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Background Cervical cancer, a prevalent malignancy in women, has a well-established etiology and can be effectively prevented through standardized screening. The WHO recommends HPV testing as the primary method for cervical cancer screening. Understanding the status of high-risk human papillomavirus (hrHPV) infection in Chengdu is crucial for optimizing primary hrHPV screening. Objective To investigate the hrHPV infection status among cervical cancer screening participants aged 35-64 years in Chengdu, and explore the related factors affecting the positive detection rate of hrHPV. Methods We retrospectively analyzed data from 459 433 women who received free cervical cancer screening in Chengdu in 2023, sourced from the "Chengdu Reproductive Health Database of Women of Childbearing Age". We analyzed the overall distribution of different hrHPV genotypes and the distribution of hrHPV subtypes in patients with cervical lesions, and compared the hrHPV infection in different populations. Multivariate Logistic regression models identified factors affecting the positive detection rate of hrHPV. Results The hrHPV prevalence among participants was 11.65% (53 509/459 433), with an increase observed with age (χ2=1 501.082, P

Recently, some travertine landscape groups in Huanglong Scenic Spot have been degraded to varying degrees. Surface water leakage, blackening and desertification have occurred on a large scale in the dense distribution area of Salix cupularis shrub, which has adversely affected the core value of the Huanglong World Natural Heritage Site. The relationship between shrub expansion and leakage enhancement has not been fully understood. In this study, travertine pool group of typical shrub area was selected in the north of Yingyue Pool in the upper reaches of Huanglong, and 4 shrub cover levels were set: no shrub (coverage 60%). In-situ infiltration test was conducted to determine the leakage intensity and to evaluate the changes of travertine pore structure and permeability parameters in shrub area. With the comparison of the leakage intensities in different shrub cover level areas, the mechanism of surface water leakage of travertine under the influence of Salix cupularis scrub is summarized. The results show that (1) the leakage intensity increases with the increase of coverage. When the coverage of Salix cupularis shrub exceeds 60%, the leakage intensity changes significantly, which should be related to the rapid diversion of large pores. (2) Under the influence of algae activities and decomposition of plant residues, new travertine with more pores and holes is formed in the scrub area, resulting in higher natural leakage intensity than that in the non-scrub area. (3) The root activities of Salix cupularis shrub changes the primary travertine structure, leading to loose primary travertine and increases of pore diameter, effective porosity, and permeability coefficient. The enhanced groundwater seepage resulted in enhanced overall surface water leakage in the travertine pool. (4) The transformation of travertine pore structure by Salix cupularis roots is depended on the root cleavage. The dissolution of travertine cement by root solution leads travertine to uniform loose accumulation. The results show that the root and algal activities in Salix cupularis scrub area mainly control the process of surface water leakage enhancement. This study have basic value for the evolution analysis and conservation of Huanglong travertine natural heritage landscape.

The Junggar Basin is known for its high potential of petroleum resources, showcasing significant oil and gas discoveries across various layers. However, the potential of utilizing the thick mudstone of the Upper Triassic as a viable source rock in the basin remains uncertain. Therefore, an urgent need exists to assess the Upper Triassic source rock across the basin and predict the distribution of effective source rocks. This evaluation is crucial for informing future exploration strategies in this layer. To shed light on the spatiotemporal distribution characteristics and hydrocarbon generation potential of the Upper Triassic source rocks in the Junggar Basin, as well as to determine the hydrocarbon generation intensity within the effective hydrocarbon kitchen's distribution range, a comprehensive evaluation was conducted. This evaluation involved assessing organic matter abundance, type, and maturity of the Upper Triassic source rock across the basin using various geochemical parameters derived from data collection, profile measurement, drill cuttings observation and sampling, and organic geochemistry testing. Key parameters were then selected, and a multi-level fuzzy mathematical evaluation method was employed to map out the development range of the effective hydrocarbon kitchen. The findings indicate that the Upper Triassic source rock exhibits a broad distribution range spanning the entire basin, with considerable thickness (reaching up to 350 m) and significant burial depth in the central region (up to 11 000 m). The total organic carbon (TOC) content of source rocks varies from 0.75% to 8.30%, with an average value of 1.74%. Additionally, the average values of S1+S2 and chloroform asphalt "A" are 2.78 mg/g and 0.354%, respectively. The predominant organic matter types in the area are type Ⅲ and type Ⅱ2, indicating a dominance of terrestrial higher plant inputs. The favorable kerogen types are primarily located from the western sag to the Fukang Sag. The thermal evolution of the organic matter ranges from low-maturity to mature stages, with some areas reaching high to over-maturity levels. As per the evaluation criteria for hydrocarbon generation potential of coal-bearing mudstone in China, the Upper Triassic mudstone generally represents poor to medium-quality source rocks with significant hydrocarbon generation potential, particularly for gas. The key hydrocarbon source kitchens are situated from the western part of the Fukang Sag to the eastern part of the Shawan Sag in the central depression, and in the Huomatu Anticline of the southern margin thrust belt. Within these areas, the Ro value of the source rock exceeds 1.3%, with oil and gas generation intensities reaching 50×104 t/km2 and 3×108 m3/km2, respectively.

