but thoracic kyphosis (TK) was different. Methods: This study retrospectively reviewed a series of Lenke type 1A female AIS patients who underwent corrective surgery in the Department of Spine Surgery of Nanjing Drum Tower Hospital from May to August 2017. After matched with the Cobb angle of the main thoracic curve, the apical vertebral, the vertebra number included in the curve, the lumber modifier in the Lenke classification and Risser sign, 12 pairs of AIS patients, whose coronal curve was matched but thoracic kyphosis was different, were included in this study. The patients were divided into normal TK group and thoracic hypokyphosis group. EOS whole-body images were taken preoperatively and reconstructed by three-dimensional reconstruction. The whole spine anteroposterior X-ray was taken at 3 weeks after surgery. The radiographic parameters were measured on the preoperative and postoperative two-dimensional X-ray images: coronal Cobb angle, TK, lumbar lordosis (LL), pelvic incidence (PI) and pelvic tilt (PT). The vertebra rotation was obtained on the EOS three-dimensional reconstructed image, and the average vertebral rotation of the major thoracic curve (MTR), the average vertebral rotation of the proximal thoracic curve (PTR) and the average vertebral rotation of the lumbar curve (LR) were calculated. The paired sample t test was used to compare the difference of preoperative and postoperative radiographic parameters between the groups. Results: A total of 24 patients (12 pairs) were included in this study with an average age of (13.7±2.9) years. The preoperative Cobb angle was similar in the two groups (53.8°±10.2° vs 51.0°±11.1°, t=0.27, P=0.81). The average preoperative TK of the normal TK groups was 28.2°±6.1°, while that of the thoracic hypokyphosis group was 11.2°±5.6°(t=7.68, P<0.01). The MTR in the normal TK group was significantly smaller than that in the thoracic hypokyphosis group (10.2° vs 12.7°, t=-3.74, P<0.01), and there was a significant correlation between TK and MTR (r=0.30, P=0.03). As for the lumbar curve rotation, the LR of the normal TK group was significantly smaller than that in the thoracic hypokyphosis group (t=-2.65, P=0.002), but the absolute value of the two groups was similar (t=-0.33, P=0.31). The lumbar Cobb angle correction rate was significantly greater in patients with thoracic and lumbar curve rotating in the same direction than that in the opposite direction (81.1% vs 61.9%, t=4.24, P=0.005). Conclusions: It indicated that when the coronal deformity is matched, the MTR of the patients with thoracic hypokyphosis is significantly larger than that in the patients with normal thoracic kyphosis. The direction of the thoracic and lumbar curve rotation is required to be well concerned in the preoperative surgical planning.

[Characteristics of non-marital and non-commercial heterosexual transmission of HIV infection in Miao-Dong Autonomous prefecture of Qiandongnan]

Objective: The goal of this research was to understand the demographic distribution and related factors of non-marital and non-commercial heterosexual transmission (non-commercial transmission) for HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome). Methods: Data related to HIV/AIDS infected by non-marital heterosexual transmission and whose present address was in Qian Dongnan, were collected from Information System on the HIV/AIDS Prevention and Control. Information included demographic characteristics, the members of non-marital sex partners, transmission path, detection source, CD4(+)T lymphocyte level, et al. cases belong to homosexual history, injective drug use or non-classified non-marital heterosexuality transmission were excluded, totally collect HIV/AIDS 919 cases. Multivariate logistic regressions were used to analyze potential factors associated with non-marital and non-commercial heterosexual transmission. In addition, in March and June 2017, using a convenience sampling, we conducted one-to-one interviews among 10 HIV/AIDS who were infected by non-marital heterosexuality and had non-marital and non-commercial heterosexual experience in Kaili Center for Disease Control and Prevention. The content of the interview included basic information, sexual orientation, the main place of making friends and sexual behavior, attitude to commercial heterosexuality and non-martial and non-commercial heterosexuality and so on. Results: Out of the 919 cases, 645 (70.2%) were male, the proportion of non-commercial transmission was 55.06% (506). The proportion of female HIV/AIDS with non-commercial transmission was 84.7% (232), which was higher than male (42.5%(274)) (χ(2)=138.35, P<0.001). The proportion of Han HIV/AIDS with non-commercial transmission was 61.5% (275), which was higher than other religion (52.2%(412)) (χ(2)=6.32, P=0.012). The proportion of HIV/AIDS with non-commercial transmission who had 0-5 non-marital sexual partners was 58.8% (498), which was higher than who had>5 non-marital sexual partners (11.1%(8)) (χ(2)=61.10, P<0.001). The proportion of HIV/AIDS with non-commercial transmission who lived mobile was 72.9% (94), which was higher than who lived fixedly (52.2%(412)) (χ(2)=19.34, P<0.001). Qualitative interviews results revealed that the age of the respondents were 22-69. Respondents whose ages are in 22-34 were more likely to use mobile phone (4/10) and respondents whose ages are in 35-69 were less likely to look partners through party and the context of working. Conclusion: The proportion of cases being infected by non-marital and non-commercial heterosexual transmission in Qian dongnan was higher than general national levels. The characteristics of sex, marriage status, migration, vocation, the members of non-marital sex partners were significant differed between commercial heterosexual transmission and non-marital and non-commercial heterosexual transmission.