Background The World Health Organization (WHO) in 2015 stated that every effort should be made to provide cesarean delivery (CD) for women in need. In China, the two-child policy largely prompts the number of advanced age childbirth, which raises the possibility of an increasing number of women who need a c-section. The aim of this study was to assess the trends in the overall and medical indication-classified CD rates in the era of the two-child policy in Jiangsu, China. Methods A retrospective cross-sectional study of 291,448 women who delivered in 11 hospitals in Jiangsu province between 2012 and 2019 was conducted. Medical cesarean indication for each woman was ascertained by manually reviewing the medical records. The 291,448 women were divided into two subgroups according to the presence of the indications: the indicated group (7.80%) and the non-indicated group (92.20%). We then fitted joinpoint regression and log-binomial regression models to estimate trends in the CD rates across the study period. Results The overall CD rate was observed with a declining trend from 52.51% in 2012–2015 to 49.76% in 2016–2019 (adjusted RR, 0.92; 95% CI, 0.91–0.93; P < 0.001), along with an annual percentage change (APC) to be − 1.0 (95% CI, − 2.1 to 0.0) across the period. The participants were then divided into two subgroups according to the presence of medical CD indications: the indicated group (7.80%) and the non-indicated group (92.20%).We found the declining trend was most pronounced in the non-indicated group, with the CD rates decreased from 50.02% in 2012–2015 to 46.27% in 2016–2019 (adjusted RR, 0.90; 95% CI, 0.89–0.90; P < 0.001). By contrast, we observed a steady trend in the CD rate of the indicated group, which maintained from 87.47% in 2012–2015 to 86.57% in 2016–2019 ( P = 0.448). In the indicated group, a higher risk of adverse pregnancy outcomes was revealed for those women who delivered vaginally as compared with those who received c-section. We further investigated that women with following specific indications had a higher proportion of vaginal delivery, i.e., pregnancy complications, fetal macrosomia, and pregnancy complicated with tumor (34.70%, 10.84%, and 16.34%, respectively). Women with the above 3 indications were observed with a higher risk of adverse pregnancy outcomes if delivered vaginally. The incidence rates of the medical indications among the general population increased considerably over the 8-year period ( P < 0.001). Conclusions Although the overall CD rate apparently decreased in the recent years, along with the decline of the unnecessary CD rate, a considerable proportion of indicated women were not provided with CD service in Jiangsu, China. Instead of targeting the overall CD rate, we need to take actions to reduce unnecessary CD rate and provide adequate c-section service for women with indications, particularly for those with underlying diseases and suspected fetal macrosomia.

Background In recent years, births to older mothers and multiparous mothers have increased rapidly with the change of birth policy in China. And mothers of advanced age are more likely to have maternal complications and poor birth outcomes. We aimed to estimate the recent trends and underlying risk factors of maternal mortality. Methods In this systematic assessment, we used data from the National Maternal and Child Health Routine Reporting System (2013–2018), Jiangsu Provincial Maternal Mortality Surveillance System (2017–2018), the Integrated National Mortality Surveillance System (2018), City Statistical Yearbooks (2018), City Health Statistical Yearbooks (2018). The factors associated with maternal mortality ratio (MMR) were explored using the stepwise regression analysis and cluster analysis. Results The MMR maintained at low levels between 2013 and 2016 and there was a slight increase in maternal mortality after 2016 in Jiangsu province. With the implementation of the China’s universal two child policies, the percentage of multiparous mothers ascended from 34.2% (95% confidence interval (CI) = 34.1–34.3%) in 2013 to 51.4% (95% CI = 51.3–51.6%) in 2018 (beta = 3.88, P < 0.001). Consistently, the percentage of advanced maternal age (≥ 35) increased from 8.4% (95% CI = 8.4–8.5%) in 2013 to 10.4% (95% CI = 10.3–10.4%) in 2018 (beta = 0.50, P = 0.012). And we found that the percentage of multiparous mothers and advanced maternal age among maternal deaths were higher than all pregnant women ( P < 0.001). In the stepwise regression analysis, four risk factors were significantly associated with maternal mortality ratio (primary industry of gross domestic product (GDP), rate of delivery in maternal and child health hospital, rate of cesarean section and rate of low birth weight). As the results derived from cluster analysis, the relatively developed regions had lower preventable maternal mortality ratio (43.5% (95% CI = 31.2–56.7%) vs. 62.6% (95% CI = 52.3–72.0%), P = 0.027). Conclusions Since the universal two child policy has been associated with changes in health related birth characteristics: women giving birth have been more likely to be multiparous, and more likely to be aged 35 and over. This somewhat magnifies the impact of differences in economic development and obstetric services on MMR. The findings based on prefecture level data suggest that interventions must target economic development, the health system and maternal risk factors in synergy. These approaches will be of great benefit to control or diminish environmental factors associated with preventable deaths and will effectively reduce MMR and narrow the gap among the different regions.