In order to achieve high quality image transmission, a novel hybrid digital-analog (HDA) wireless transmission method was proposed.Firstly, the image residual layer was constructed by subtracting the downsampled and upsampled images from the original image respectively.Secondly, an adaptive-clustered block-level discrete cosine transform (DCT) algorithm was proposed to efficiently remove the correlation between image pixels in the residual layer.Finally, an image block level-based unequal power allocation strategy for further boosting the quality of received images was proposed.Extensive experiments results demonstrate that the proposed method is significantly superior to existing successful hybrid digital analog image wireless transmission methods in both qualitative evaluation and quantitative measurement.

Background Time in range (TIR) is a new indicator of glycemic management in diabetes mellitus which has been thriving in recent years. Studies have confirmed that TIR is closely associated with chronic complications of diabetes. Previous studies have confirmed a close association between TIR and chronic complications of diabetes. Current studies on TIR and diabetic kidney disease (DKD) mainly focus on proteinuria, however the role of glomerular filtration rate (eGFR) in it is often neglected, and there are few studies on the cut points of TIR in evaluating glycemic control. Objective To investigate the relationship between TIR and the development of DKD in type 2 diabetes mellitus (T2DM), so as to provide theoretical foundations for the timely clinical detection, diagnosis and treatment of DKD in patients with T2DM. Methods A total of 214 T2DM patients admitted to the Department of Endocrinology in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from July 2021 to December 2021 were included. The general data, laboratory indices and medication use were collected. The included patients were divided into group of DKD〔UACR ≥ 30 mg/g and/or eGFR < 60 ml·min-1 (1.73 m2) -1, n=58〕 and group of T2DM alone〔UACR85%, n=90), TIR2 group (70%

【Objective】 The time series of rainfall is a nonlinear, non-stationary process and can be analyzed statistically. The purpose of this paper is to analyze the chaotic characteristics of rainfalls in attempts to develop a chaotic model to predict monthly precipitation. 【Method】 We took monthly precipitation measured from the weather station at Bomi between Linzhi and Bomi on the G318 highway as an example, the C-C correlation integral method was used to determine the delay time τ and the embedding dimension m in it. The time series was then reconstructed in phase space whose Lyapunov exponent was obtained for a small sub-dataset to determine the chaotic characteristics, from which we constructed a Volterra model to predict monthly rainfall in both short-term (5 years) and long-term (15 years) respectively. The predicted monthly rainfalls using the proposed model were compared with those predicted by the wavelet model and the SVR prediction model. 【Result】 The MAPE and EC of the rainfalls predicted using the proposed Volterra model for short-term was 4.04% and 0.941 respectively. Compared with the wavelet and SVR model, the proposed Volterra model was more accurate, and its superposition prediction error was smaller, with its associated MAPE and EC being 7.657% and 0.894 respectively. However, the rainfalls predicted by the proposed for long-term were not as good as those by the SVR model. When the time series of the rainfall was less chaotic, the prediction of Volterra model for short-term rainfall was less reliable, with its associated MAPE and EC being 54.855% and 0.566, respectively. 【Conclusion】 The chaotic model was more accurate than the traditional model for predicting monthly rainfall only for short-term and when the time series of the rainfalls is chaotic. Therefore, it should be used with care.

An ad hoc mobile cloud had been proposed to offload workload to neighboring mobile devices for resource sharing.The issues that whether to offload or not was addressed,how to select the suitable mobile device to offload,and how to assign workload.Game theoretic approach was used to formulate this problem,and then,a distributed scheme was designed to achieve the optimal solution.The experimental results validate the rightness and effectiveness of proposed scheme.

Objective: To investigate the short-term effectiveness of unilateral biportal endoscopy (UBE) in treatment of lumbar lateral saphenous fossa combined with intervertebral foramina stenosis via contralateral sublaminar approach., Methods: A clinical data of 15 patients with lumbar lateral saphenous fossa combined with intervertebral foramina stenosis, who were admitted between September 2021 and December 2023 and met selective criteria, was retrospectively analyzed. There were 5 males and 10 females with an average age of 70.3 years (range, 46-83 years). Surgical segment was L 4, 5 in 12 cases and L 5 , S 1 in 3 cases. The disease duration was 12-30 months (mean, 18.7 months). All patients were treated by UBE via contralateral sublaminar approach. The operation time, intraoperative blood loss, postoperative hospital stay, and the occurrence of complications were recorded. The visual analogue scale (VAS) score was used to evaluate the degree of lower back and leg pain before and after operation; the Japanese Orthopaedic Association (JOA) score and the Oswestry disability index (ODI) were used to evaluate the lumbar function; and the clinical outcome was evaluated using the MacNab criteria at 6 months after operation. Postoperative MRI and CT were taken to observe whether the lateral saphenous fossa and intervertebral foramen stenosis were removed or not, and the cross-sectional area of the spinal canal (CSA-SC), cross-sectional area of the intervertebral foramen (CSA-IVF), and cross-sectional area of the facet joint (CSA-FJ) were measured., Results: The operation time was 55-200 minutes (mean, 127.5 minutes); the intraoperative blood loss was 10-50 mL (mean, 27.3 mL); the length of postoperative hospital stay was 3-12 days (mean, 6.8 days). All patients were followed up 6-12 months (mean, 8.9 months). At 1 day, 1 month, 3 months, and 6 months after operation, the VAS scores of low back and leg pain and ODI scores after operation were significantly lower than preoperative scores and showed a gradual decrease with time; the JOA scores showed a gradual increase with time; the differences in the above indexes between different time points were significant ( P <0.05). The clinical outcome was rated as excellent in 10 cases, good in 4 cases, and poor in 1 case according to the MacNab criteria at 6 months after operation, with an excellent and good rate of 93.33%. Imaging review showed that the compression on the lateral saphenous fossa and intervertebral foramina had been significantly relieved, and the affected articular process joint was preserved to the maximum extent; the CSA-SC and CSA-IVF at 3 days after operation significantly increased compared to the preoperative values ( P <0.05), and the CSA-FJ significantly reduced ( P <0.05)., Conclusion: The UBE via contralateral sublaminar approach can effectively reduce pressure in the lateral saphenous fossa and the intervertebral foramina of the same segment while preserving the bilateral articular process joints. The short-term effectiveness is good and it is expected to avoid fusion surgery caused by iatrogenic instability of the lumbar spine. However, further follow-up is needed to clarify the mid- and long-term effectiveness.

