Increasing research has shown that the abnormal expression of circRNAs is closely related to tumorigenesis, apoptosis, and patient prognosis in cervical cancer. This study aimed to reveal the procancer role of circIL21R in cervical cancer and investigate its related molecular mechanisms. Bioinformatics analysis revealed that circIL21R promotes the progression of cervical cancer via the miR-1205/PTBP1 axis. CircIL21R expression was significantly greater in tumor tissue than in adjacent normal tissue, and higher circIL21R expression indicated shorter survival. We applied MTS assays, EdU assays, and Transwell assays to show that the overexpression of circIL21R promoted cervical cancer cell proliferation and invasion. Mechanistically, circIL21R promoted the expression of PTBP1 by sponging miR-1205. Moreover, rescue assays confirmed that regulating the expression of miR-1205 or PTBP1 could reverse the tumorigenic effect caused by circIL21R overexpression. In addition, circIL21R promoted the tumorigenesis of cervical cancer in vivo. In summary, our study demonstrated that circIL21R was highly expressed in cervical cancer and upregulated PTBP1 expression by acting as a ceRNA for miR-1205, making outstanding contributions to several malignant biological processes in cervical cancers, such as growth, proliferation, and invasion. CircIL21R is a potential biomarker for the diagnosis and treatment of cervical cancer.

目的 探讨甲状腺微小乳头状癌(PTMC)患者发生中央淋巴结转移(CLNM)的影响因素.方法 收集804例接受甲状腺手术的PTMC患者的病历资料,分析PTMC患者发生CLNM的危险因素.结果 804例PTMC患者中,324例(40.3％)患者发现CLNM.无CLNM和有CLNM患者性别、年龄、肿瘤直径、多灶性及存在微钙化情况比较,差异均有统计学意义(P﹤0.05).多因素分析结果显示,男性、年龄﹤45岁、存在微钙化、多灶性均是CLNM的独立危险因素(P﹤0.05).不具有任何一个独立危险因素的PTMC患者CLNM发生率为32.1％(80/249),明显低于至少具有一个独立危险因素患者的44.1％(245/555),差异有统计学意义(P﹤0.01).结论 PTMC患者发生CLNM与性别、年龄、是否存在微钙化和多灶性有关.

目的 探讨子宫动静脉瘘(UAVF)的临床特点、诊断与治疗方法.方法 回顾性分析2012年1月至2021年8月在首都医科大学附属北京安贞医院妇产科收治的9例UAVF患者的临床资料.结果 9例UAVF患者均有不同次数的既往妊娠、子宫手术或感染史.7例患者表现突发突止的阴道大量出血,其中反复出现者6例.出现临床症状的时间距前次妊娠或宫腔操作史＜1个月的为5例,≥1个月的为3例.9例患者均经彩色多普勒超声检查诊断.1例保守治疗,8例手术治疗,包括1例超声监测下清宫术+宫腔球囊压迫术,1例二次双侧子宫动脉栓塞术,3例超声或腹腔镜监测下宫腔镜UAVF电切术,1例腹腔镜全子宫切除术,2例多种方法综合治疗.结论 阴道出血是UAVF患者的常见症状,彩色多普勒超声是诊断UAVF的首选方法.提高早期识别和诊断UAVF的能力,根据患者的综合情况制定合适的治疗方案可为患者带来最好的治疗效果和最小的损伤.

目的 探讨甲状腺乳头状癌(PTC)患者行甲状腺全切除术+颈部淋巴结清扫术后发生甲状旁腺功能减退症的影响因素.方法 选取128例接受甲状腺全切除术+颈部淋巴结清扫术的PTC患者,以术后第一天甲状旁腺激素(PTH)水平﹤15 pg/ml定义为甲状旁腺功能减退症,分析PTC患者术后发生甲状旁腺功能减退症的影响因素.结果 128例患者中,63例患者术后发生甲状旁腺功能减退症.单因素分析结果显示,术前PTH水平、术前磷水平、预防性补钙均可能与PTC患者术后甲状旁腺功能减退症的发生有关(P﹤0.05).多因素分析结果显示,预防性补钙是PTC患者术后发生甲状旁腺功能减退症的独立危险因素(P﹤0.01).结论 预防性补钙会导致PTC患者甲状腺全切除术后甲状旁腺功能减退症的发生风险增加.