A primary tumor cell isolation and culture method comprises the following steps: removing necrotic and non-tumor tissue around tumor tissue of a tumor specimen; cutting and digesting the tumor tissue,and filtering the obtained tissue after digestion through a sieve, conducting centrifugation and PBS resuspension, conducting centrifugation again, and discarding the supernatant to obtain isolated tissue cells; resuspending the isolated tissue cells in a primary cell serum-free medium to obtain a resuspension, adjusting cell density, and inoculating a primary cell ultra-low adhesion culture dish; every 48 hours, conducting centrifugation and cell collection, discarding the original primary cell serum-free medium supernatant, and conducting resuspension liquid replacing with the primary cellserum-free medium; continuing culturing the cells in the primary cell ultra-low adhesion culture dish for a week or more; and then culturing the cells by a conventional cell culture method to obtain high-purity primary tumor cells. The cells prepared by the method have high acquisition rate and high degree of purification; and the method has no higher requirements on existing experimental equipment, and is suitable for wide application and promotion in the field of tumor research.

Background: The aim of this study was to assess, using comprehensive meta-analysis, if there was a significant association between polymorphisms in cyclooxygenase-2 (COX-2) gene and lung cancer risk. Methods: PubMed, MEDLINE, EMBASE, Web of Science, CBM, CNKI, WanFang, and CQVIP were searched for all eligible studies through July 2018. A total of 612 citations were retrieved. Odds ratios (OR) and corresponding 95% confidence intervals (CIs) were utilized to evaluate the strength of association between COX-2 gene polymorphisms and lung cancer risk. Meta-analysis, sensitivity analysis, Begg’s funnel plot, Egger’s linear regression, and subgroup analyses were carried out to clarify and validate pooled results. Results: A total of 8 studies met the inclusion criteria and were included in the meta analysis. This current systematic review indicated that COX-2 rs689466 polymorphism correlates with increased lung cancer risk in the allele model (A vs. G), dominant model (AA vs. GG/AG), and homozygous model (AA vs. GG). According to subgroup-analysis, the AA genotype of COX-2 gene rs689466 site increased lung cancer risk in Asian populations, population-based, and hospital-based. Conclusion: COX-2 rs689466 site may moderately increase the risk of lung cancer, especially in Asian populations, PB, and HB studies. In addition, AA homozygotes may contribute to early diagnosis and prevention, providing timely treatments. Results suggest that COX-2 rs689466 polymorphism may be a potential pathogenic factor in lung cancer.

The invention relates to an osteosarcoma stem cell molecular marker CD24 and application thereof. The molecular marker comprises a CD24 gene or CAD24 protein. The molecular marker CD24 is used as an osteosarcoma stem cell molecular marker, a product for detecting CD gene expression is used for detecting the CD24 gene expression level in a to-be-measured osteosarcoma tissue sample, the CD24 gene expression level in the to-be-measured osteosarcoma tissue sample is compared with that in the normal para-carcinoma tissue, the progression of the osteosarcoma disease is diagnosed, assessment and prognosis are conducted, the marker has good specificity and high sensitivity, and a brand-new approach is provided for osteosarcoma diagnosis and/or treatment.