Objective: To compare the effectiveness of unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) and endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) in the treatment of single-segment degenerative lumbar spinal stenosis with lumbar spondylolisthesis., Methods: Between November 2019 and May 2023, a total of 81 patients with single-segment degenerative lumbar spinal stenosis with lumbar spondylolisthesis who met the selection criteria were enrolled. They were randomly divided into UBE-TLIF group (39 cases) and Endo-TLIF group (42 cases). There was no significant difference in baseline data between the two groups ( P >0.05), including gender, age, body mass index, surgical segment, and preoperative visual analogue scale (VAS) scores for low back and leg pain, Oswestry Disability Index (ODI), and serum markers including creatine kinase (CK) and C reactive protein (CRP). Total blood loss (TBL), intraoperative blood loss, hidden blood loss (HBL), postoperative drainage volume, and operation time were recorded and compared between the two groups. Serum markers (CK, CRP) levels were compared between the two groups at 1 day before operation and 1, 3, and 5 days after operation. Furthermore, the VAS scores for low back and leg pain, and ODI at 1 day before operation and 1 day, 3 months, 6 months, and 12 months after operation, and intervertebral fusion rate at 12 months after operation were compared between the two groups., Results: All surgeries were completed successfully without occurrence of incision infection, vascular or nerve injury, epidural hematoma, dural tear, or postoperative paraplegia. The operation time in UBE-TLIF group was significantly shorter than that in Endo-TLIF group, but the intraoperative blood loss, TBL, and HBL in UBE-TLIF group were significantly more than those in Endo-TLIF group ( P <0.05). There was no significant difference in postoperative drainage volume between the two groups ( P >0.05). The levels of CK at 1 day and 3 days after operation and CRP at 1, 3, and 5 days after operation in UBE-TLIF group were slightly higher than those in the Endo-TLIF group ( P <0.05), while there was no significant difference in the levels of CK and CPR between the two groups at other time points ( P >0.05). All patients were followed up 12 months. VAS score of low back and leg pain and ODI at each time point after operation significantly improved when compared with those before operation in the two groups ( P <0.05); there was no significant difference in VAS score of low back and leg pain and ODI between the two groups at each time point after operation ( P >0.05). There was no significant difference in the intervertebral fusion rate between the two groups at 12 months after operation ( P> 0.05)., Conclusion: UBE-TLIF and Endo-TLIF are both effective methods for treating degenerative lumbar spinal stenosis with lumbar spondylolisthesis. However, compared to Endo-TLIF, UBE-TLIF requires further improvement in minimally invasive techniques to reduce tissue trauma and blood loss.

Objective: To review the application and progress of different minimally invasive spinal decompression in the treatment of lumbar spinal stenosis (LSS)., Methods: The domestic and foreign literature on the application of different minimally invasive spinal decompression in the treatment of LSS was extensively reviewed, and the advantages, disadvantages, and complications of different surgical methods were summarized., Results: At present, minimally invasive spinal decompression mainly includes microscopic bilateral decompression, microendoscopic decompression, percutaneous endoscopic lumbar decompression, unilateral biportal endoscopy, and so on. Compared with traditional open surgery, different minimally invasive spinal decompression techniques can reduce the operation time, intraoperative blood loss, and postoperative pain of patients, thereby reducing hospital stay and saving treatment costs., Conclusion: The indications of different minimally invasive spinal decompression are different, but there are certain advantages and disadvantages. When patients have clear surgical indications, individualized treatment plans should be formulated according to the symptoms and signs of patients, combined with imaging manifestations.