目的:在生物信息学数据库中挖掘乳腺癌骨转移的差异表达基因(differentially expressed genes,DEGs),探讨DEGs的细胞定位、分子功能及其潜在的分子机制,寻找乳腺癌骨转移的潜在治疗靶点和预后预测基因.方法:通过在基因表达数据库(GEO)中筛选乳腺癌骨转移相关芯片数据,使用RStudio对芯片进行质量评价后筛选DEGs并绘制热图和火山图.对共同DEGs进行基因本体(gene ontology,GO)功能注释并使用Kaplan Meier Plotter进行生存分析.结果:根据纳入标准在GEO中共筛选出两组芯片,对GSE137842、GSE51232进行分析后得到44个共同DEGs.对共同DEGs进行GO富集分析得出分子功能主要富集在连接酶活性,包括下调基因ZNRF3、RNF182、UHRF1;生物学过程富集在凋亡和血管内皮生长因子受体信号通路,涉及上调基因ELMO1、SULF1、DAPK1;通过生存分析得出12个与基因表达情况相符且与无复发生存期(re-currence-free survival,RFS)或总生存期(overall survival,OS)密切相关的下调基因.最终GO富集分析以及生存分析共得到16个DEGs.结论:GO富集分析和生存分析得到的16个DEGs即ELMO1、SULF1、DAPK1、UHRF1、TOX2、BMPR1B、NXPE3、AEBP2、ADIPOR2、GPR63、ZNRF3、NECAP1、SLAIN1、MICB、POPDC3、ALKBH6可以作为乳腺癌骨转移的治疗靶点,其中生存分析得到的12个DEGs包括TOX2、BMPR1B、NXPE3、AEBP2、ADIPOR2、GPR63、ZNRF3、NECAP1、SLAIN1、MICB、POPDC3、ALKBH6,可作为乳腺癌骨转移患者预后预测基因.

研究PDCA循环理论在医学英语教学中的应用.对2014级首都医科大学定向本科班临床医学生采用此教学管理方法,进行规范化教学,进一步完善医学英语教学管理体系.使学生对医学英语的兴趣明显增加,其医学英语水平得到了提高.为医学英语教育水平的发展提供了一条新的途径.

We aimed to explore what kind of endocrine treatments are optimal for hormone receptor-positive and human epidermal growth factor receptor 2-negative locally advanced or metastatic breast cancer in some specific clinical situations. We searched randomized controlled trials in Embase, Medline, the Cochrane library, and PubMed from inception to April 1, 2020 and performed a network meta-analysis based on a Bayesian fixed-effects model. Progression-free survival (PFS) with hazard ratios and corresponding 95% confidence interval was defined as the primary endpoint, while overall survival (OS), objective response rate (ORR), clinical benefit rate and serious adverse events were used as secondary endpoints. A total of 35 studies involving 12,285 patients and 24 treatment options were included. In general, most co-treatment options prolonged PFS compared to single-agent therapy, of which aromatase inhibitor (AI) plus everolimus and fulvestrant plus palbociclib were probably the most effective agents, and the latter had the best safety record. However, despite the superior efficacy of fulvestrant plus capecitabine for PFS and OS, palpable toxic effects have been demonstrated for this treatment, so its application must be scrupulously considered. The results of subgroup analysis indicated that fulvestrant combined with palbociclib improved prognosis for phosphatidylinositol 3-kinase (PI3K)-mutated patients, PI3K-unmutated patients, patients with endocrine therapy resistance, and visceral metastatic patients, while no obvious improvement was detected in OS. Moreover, the efficacy of fulvestrant plus cyclin-dependent kinase 4/6 (CDK4/6) inhibitors was slightly better than that of AI plus CDK4/6 inhibitors, while AI plus everolimus was more efficacious than fulvestrant combined with everolimus in terms of PFS, OS, and ORR. In conclusion, our results provide moderate evidence that fulvestrant plus palbociclib and AI plus everolimus were the most effective treatments, while the efficacy and safety of fulvestrant plus palbociclib was obviously superior in some specific clinical situations.