OBJECTIVES:Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) has significant therapeutic efficacy in non-small-cell lung cancer (NSCLC) patients. However, acquired resistance is inevitable and limits the long-term efficacy of EGFR-TKI. Our study aimed to investigate the role of ras-associated binding protein 25 (Rab25) in mediating EGFR-TKI resistance in NSCLC.MATERIALS AND METHODS:Rab25 expression in NSCLC patients was measured by immunohistochemical staining. Western blotting was used to analyse the expression of molecules in the Rab25, EGFR and Wnt signalling pathways. Lentiviral vectors were constructed to knock in and knock out Rab25. The biological function of Rab25 was demonstrated by cell-counting kit-8 and flow cytometry. The interaction between Rab25 and β1 integrin was confirmed by co-immunoprecipitation.RESULTS:Rab25 overexpression induced erlotinib resistance, whereas Rab25 knockdown reversed this refractoriness in vitro and in vivo. Moreover, Rab25 interacts with β1 integrin and promotes its trafficking to the cytoplasmic membrane. The membrane-β1 integrin induced protein kinase B (AKT) phosphorylation and subsequently activated the Wnt/β-catenin signalling pathway, promoting cell proliferation. Furthermore, high Rab25 expression was associated with poor response to EGFR-TKI treatment in NSCLC patients.CONCLUSIONS:Rab25 mediates erlotinib resistance by activating the β1 integrin/AKT/β-catenin signalling pathway. Rab25 may be a predictive biomarker and has potential therapeutic value in NSCLC patients with acquired resistance to EGFR-TKI.

In this paper, a permanent magnet synchronous motor controller that improves the robustness to parameter perturbations and load disturbances is proposed for electric drive applications. The speed loop uses global integral sliding mode control strategy, chooses an appropriate global integral sliding surface, maintains a continuous control law, realizes the sliding mode motion throughout the entire motion of the system through a dynamic nonlinear sliding surface, effectively weakens the chattering inherent in the sliding mode control system, and significantly improves the dynamic quality. The load torque sliding mode observer is used to realize the feed-forward compensation of the load torque, the influence on the performance of control system caused by load torque disturbance can be inhibited. The proposed controller is found to be more effective than the conventional controller, as demonstrated through simulations and experiments.