This study aims to establish an ultra-high performance liquid chromatography-tandem mass spectrometry(UHPLC-MS/MS) method for determining the concentrations of triptolide(TP) in plasma and liver, and to explore the toxicokinetics of TP and the relationship between TP exposure and liver injury in C57 BL/6 mice, so as to provide reference for dissecting the toxicity mechanism of TP. The liquid chromatography was conducted with ZORBAX SB-C&#95;(18) column(3.0 mm×100 mm, 3.5 μm) and the mobile phase of methanol-0.05 mmol·L~(-1) ammonium acetate. Electrospray ionization(ESI) and multiple reaction monitoring(MRM) mode were employed for mass spectrometry. After oral administration of TP(toxic dose 600 μg·kg~(-1)), the blood and liver tissues of the C57 BL/6 mice were collected at different time points to measure the TP concentrations in plasma and liver tissues. Furthermore, the blood biochemical indexes, including alkaline phosphatase(ALP), alanine aminotransferase(ALT), aspartate aminotransferase(AST), and total bile acid(TBA), were determined. After being processed by DAS 2.0, the experiment data showed that the TP in mice had the toxicokinetic parameters of T&#95;(max)=5 min, C&#95;(max)=14.38 ng·mL~(-1), t&#95;(1/2)=0.76 h, AUC&#95;(0-t)=5.63 h·ng·mL~(-1), MRT&#95;(0-t)=0.56 h, and CL&#95;(Z/F)=103.19 L·h~(-1)·kg~(-1). The trend of TP concentration in mouse liver tissue was consistent with that in plasma. The concentration of TP peaked at the time point of 5 min and then decreased until TP was completely metabolized. The plasma biochemical indexes(ALT, AST, ALP, and TBA) showed no significant changes within 3 h after TP administration. TP had high clearance rate and short residence time and did not significantly increase the blood biochemical indexes in mice. The results suggested that the exposure amount of free TP in vivo cannot directly cause liver injury, which might be caused by the binding of TP to some substances or the stimulation of inflammation and immune response.

Objective: To investigate the rationality of nerve-plane sparing radical hysterectomy (NPSRH) for cervical cancer by observing the anatomical and histological characteristics of pelvic autonomic plane based on fresh cadaver. Methods: From October 2015 to September 2020, 14 fresh female cadavers were anatomically and histologically studied in the Laboratory of Anatomy and Embryology Department, Peking Union Medical College, Chinese Academy of Medical Sciences. The median age of the specimens was 79 years (range: 67 to 92 years). Twenty-eight hemi-pelvic specimens were obtained from 14 fresh female cadavers. NPSRH procedures were simulated in 8 hemi-pelvic cavities to prove its feasibility. Detailed dissection was conducted to recognize nerve plane and to observe the distribution of pelvic nerves in 10 hemipelvis. In the other 10 hemipelvis, whole parametrium tissue was taken from the crossing of ureter and the uterine artery to the ureterovesical entrance and be embedded, then continuous section was performed, and was stained by hematoxylin-eosin staining (HE) to observe the relationship of nerves and vessels. Immunohistochemical staining of S100, tyrosine dehydrogenase (TH), and vasoactive intestinal peptide (VIP) were performed to count and distinguish sympathetic and parasympathetic nerves, respectively. Results: (1) The pelvic autonomic nerve-plane was completely preserved in 7 of 8 hemipelvis by simulating NPSRH. (2) After detailed dissection in 10 hemipelvis, it was found that hypogastric nerve, pelvic splanchnic nerve, and their confluence of inferior hypogastric plexus were distributed in a planar statelocating in the ureteral mesentery and its caudal extension. This nerve plane showed a cross relationship with deep uterine vein and its branches. The bladder branches and vesical venous plexus were closely related to the inferior hypogastric plexus. The middle vesical vein and inferior vesical vein were intact in 7 of 10 hemipelvis, and either vesical vein was missing in 3 of them. It was observed that the vesical venous plexus communicated with the deep uterine vein trunk on the medial side of the nerve plane in 6 hemipelvis, while flowed into the deep uterine vein on the lateral side of the nerve plane in 2 hemipelvis, and in the other 2 hemipelvis it directly flowed into the internal iliac vein. (3) It was revealed that autonomic nerves were continuously distributed beneath the ureteral with sagittal plane by HE staining. The average nerve content below the ureteral width was 70.9% of the total in nerve plane by S100 staining. TH and VIP staining showed that the average number of sympathetic fibers was 13.5 and parasympathetic fibers was 8.2, reminding sympathetic predominated. Conclusion: Pelvic autonomic nerves are mainly distributed within the mesangial plane below the ureter, which provides an anatomic justification for NPSRH.