目的 应用纤维乳管镜联合全容积乳腺成像系统诊断乳头溢液,明确手术指征,降低盲目的手术几率及患者的心里负担.方法 选取60例临床乳头溢液的患者,进行全容积乳腺超声检查及纤维乳管镜检查,结合报告,明确手术指征.结果?60例患者乳头溢液,其中血性溢液18例,透明溢液36例,脓性溢液1例,溢乳5例.乳管镜下诊断:镜下未见异常21例,导管扩张5例,镜下乳管管壁欠光滑有沉淀物23例,导管内乳头状瘤3例,镜下出血点7例,实性占位1例.结论 纤维乳管镜联合全容积乳腺成像系统诊断乳头溢液,尤其对超声下未见占位单孔单侧乳头溢血的患者意义更大,明确手术指征,降低手术率及患者的心里负担.

Objective: To analyze the risk factors for complications in pregnancy associated with pulmonary hypertension (PH) and to develop a logistic regression model to predict cardiac outcomes. Methods: A retrospective analysis was performed on 249 women with PH, who were followed at the Beijing Anzhen Hospital, Affiliated to the Capital Medical University, from January 2012 to March 2015. All pregnancies were recorded. Overall, 214 cases of pulmonary arterial hypertension were identified. Univariate analysis and multivariate analysis were performed to determine the risk factors occurring during or after pregnancy in women with PH. Ultimately, six independent risk factors for cardiac events were determined. Results: There were 70 cases of cardiac complications (28.1%) with PH, including 7 cases of maternal death (2.81%). Independent risk factors were rapid progression of symptoms [OR = 3.044, 95% CI (1.042-8.895), P < 0.05], brain natriuretic peptide (BNP) plasma levels >= 300pg/mL [OR= 5.543, 95% CI (1.403-21.896), P < 0.05], severe pulmonary hypertension (PAP >= 80mmHg, 1mmHg = 0.133 kPa) [OR = 6.769, 95% CI (2.748-16.677), P < 0.05], World Health Organization functional class (WHO-FC) III-IV [OR = 6.053, 95% CI (2.638-13.886), P < 0.05], PH pre-pregnancy [OR = 5.434, 95% CI (1.298-22.738), P < 0.05], and delivery >= 28 weeks gestation [OR = 10.876, 95% CI (3.957-29.893), P < 0.05]. Conclusions: Early advice on contraception for patients with PH, and the need for patients to undergo a comprehensive assessment of cardiac function pre-pregnancy are suggested from the results of the present study.

目的 回顾性研究男性乳腺发育症自动乳腺全容积成像系统(ABVS)图像特征及临床应用.方法 应用自动乳腺全容积成像系统容积探头对59例男性乳腺发育症患者进行扫描,观察ABVS图像特征并分析其临床特点.结果 59例男性乳腺发育症,双乳发病28例,右乳22例,左乳9例.其ABVS图像呈现出以乳头为中央呈圆盘状或偏于一侧的扇状低或较高回声,与周围脂肪组织分界清楚,并可见向乳头方向延伸的管状无回声.结论 ABVS不仅适用于女姓,在男性患者中检测时,因其乳房较小,一个方位扫查即可显示病变全貌.ABVS图像特征明显,结合临床表现,男性乳腺发育症较易作出正确诊断.诊断时尚需与男性乳腺癌相鉴别.

WebAnalysis of gene expression at single-cell resolution in the developing prefrontal cortex of the human embryo reveals a diversity of cell types, elucidates cell lineages and identifies signalling pathways that regulate development.