Objective To investigate the prognostic factors of renal cell carcinoma and to establish a prognostic model for patients with non-metastasis renal cell carcinoma (RCC) after operation.Methods We retrospectively reviewed the clinical data of patients with RCC who underwent radical or partial nephrectomy from January 2008 to December 2012,including 392 males (67.6％) and 188 females (32.4％),with an average age of 56 years(range 24-86 years).The average diameter of tumor was 4.8 cm (range 1.5-17.5 cm).The pathological slides of tumor tissue were reviewed by pathologist,and the tissue microarray (TMA) were constructed.The immunohistochemical staining of TMA were carried out.All patients were followed up the prognosis information of the overall survival (OS),cancer specific survival (CSS) and progression free survival (PFS).Based on these data,univariate and multivariate analysis and survival analysis were performed.Independent prognostic factors related to different follow-up endpoints of patients were screened out.A Nomogram prognostic model for RCC was established and verified.Internal validation were performed by boots value analysis.Results Among 580 cases,160 cases (27.6％) accepted nephron sparing surgery and 420 cases (72.4％) radical nephrectomy,included 514 cases (88.6％) of laparoscopic surgery and 66 cases (11.4％) of open surgery.There were 468 cases of clear cell carcinoma (80.7％),56 cases of papillary carcinoma (9.7％),32 cases of chromophobe cell carcinoma (5.5％),24 patients with other subtypes of cancer cells (4.1％).In pathological staging,stage Ⅰ,Ⅱ,Ⅲ,Ⅳ were 442 cases (76.2％),88 cases (15.2％),48 cases (8.3％),2 cases (0.3％),respectively.There were 424 cases (73.1％) with high expression of CA9,and 156 cases (26.9％) with low expression.The median followup was 66 (4-82) months,and 41 cases (7.1％) were lost of follow-up.For 3 and 5 years,OS,CSS and PFS were 83.4％,88.2％,72.4％ and 69.6％,73.0％,55.8％ respectively.Multivariate analysis showed that tumor pathological subtypes,tumor stage,tumor diameter and positive expression of carbonic anhydrase 9 (CA9) were independent prognostic factors associated with the survival of RCC patients.The Nomogram prognostic model was established by the above four factors.The established Nomogram prognostic model for RCC patients was verified by Harrell's consistency index,and the c-index of OS,CSS and PFS of RCC patients were 0.72 (95％ CI 0.69-0.75),0.77 (95％ CI 0.74-0.81),0.79 (95％ CI 0.76-0.83),respectively.Conclusions Tumor pathological subtypes,staging,tumor diameter and CA9 are independent risk factors for patients with non metastatic renal cell carcinoma.The established Nomogram prognostic model certified by internal validation should be tested by large samples and multicenter studies need tested.

Lung cancer is the leading cause of cancer-related fatalities worldwide, and non-small cell lung cancer (NSCLC) is the main pathological type. MicroRNAs (miRNAs or miRs) are a class of small non-coding RNAs, which are involved in tumor initiation and progression. miR-223 is a tumor suppressor miRNA that has been reported in various types of cancer, including lung cancer. In the present study, to characterize the biological behavior of miR-223 in NSCLC, we established an miR-223 overexpression model in erlotinib-resistant PC-9 (PC-9/ER) cells by infection with lentivirus to induce the overexpression of miR-223. As a result, miR-223 enhanced the sensitivity of the PC-9/ER cells to erlotinib by inducing apoptosis in vitro. Additionally, in vivo experiments were performed using nude mice which were injected with the cancer cells [either the PC-9 (not resistant), PC-9/ER, or the PC-9/ER cells infected with miR-223)]. We found that the tumor volumes were reduced in the rats injected with the cells infected with miR-223. To further explore the underlying mechanisms, reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blot analysis were used to identify the target molecules of miR-223. miR-223 was demonstrated to act as a local regulator of insulin-like growth factor-1 receptor (IGF-1R) in the acquired resistance to tyrosine kinase inhibitors (TKIs). Notably, the overexpression of IGF-1R in NSCLC was downregulated by miR-223, and the activation of Akt/S6, the downstream pathway, was also inhibited. The inhibition of IGF-1R by miR-223 was attenuated by exogenous IGF-1 expression. Therefore, miR-223 may regulate the acquired resistance of PC-9/ER cells to erlotinib by targeting the IGF-1R/Akt/S6 signaling pathway. The overexpression of miR-223 may partially reverse the acquired resistance to epidermal growth factor receptor-TKIs, thus, providing a potential therapeutic strategy for TKI-resistant NSCLC.

In this study, ZrO2/TiO2 nanoparticles were synthesized and loaded upon carbon nanotubes with TiCl4, ZrOCl2 and HNO3, using hydrothermal synthetic method. Prepared particles were then subjected to structural characterization with XRD and TEM. Our XRD results suggest that, in the ZrO2/TiO2-carbon nanotubes complexes, phase transition of TiO2 crystallites occurs from rutile tinania to anatas as the doped ZrO2 content increases. TEM results indicate that, ZrO2/TiO2 particles can be supported homogeneously on the surface of carbon nanotubes only when the complex has 10 % ZrO2, under our experimental conditions.