Objective: To evaluate the security and clinical outcomes of open nerve-plane sparing radical hysterectomy (NPSRH) for operable locally advanced cervical cancer, compared with conventional radical hysterectomy (CRH). Methods: All 389 cases with International Federation of Gynecology and Obstetrics (FIGO, 2009) stage Ⅰb2 and Ⅱa2 cervical cancer were retrospectively analyzed in Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences between January 2008 and December 2014. Of all the patients, 69 cases underwent laparotomic NPSRH, and other 320 cases underwent CRH. Patients' general characteristics and intraoperative parameters were evaluated between the two groups. Basic clinical and pathological informations between the two groups were matched. After median 82 months' follow-up,disease-free survival (DFS), overall survival (OS), and postoperative recovery of bladder function were compared between the two groups. Results: (1) Compared to CRH group, NPSRH group had less intraoperative bleeding [(366±302) vs (457±301) ml; t =2.305, P =0.022], and a little bit longer operation time [(262±51) vs (245±52) minutes; t =2.621, P =0.009]. (2) Compared to CRH group, NPSRH group had shorter duration of urethral catheterization [(11±9) vs (16±7) days; t =3.906, P <0.01], and better postoperative bladder sensation and function in one year (6.1% vs 16.0%; χ 2 =4.418, P =0.036). (3) The 5-year DFS rate and 5-year OS rate of all patients were 89.6% and 89.9%, respectively. Either preserving pelvic autonomic nerves or not had little effect on the 5-year DFS rate (NPSRH vs CRH: 90.9% vs 89.4%; P =0.714) or on 5-year OS rate (NPSRH vs CRH: 90.0% vs 89.9%; P =0.910) for locally advanced cervical cancer. Univariate analysis showed that lymphatic vascular space infiltration (LVSI) and pelvic lymphatic metastasis were significantly correlated with prognosis ( P <0.05). Multivariate analysis showed that pelvic lymphatic metastasis was the independent prognostic factor of 5-year DFS rate ( HR =1.31, 95% CI : 1.01-1.68, P =0.040) as well as 5-year OS rate ( HR =1.30, 95% CI : 1.01-1.67, P =0.046) for locally advanced cervical cancer. Conclusion: Open NPSRH is feasible for patients with locally advanced cervical cancer, which could improve both short-term and long-term bladder function, and is not a risk factor for the prognosis of patients.

Comparison of total organic carbon(TOC), total nitrogen(TN), total phosphorus(TP), soil microbial biomass carbon(MBC), nitrogen(MBN), phosphorus(MBP) and their stoichiometric ratios measuring from understory planting of Paris polyphylla and Panax japonicus rhizosphere soil with the data of the original forest soil will help us to understand the influence of different planting patterns between soil traits and soil microbial interaction and nutrient cycle characteristics. The results showed that the contents of TOC, TN and MBN were the highest in the rhizosphere soil of P. japonicus, while the highest values of TP, MBC and MBP were found in the rhizosphere soil of P. polyphylla. The changes of TOC∶TN, TOC∶TP, TN∶TP, MBC∶MBN, MBC∶MBP and MBN∶MBP of P. polyphylla and P. japonicus rhizosphere soil compared with the data of the original forest soil were 3.65 and 37.32%,-14.89 and 82.23%,-17.87 and 32.76%, 25.67 and-50.60%,-75.95 and-16.33% as well as-80.79 and 69.76%, respectively. TN and TP were significantly correlated with MBN and MBP respectively. Although, monoculture of P. polyphylla and P. japonicus changed soil nutrient level, it did not reach the state of nutrient deficiency. The demands for nitrogen and phosphorus between P. polyphylla and P. japonicus were quite different. According to their different habits, monoculture of P. polyphylla and P. japonicus could change the understory soil traits, resulting in allometric changes in part of soil nutrient stoichiometry and soil microbial stoichiometry, and then the disappearance of internal stability. The variations in the understory soil caused by P. polyphylla and P. japonicus is developing in completely different directions, whether this phenomenon indicates that the two species have less niche overlap needs further study.

Tripterygium wilfordii multiglycoside( GTW),an extract derived from T. wilfordii,has been used for rheumatoid arthritis and other immune diseases in China. However its potential hepatotoxicity has not been investigated completely. Firstly,the content of triptolid( TP) in GTW was 0. 008% confirmed by a LC method. Then after oral administration of GTW( 100,150 mg·kg-1) and TP( 12 μg·kg-1) in female Wistar rats for 24 h,it was found that 150 mg·kg-1 GTW showed more serious acute liver injury than 12 μg·kg-1 TP,with the significantly increased lever of serum ALT,AST,TBA,TBi L,TG and bile duct hyperplasia even hepatocyte apoptosis. The expression of mRNA and proteins of liver bile acid transporters such as BSEP,MRP2,NTCP and OATP were down-regulated significantly by GTW to inhibit bile acid excretion and absorption,resulting in cholestatic liver injury. Moreover,GTW was considered to be involved in hepatic oxidative stress injury,although it down-regulated SOD1 and GPX-1 mRNA expression without significant difference in MDA and GSH levels. In vitro,we found that TP was the main toxic component in GTW,which could inhibit cell viability up to 80% in Hep G2 and LO2 cells at the dose of 0. 1 μmol·L-1. Next a LC-MS/MS method was used to detect the concentration of triptolid in plasma from rats,interestingly,we found that the content of TP in GTW was always higher than in the same amount of TP,suggesting the other components in GTW may affect the TP metabolism. Finally,we screened the substrate of p-glycoprotein( p-gp) in Caco-2 cells treated with components except TP extrated from GTW,finding that wilforgine,wilforine and wilfordine was the substrate of p-gp. Thus,we speculated that wilforgine,wilforine and wilfordine may competitively inhibit the excretion of TP to bile through p-gp,leading to the enhanced hepatotoxity caused by GTW than the same amount of TP.