Human brain evolution is associated with expansion and folding of the neocortex. Increased diversity in neural progenitor (NP) populations (such as basally located radial glia [RG], which reside in an enlarged outer subventricular zone [OSVZ]) likely contributes to this evolutionary expansion, although their characteristics and relative contributions are only partially understood. Through single-cell transcriptional profiling of sorted human NP subpopulations, we identified the primate-specific TMEM14B gene as a marker of basal RG. Expression of TMEM14B in embryonic NPs induces cortical thickening and gyrification in postnatal mice. This is accompanied by SVZ expansion, the appearance of outer RG-like cells, and the proliferation of multiple NP subsets, with proportional increases in all cortical layers and normal lamination. TMEM14B drives NP proliferation by increasing the phosphorylation and nuclear translocation of IQGAP1, which in turn promotes G1/S cell cycle transitions. These data show that a single primate-specific gene can drive neurodevelopmental changes that contribute to brain evolution.

Objective To detect the expression difference of AT-rich interactive domain-containing protein 1A (ARID1A) in malignant and benign breast tumor, and its impact on patients’ prognosis. Methods The specimens from 50 cases of breast invasive ductal carcinoma and 50 cases of breast fibroma were collected in Beijing Electric Power Hospital between January 2009 and May 2015 by random number table. The expression of ARID1A protein was detected by immunohistochemical EnVision method. The relationship between ARID1A expression and clinicopathological features was analyzed. The 50 breast cancer patients were followed up until December 31, 2015 by phone or reviewing case history. DFS and OS were calculated. The correlations of ARID1A with HER-2, ER and P53 were analyzed by nonparametric Spearman test. Kaplan-Meier method was used for survival analysis and Log-rank test was used to compare the survival rate. Cox proportional hazards regression model was used to analyze the prognostic factors. Results The high expression rate of ARID1A was 46% (23/50) in 50 cases of breast invasive ductal carcinoma, and 72% (36/50) in 50 cases of fibroma, indicating a significant difference (χ2=6. 986, P=0. 008). The expression of ARID1A was significantly different in the patients with different breastfeeding time, histological grade, P53 expression, ER expression, PR expression, molecular types and HER-2 expression (χ2= 4. 177, 4. 726, 4. 177, 5. 469, 14. 661, 5. 469, P<0. 050). ARID1A expression was positively correlated with P53 (r=0. 289, P=0. 042) and ER expression (r=0. 331, P=0. 019), but negatively correlated with HER-2 (r=-0. 372, P=0. 008). The 3-year DFS in TNM stages Ⅲ and Ⅳ patients was significantly higher than that in TNM stage I and Ⅱpatients (85. 5% vs 42. 4%,χ2=9. 657, P=0. 002), and 5-year OS in patients with tumor diameter≤2 cm was significantly higher than that in patients with tumor diameter> 2 cm (100% vs 71. 3%, χ2=5. 598, P=0. 018). The 3-year DFS and 5-year OS in P53 positive patients were significantly higher than those in P53 negative patients respectively (86. 3% vs 45. 5%, χ2= 5. 077, P=0. 024;95. 2% vs 50. 8%, χ2=9. 476, P=0. 002). The 3-year DFS and 5-year OS in patients with high expression of ARID1A were significantly higher than those in patients with low expression of ARID1A(81. 8% vs 70. 2%,χ2=0. 454,P=0. 500;90. 9%vs 76. 1%,χ2 =0. 090,P=0. 765). Multivariable Cox regression model showed that P53 positive was an independent protective factor (P=0. 028, OR=0. 079, 95%CI:0. 008-0. 761), which could affect the OS of breast cancer patients, but ARID1A expression was not an Independent prognostic factor ( P=0. 194, OR=4. 758, 95%CI:0. 453-49. 957). Conclusion The expression of ARID1A in breast cancer tissue is lower than that in breast fibroadenoma, and ARID1A may play an important role in the development of breast cancer.