Cupric oxide nanosheets with uniform thickness less than 20 nm have been prepared by a low-temperature soft solution processing simply using Cu(NO3)(2), NH4Cl and ammonia instead of any toxic and dangerous reagents. The results illustrate that well defined CuO nanosheets can be obtained at 80 degrees C for 1 h with pH of 10. The prepared CuO nanosheets show quite good photocatalytic activity under irradiation of solar simulator lamp. The photocatalytic degradation is strongly dependent on solution pH, and H2O2 is quite favorable for degradation of methyl orange in CuO nanosheets photocatalytic system.

Phase pure anatase TiO2 nanoparticles have been synthesized using a simple sol-hydrothermal method. The products were characterized by X-ray diffraction, Raman spectroscopy, transmission electron microscopy and ultraviolet-visible spectroscopy. The results showed that the TiO2 particles were well-dispersed and the average size was limited in the range of 10 nm. The optical measurement displayed the obvious quantum-size effect of the products.

YVO4 nanoparticles with various morphologies were tuned directly by hydrothermal treatment in different solutions, including pure water, potassium hydroxide solution, hydrazine hydrate, ethanolamine, triethylamine, and pyridine. X-ray diffraction (XRD), Raman, and transmission electron microscopy (TEM) were utilized to characterize the structure, morphology, and size of the products, which indicated that tetragonal phase YVO4 crystallites displaying rod-like, square, and olivary shapes were obtained. It was found that the selected solvents play an important role in modulating the morphology and confining the size of the obtained products.

Uniform and crack-free cupric oxide (CuO) films have been prepared by chemical bath deposition method simply using Cu(NO3)(2) and ammonia. Crystal structure and morphology of the deposited CuO films were characterized by XRD and SEM. The results illustrate that well defined nanostructured CuO thin film with unique morphologies can be deposited onto glass slide substrate at 40-80 degrees C for 1-5 h with pH value ranging from 8.5-10. Unique elliptic sheet-like morphology can be obtained at higher temperature (>= 70 degrees C), while interesting corncob-like nano-structured CuO film can be obtained at lower temperature (<= 60 degrees C). Ammonia is the key parameter to the film deposition. It has much effect on morphology of the obtained film in the range of 2.6-3.0 mL, as well as not on deposition duration.

In this paper, we propose a parallel encryption scheme based on the logistic map in order to meet the dual-core processor. The chaos-based cryptosystem is generated by the logistic map in high-precision floating-point arithmetic. The parallel algorithm is designed with a master/slave communication model with the Message Passing Interface (MPI). The experimental results show that the parallel algorithm provides more enhanced performance against the serial execution of the algorithm.

VIT75 is a 75-kDa melanocyte membrane antigen (Ag) that had been observed, but not identified until now. Its immunopathogenic role in vitiligo remains unknown. In this study, serological proteome analysis based on mass spectrometry was employed to identify VIT75. Three disparate 75-, 60-, and 45-kDa proteins on two-dimensional (2D) gel were, respectively, identified as lamin A, tyrosinase-related protein 1, and melanin-concentrating hormone receptor 1. The latter two proteins are well-known Ags. Immunoreactivity analysis showed that the 75-kDa protein displayed on the 2D gel was recognized by human anti-lamin A IgG. Antibody (Ab) reactivity to lamin A was positive in 28.6% of patients' sera. Only 3.1% healthy sera reacted with the lamin A. A total of 91.7% of the positive sera was from the active non-segmental vitiligo (NSV). The positive rate and mean titer of anti-lamin A Ab are higher for NSV with autoimmune disease than for NSV without autoimmune disease. These data demonstrate that VIT75 is lamin A. To our knowledge, this is a previously unreported vitiligo Ag. Anti-lamin A Ab may be a potential marker of NSV with autoimmune disease. The study indicates that the targets of autoantibodies in vitiligo patients can be revealed by serological proteome analysis.