Objective: To compare the clinical effects and the subjective perception of surgeons with three-dimensional (3D) and two-dimensional (2D) laparoscopic C1 radical hysterectomy surgeries for cervical cancer. Methods: The retrospective cohort study was conducted. The clinicopathological data of 101 patients with cervical cancer who received C1 laparoscopic radical hysterectomy (C1-LRH) surgery from June 2015 to August 2017 were collected. Of all patients, 42 cases undergoing 3D laparoscopic surgery and 59 cases undergoing 2D laparoscopic surgery were respectively allocated into the C1-3DLRH group or C1-2DLRH group. The clinical effect and the subjective perception of surgeons were compared between the two groups. Results: (1) There was no significant difference between the C1-3DLRH group and C1-2DLRH group in terms of age, body mass index (BMI), International Federation of Gynecology and Obstetrics (FIGO) stage, pathologic type, etc. (all P> 0.05). Compared with C1-2DLRH group, the operation time was significantly shortened [(192±54) vs (221±54) minutes, P< 0.01], blood loss was significantly less [(102±88) vs (167±117) ml, P< 0.01], and the success rate of inferior hypogastric plexus (IHP) bladder branch preservation was significantly increased [86% (36/42) vs 66% (39/59), P< 0.05] in C1-3DLRH group. There were no significant difference in the number of lymph nodes, the incidence of operative complications, the infection rate, the time of catheterization and the length of hospitalization between the two groups (all P> 0.05). The long-term bladder function was evaluated at the twelfth month after operation, 39 patients in the C1-3DLRH group and 53 patients in the C1-2DLRH group were completed the survey. The results showed that 13% (5/39) of the patients in the C1-3DLRH group had long-term bladder dysfunction, which was lower than that 21% (11/53) of the C1-2DLRH group, but there was no significant difference between the two groups (χ(2)=0.980, P =0.322). (2) A total of 251 laparoscopic surgeons questionnaires were eligible. The incidence of side effects in the first and second generation of 3D and 2D laparoscopic surgeons was 20.4% (10/49), 6.9% (6/87) and 3.5% (4/115), respectively. The incidence of side effects in the first generation of 3D laparoscopic surgeons was higher than that in the second generation of 3D (χ(2)=5.463, P =0.019) and 2D laparoscopic surgeons (χ(2)=12.475, P< 0.01). There was no difference between the second generation of 3D and 2D laparoscopic surgeons (χ(2)=1.208, P =0.272). Conclusions: 3D laparoscopy is advantageous to the preservation of autonomic nerve in C1-LRH operation and may improve the quality of operation compared with 2D laparoscopy. The second generation of 3D laparoscopic device might overcome the side effects of the surgeons.

Objective: To observe the effect of medicated-catgut embedding at "Changqiang"(GV 1) on regional pain reaction and expression of p 38 MAPK in the dorsal horn of spinal cord in anus incisional pain rats, so as to explore its analgesic mechanism., Methods: Forty male SD rats were randomly divided into control, model, GV 1-embedding and sham acupoint embedding groups ( n =10 rats in each group). The anus incisional pain model was established by making a radial incision (about 10 mm length) at the left lithotomy position of the anus with a surgical knife, and the mechanical pain threshold (PT) was measured by using a Von Frey before and 4, 8, 12, 24 h after operation. The medicated-catgut (about 12.5 mm length/kg body weight) was implanted in the subcutaneous tissue of GV 1 region. The immunoactivity of p 38 MAPK was determined by immunohistochemistry., Results: Compared with the control group, the mechanical PTs were significantly decreased 4, 8, 12 and 24 h after operation both at the site of incision and about 15 mm proximal to the site of incision in the model group ( P <0.05), and the immunoactivity of phosphorylated (p)-p 38 MAPK in the superficial layer of dorsal horns of lumbar spinal cord was significantly increased(24 h)after operation( P <0.05). Compared with the model group, the PTs were significantly increased 8, 12 and 24 h after operation at the site of incision, and 12 h and 24 h at the site about 15 mm proximal to the incision region ( P <0.05), and the immunoactivity level of p-p 38 MAPK was significantly down-regulated in the GV 1-embedding group ( P <0.05). No significant changes were found in the PT and p-p 38 MAPK immunoactivity levels in the sham acupoint embedding group ( P <0.05)., Conclusions: Medicated-catgut embedding at "Changqiang"(GV 1) has an analgesic effect in anus incisional pain model rats, which may be related to its effect in down-regulating the expression of p 38 MAPK in the dorsal horn of lumbar spinal cord.