目的:探讨micro RNA-25（mi R-25）在直肠癌细胞中的表达及作用。方法:检测多种不同直肠癌细胞中mi R-25的表达,并检测直肠癌细胞转染mi R-25前体（pre-mi R-25）上调mi R-25的表达或转染mi R-25抑制剂（anti-mi R-25）下调mi R-25的表达后生物学行为的变化。结果:与正常直肠黏膜组织比较,不同的直肠癌细胞中mi R-25的表达均不同程度的明显升高（均P＜0.05）。在mi R-25表达水平相对较低的直肠癌HR-834细胞中转染pre-mi R-25,在mi R-25高表达的直肠癌SW-837细胞中转染anti-mi R-25后,两种细胞的增殖、细胞周期、凋亡无明改变（均P＞0.05）,但侵袭及迁移能力在HR-834细胞的明显增强,SW-837细胞减弱（均P＜0.05）。结论:mi R-25在直肠癌细胞中的表达升高,且其升高程度与细胞的侵袭和迁移能力密切相关。

目的:评价超声自动乳腺全容积成像(ABVS)与钼靶X线对乳腺癌的诊断价值及其临床意义.方法:我院68例女性患者均经ABVS和钼靶X线检查证实存在乳腺肿块,其乳腺影像报告数据系统(BI-RADS)评估指标均在4到5级.经由手术或超声引导下穿刺活检取得标本,进行病理检查证实.其中乳腺癌62例;乳腺良性病变6例.将ABVS和钼靶X线检查的诊断资料进行数据收集并对比分析.结果:ABVS对乳腺癌的诊断准确率为86.76％;钼靶X线对乳腺癌的诊断准确率为76.47％;二者联合检查对乳腺癌的诊断准确率为91.18％.尽管使用ABVS检查对乳腺癌的诊断准确率稍高于钼靶X线,但二者差异无显著的统计学意义(P＞0.05),二者联合对乳腺癌的诊断准确率明显优于单纯采用ABVS或钼靶X线检查,差异有统计学意义(P＜0.05).59例乳腺癌患者中,有48例在ABVS冠状切面上存在“火山口”征(81％).结论:在乳腺癌的诊断过程中ABVS和钼靶X线各有其优势,若两种检查联合应用可提高其检出率和诊断准确率.ABVS冠状切面上“火山口”征对诊断乳腺癌具有较高价值.

OBJECTIVE:To study the impact of severe idiopathic pulmonary arterial hypertension (IPAH) on pregnancy outcome and to investigate the effect of multidisciplinary approach during pregnancy on the pregnancy outcome in pregnant woman with severe IPAH.METHODS:Between March 2007 and November 2013, 10 pregnant women with severe IPAH undergoing treatment in Beijing Anzhen Hospital were studied retrospectively.Hemodynamic measurements, medical therapy, manner of delivery, anesthetic administration, multidisciplinary management and outcomes were assessed.RESULTS:All 10 cases were first diagnosed at the mean of (24 ± 3) weeks during the pregnancy. The systolic pulmonary artery pressure (sPAP) estimated by transthoracic echocardiography was (95.6 ± 1.3) mmHg (1 mmHg = 0.133 kPa) .Seven cases of class III and 3 cases of class IV were recorded by World Health Organization functional class.One patient underwent pregnancy termination at gestational age of 21 weeks with no maternal death or complications, nine patients continued pregnancy and all the patients underwent cesarean section. The mean pregnancy length was (31 ± 5) weeks.Nine had cesarean deliveries during continuous epidural anesthesia, and one during general anesthesia. There were three maternal deaths in hospital (5, 2, 3 days postpartum), and seven patients were alive, and the average hospitalization days was (8 ± 4) days.One fetus lost with cesarean section. Two were term delivery, and seven cases were premature delivery. The average weight is (1 948 ± 731) g and nine were alive and no malformation.CONCLUSIONS:Because of maternal mortality in patients with severe IPAH remains prohibitively high, patients should continue to be counseled to avoid pregnancy.Women with severe IPAH who become pregnancy should be followed by multidisciplinary approach, and cesarean deliveries during continuous epidural anesthesia are a relatively safe way for pregnancy termination in patients with severe IPAH.

OBJECTIVE:Study of pulmonary hypertension (PAH) during pregnancy has characteristics of the high risk factors for patient death and its clinical characteristics.METHODS:Death in patients with clinical data was collected from January 2006 to October 2013 in Beijing Anzhen Hospital Affiliated to Capital Medical University treated 8 cases of pregnancy complicated with PAH in hospital. According to the mechanism of PAH patients will be divided into two categories, Idiopathic pulmonary arterial hypertension (IPAH) in 4 cases, 4 cases of secondary PAH [are secondary to congenital heart disease, also known as congenital heart disease associated PAH (CHD-PAH)]. Analyze the clinical features of 8 cases of patients and pregnancy outcome.RESULTS:(1) In 8 patients, 4 cases were IPAH, none of them with primary diseases, and they were complicated with severe tricuspid regurgitation. 4 cases were CHD-PAH, all with Eisenmenger's syndrome. 8 patients were not preconception counseling and regular prenatal examination. (2) The pregestational cardiac function of 8 cases was grade I-II, and it was grade III-IV on admission. The estimation pressure (sPAP) of pulmonary artery systolic by echocardiography was 101 mmHg (1 mmHg = 0.133 kPa). In 8 patients, 7 cases were in pregnancy 27 weeks and beyond for treatment since the clinical symptoms increased, 1 case of pregnant 18 weeks for treatment caused by the increased clinical symptoms. (3) In 8 patients, 1 patient with CHD- PAH secondary to patent ductus arteriosus, its sPAP was 170 mmHg, dead at 12 hours after admission; the remaining 7 cases termination with cesarean section. 4 patients with IPAH were continuous epidural anesthesia, including 1 case for the intraoperative PAH crisis and respiratory and cardiac arrest with general anesthesia, 3 cases of CHD- PAH patients in 1 case with continuous epidural anesthesia, 2 cases of general anesthesia.(4) In 8 patients, 7 cases of median death time were 3 days after delivery, including 4 cases of IPAH patients death for 2.5 days after delivery; the causes of death were PAH crisis and heart failure. Time of death in 4 cases of CHD-PAH, 1 case was dead at 12 hours after admissions, the remaining 3 cases median death time were 13 days after delivery; the death causes for 4 cases of CHD-PAH were PAH crisis and multiple organ failure. (5) In 8 patients, 1 patient with CHD-PAH secondary to patent ductus arteriosus in gestational week 31 stillbirths occur. 1 case of pregnant 19 weeks had treatment of caesarean operation, the remaining 6 cases respectively at 28-30 weeks of gestation live birth, neonatal survival. (6) Before delivery, 4 cases of IPAH and 3 cases of CHD-PAH patients treated with alprostadil, iloprost, sildenafil, reduction of pulmonary artery pressure treatment, 1 case of CHD-PAH patient was dead after 12 hours in hospital, no drug treatment.CONCLUSIONS:(1) PAH in patients need for consultation prior to conception, pregnancy must conduct regular prenatal examination, symptoms occur during pregnancy, the cardiac function was significantly decreased, and no improvement of drug treatment should be early terminated the pregnancy. (2) Compared with the pregnant women with CHD- PAH, faster progress and poor prognosis in patients with IPAH disease. (3)The patients during cesarean operation or intrapartumare easy to cause PAH crisis and heart failure or multiple organ failure. Taking active measures to maintain stability of hemodynamics is the key to prevent the occurrence of death of pregnant women with PAH.

目的 研究microRNA-25(miR-25)在直肠癌组织中的表达及与患者临床指标的关系.方法 采用TaqMan探针法,进行实时定量PCR,检测64对石蜡包埋的直肠癌组织及其配对的癌旁正常组织,24对直肠腺瘤及其配对的瘤旁正常组织中miR-25的相对表达水平.结果 miR-25在直肠癌及腺瘤组织中表达增高.在淋巴结转移和临床(TNM)分期差的病例中,miR-25的表达较高.结论 在直肠癌组织中miR-25过度表达,这种异常高表达可能是直肠癌发生的一个早期事件.miR-25的表达水平与患者的临床分期和淋巴结转移有关.随着进一步研究的深入,miR-25有可能作为直肠癌诊断和转移危险度预测的一种新的指标.