Objective: To analyze the relative position between lumbar plexus and access corridor of minimally invasive lateral transpsoas approach based on magnetic resonance imaging distribution of lumbar plexus by three dimensional reconstruction technique, so as to evaluate approach safety., Methods: Three-dimensional fast imaging employing steady-state acquisition sequences of lumbar spine were performed on 71 patients with lumbar degenerative diseases between July 2012 and January 2015. The axial image distance between the anterior edge of lumbar plexus and sagittal central perpendicular line (SCPL) of disc was determined using the distance formula at the mid-disc space from L 1, 2 to L 4, 5 level. SCPL was drawn perpendicularly to the sagittal plane of intervertebral disc and it passed through its central point, which is initial dilator trajectory for transpsoas approach. With respect to the SCPL of disc, the distance with a positive value indicated neural tissue posterior to it whereas anterior to it represented by a negative value., Results: Various branches of lumbar plexus which passed through the psoas major anterior to the SCPL of disc were identified in 42 (59.2%), 58 (81.7%), and 70 (98.6%) patients at L 2, 3 , L 3, 4 , and L 4, 5 levels, respectively. It is possible to infer the presence of genitofemoral nerve in accordance with relevant anatomic research. A ventral migration of intrapsoas nerves is identified from L 1, 2 to L 4, 5 level. All differences between levels were statistically significant ( P <0.05)., Conclusions: With respect to the SCPL of disc, a pass way of guide wire or a radiographic reference landmark to place working channel, lumbar plexus lie posterior to it from L 1, 2 to L 3, 4 level and shift anteriorly to it at L 4, 5 level, while genitofemoral nerve locate anterior to the SCPL from L 2, 3 to L 4, 5 level. Neural retraction may take place during sequential dilation of working channel especially at L 4, 5 level.

Objective: To investigate the expression of elongation of very long-chain fatty acids family member 6 (ELOVL6) in high-grade serous ovarian carcinoma (HSOC), and explore the correlation between its expression and clinical prognosis in these patients., Methods: The expression of ELOVL6 at mRNA and protein levels were respectively detected by reverse transcription (RT)-PCR and immune histochemistry method in 12 cases with normal ovarian tissues and 172 cases with HSOC from primary tumor site, forty of which had paired peritoneal metastatic tissues., Results: (1) The results tested by RT-PCR showed that ELOVL6 expression in normal ovarian tissue was 4.8±1.1, while 1.2±0.7 in primary tumors and 1.8±0.9 peritoneal metastatic sites in HSOC. Compared with normal ovarian tissue, the level of ELOVL6 mRNA was significantly lower in HSOC (P<0.05). There was no significant difference between primary and peritoneal metastatic sites in HSOC (P=0.610). It was shown that ELOVL6 protein localized in cytoplasm of ovarian cancer cell by immunostaining assay. (2) ELOVL6 expression was observed in all normal ovarian tissue, 70.2% of G1-G2 and 48.8% of G3 HSOC (P<0.05). ELOVL6 expression in drug-resistant group were significantly lower than that in non-resistant group (39.1% vs 65.0%, P<0.01). The median disease-free survival was 41 months in the ELOVL6-positive group and 39 months in ELOVL6-negative group (P>0.05). The total median survival was 52 months in ELOVL6-positive group and 44 months in ELOVL6-negative group (P>0.05)., Conclusion: Low expression of ELOVL6 may correlate with the poor differentiation and drug resistance in HSOC.

Objective: To evaluate the effectiveness of modified "eggshell" osteotomy for the treatment of thoracolumbar kyphoscoliosis. METHODS Between April 2009 and June 2014, 19 patients with spinal deformity underwent modified "eggshell" osteotomy consisting of preserving posterior bony structures initially and enlarging surgical field for cancellous bone removal. There were 14 males and 5 females with an average age of 37.8 years (range, 18-76 years) and with a median disease duration of 7 years (range, 1-40 years). The disease causes included ankylosing spondylitis in 13 cases, spinal tuberculosis in 3 cases, and chronic vertebral compression fracture in 3 cases. Eleven patients showed single kyphosis and 8 patients had kyphoscoliosis. Preoperative Cobb angle of kyphosis was (64.2 ±30.1)degrees, while Cobb angle of scoliosis was (19.9 ± 12.8)degrees. Apical vertebraes were T10 in 1 case, L1 in 3 cases, L2 in 7 cases, T10, 11 in 2 cases, T12, L1 in 4 cases, T12-L2 in 1 case, and T10-L1 in 1 case. Preoperative visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score were 6.1 ± 1.9 and 15.2 ± 5.6, respectively. According to Frankel criteria for spinal cord function, 16 cases were rated as grade E and 3 cases as grade D before operation. Cobb angle, VAS, and JOA scors were used to assess relief of symptom., Results: The operation time was 215-610 minutes (mean, 343 minutes); intraoperative blood loss ranged from 900 to 3 000 mL (mean, 1 573 mL). All incisions healed primarily. Delayed onset ischemia-reperfusion injury of spinal cord occurred in 1 case at 6 days after operation, and symptoms alleviated after conservative treatments. All 19 cases were followed up 14-76 months (mean, 46 months). No loosening or breakage of internal fixation was observed during follow-up. Cobb angle of kyphosis, Cobb angle of scoliosis, VAS and JOA scores at 1 week after operation and last follow-up were significantly improved when compared with preoperative ones (P < 0.05). VAS and JOA scores at last follow-up were significantly improved when compared with scores at 1 week after operation (P < 0.05), but no significant difference was found in Cobb angle of both kyphosis and scoliosis between at 1 week after operation and at last follow-up (P > 0.05). At 1 week after operation, the correction rate for kyphosis was 34.1%-93.4% (mean, 62.2%), and the correction rate for scoliosis was 42.4%-100% (mean, 68.9%). At 48 months after operation, 3 patients with preoperative impaired spinal cord function achieved full recovery., Conclusion: Modified "eggshell" osteotomy owns the advantages of shorter operation time and less intraoperative blood loss, thus it is able to correct thoracolumbar kyphoscoliosis safely and effectively.

Objective: To investigate the clinical characteristics and prognostic factors for patients with stage Ia-IIb cervical cancer with pulmonary metastasis (CCMP)., Methods: Clinical information of 106 patients with stage Ia-IIb cervical cancer with lung metastases admitted in the Chinese Academy of Medical Sciences Cancer Hospital from January 1999 to June 2013 was collected. The efficacy of different therapeutic methods for lung metastases was compared and relevant prognostic factors were analyzed., Results: Pulmonary metastases were detected in 89 (83.9%) out of a total of 106 patients within 2 years after initial treatment of cervical cancer. The median disease-free interval (DFI) of the 106 patients was 13 months. The median survival after CCMP was 18 months, with 2-year and 5-year survival rates of 37.7% and 7.5%, respectively. Metastases were mainly distributed in the inferior lobe of right lung. The surgical treatment was proven to be clinically effective in both unilateral and bilateral CCMP. The response rate was 60.2% in patients choosing non-operative treatment. The univariate analysis showed that pathological type of cervix carcinoma, low degree of differentiation, scope of pulmonary metastasis and whether CCMP simultaneously accompanied with other parts of recurrence were closely related to the prognosis, while the differentiation of cervical tumor was an independent prognostic factor drawn from multivariate regression analysis., Conclusions: Regular CT lung screening is recommended for patients with stage Ia-IIb cervical cancer during their follow-up period. Both operative and non-operative treatments are feasible therapeutic methods for CCMP. But surgical resection is strictly restricted to certain operative indications. Ia-IIb stage cervical cancer of low differentiation has poorer prognosis after lung metastasis.

Objective: To investigate the protocols of combined culture of human placenta-derived mesenchymal stem cells (HPMSCs) and human umbilical vein endothelial cells (HUVECs) from the same and different individuals on collagen material,to provide the., Methods: Under voluntary contributions, HPMSCs were isolated and purified from human full-term placenta using collagenase IV digestion and lymphocyte separation medium, and confirmed by morphology methods and flow cytometry, and then passage 2 cells were cultured under condition of osteogenic induction. HUVECs were isolated from fresh human umbilical vein by collagenase I digestion and subcultured to purification, and cells were confirmed by immunocytochemical staining of von Willebrand factor (vWF). There were 2 groups for experiment. Passage 3 osteoblastic induced HPMSCs were co-cultured with HUVECs (1:1) from different individuals in group A and with HUVECs from the same individual in group B on collagen hydrogel. Confocal laser scanning microscope was used to observe the cellular behavior of the cell-collagen composites at 1, 3, 5, and 7 days after culturing., Results: Flow cytometry showed that HPMSCs were strongly positive for CD90 and CD29, but negative for CD31, CD45, and CD34. After induction, alizarin red, alkaline phosphatase, and collagenase I staining were positive. HUVECs displayed cobble-stone morphology and stained positively for endothelial cell marker vWF. The immunofluorescent staining of CD31 showed that HUVECs in the cell-collagen composite of group B had richer layers, adhered and extended faster and better in three-dimension space than that of group A. At 7 days, the class-like microvessel lengths and the network point numbers were (6.68 +/- 0.35) mm/mm2 and (17.10 +/- 1.10)/mm2 in group A, and were (8.11 +/- 0.62) mm/mm2 and (21.30 +/- 1.41)/mm2 in group B, showing significant differences between the 2 groups (t = 0.894, P = 0.000; t = 0.732, P = 0.000)., Conclusion: Composite implant HPMSCs and HUVECs from the same individual on collagen hydrogel is better than HPMSCs and HUVECs from different individuals in integrity and continuity of the network and angiogenesis.

Objective: To compare the therapeutic effect of postoperative pain of hemorrhoid treated with thread embedding at Changqiang (GV 1) and Indometacin suppository., Methods: Eighty cases were randomly divided into an acupoint catgut-embedding group (group A) and an Indometacin group (group B), forty case in each group. In group A, thread embedding at Changqiang (GV 1) was applied, and Indometacin suppository was put into rectum in group B. The pain intensity after 6, 12, 24, 72 hours of treatment and the the maximum scores of VAS in 24 hours (T24max VAS) of 1-3 days of postopration were evaluated with pain Visual Analogue Scale (VAS); the quantity demanded of analgesic and the adverse reaction were observed., Results: The scores of VAS after 6, 12, 24, 72 hours of treatment in group A were obviously lower than those in group B (all P < 0.05); the T24max VAS scores in group A were obviously lower than those in group B (all P < 0.05). Six cases in group A and 14 cases in group B were treated with non-steroidal anti-inflammatory drug as well. The total effective rate of 87.5% (35/40) in group A was superior to that of 62.5% (25/40) in group B, indicating the statistically significant differences between two groups (P < 0.05). There was no obvious adverse reaction in group A; in group B, headache, dizziness, nausea, vomiting, distention of chest and palpitation appeared, accounting for 11 cases., Conclusion: The therapeutic effect of postoperative pain of hemorrhoid treated with thread embedding at Changqiang (GV 1) is favorable, it can reduce the quantity of analgesic, the adverse reaction, its effect is better than that of Indometacin suppository.