The simultaneous repair of an Irreducible Diaphragmatic Hernia while carrying out a Cesarean Section

AbstractINTRODUCTIONDiaphragmatic hernia complicating pregnancy rarely occurs while it is frequently misdiagnosed.PRESENTATION OF CASEA pregnant woman who had suffered from recurrent right upper-quadrant abdominal pain for 4 months was hospitalized near full term because the unrelieved abdominal pain was so severe that she couldn’t lie down. Following the emergency caesarean, we found a part of the transverse colon and a part of omentum were trapped in the thorax through a 3cm by 3cm laceration in the patient's diaphragm. We removed all trapped intestine which was about 40cm long and repaired diaphragmatic hernia at the same time.DISCUSSIONRadiography is useful to diagonisis diaphragmatic hernia, but it had little use for pregnant women. An irreducible diaphragmatic hernia represent a surgical emergency irrespective of fetal maturity. In our case, she had her hernia repaired just during caesarean section by laparotomy.CONCLUSIONCareful examination and a timely operation are needed to treat diaphragmatic hernia complicating pregnancy

Transition routes of electrokinetic flow in a divergent microchannel with bending walls

Electrokinetic flow can be generated as a highly coupled phenomenon among velocity field, electric conductivity field and electric field. It can exhibit different responses to AC electric fields in different frequency regimes, according to different instability/receptivity mechanisms. In this investigation, by both flow visualization and single-point laser-induced fluorescence (LIF) method, the response of AC electrokinetic flow and the transition routes towards chaos and turbulence have been experimentally investigated. It is found, when the AC frequency $f_f<30$ Hz, the interface responds at both the neutral frequency of the basic flow and the AC frequency. However, when $f_f>=30$ Hz, the interface responds only at the neutral frequency of the basic flow. Both periodic doubling and subcritical bifurcations have been observed in the transition of AC electrokinetic flow. We hope the current investigation can promote our current understanding on the ultrafast transition process of electrokinetic flow from laminar state to turbulence

Gender-Specific Risk of Central Compartment Lymph Node Metastasis in Papillary Thyroid Carcinoma

Our aim was to evaluate the impact of gender on the predictive factors of central compartment lymph node metastasis (CLNM) in papillary thyroid carcinoma (PTC). A retrospective study of 590 patients treated for PTC was performed. Univariate and multivariate analyses showed that gender (female; P=0.001), age (≥45 y; P<0.001), tumor size (>1 cm; P<0.001), and multifocality (P=0.004) were independent predictive factors of CLNM in PTC patients. Patients were divided into male group (n=152) and female group (n=438). Age (≥45 y; P=0.001), T4 (P=0.006) and multifocality (P=0.024) were independent predictive risk factors of CLNM in male patients. As for female patients, age (≥45 y; P<0.001), tumor size (>1 cm; P<0.001), multifocality (P=0.002), and microcalcification (P=0.027) were independently correlated with CLNM. The sensitivity of the multivariate model for predicting CLNM in male patients was 64.9%, specificity was 82.9%, and area under the ROC curve (AUC) was 0.764. As for female patients, the sensitivity was 55.7%, specificity was 77.9%, and AUC was 0.73. This study showed that the predictive factors of CLNM indeed varied according to gender. To have a more accurate evaluation of CLNM, different predictive systems should be used for male and female patients

Lymphoma endothelium preferentially expresses Tim-3 and facilitates the progression of lymphoma by mediating immune evasion

Angiogenesis is increasingly recognized as an important prognosticator associated with the progression of lymphoma and as an attractive target for novel modalities. We report a previously unrecognized mechanism by which lymphoma endothelium facilitates the growth and dissemination of lymphoma by interacting with circulated T cells and suppresses the activation of CD4+ T cells. Global gene expression profiles of microdissected endothelium from lymphoma and reactive lymph nodes revealed that T cell immunoglobulin and mucin domain–containing molecule 3 (Tim-3) was preferentially expressed in lymphoma-derived endothelial cells (ECs). Clinically, the level of Tim-3 in B cell lymphoma endothelium was closely correlated to both dissemination and poor prognosis. In vitro, Tim-3+ ECs modulated T cell response to lymphoma surrogate antigens by suppressing activation of CD4+ T lymphocytes through the activation of the interleukin-6–STAT3 pathway, inhibiting Th1 polarization, and providing protective immunity. In a lymphoma mouse model, Tim-3–expressing ECs promoted the onset, growth, and dissemination of lymphoma by inhibiting activation of CD4+ T cells and Th1 polarization. Our findings strongly argue that the lymphoma endothelium is not only a vessel system but also a functional barrier facilitating the establishment of lymphoma immune tolerance. These findings highlight a novel molecular mechanism that is a potential target for enhancing the efficacy of tumor immunotherapy and controlling metastatic diseases

MEIS2C and MEIS2D promote tumor progression via Wnt/β-catenin and hippo/YAP signaling in hepatocellular carcinoma

Abstract Background MEIS2 has been identified as one of the key transcription factors in the gene regulatory network in the development and pathogenesis of human cancers. Our study aims to identify the regulatory mechanisms of MEIS2 in hepatocellular carcinoma (HCC), which could be targeted to develop new therapeutic strategies. Methods The variation of MEIS2 levels were assayed in a cohort of HCC patients. The proliferation, clone-formation, migration, and invasion abilities of HCC cells were measured to analyze the effects of MEIS2C and MEIS2D (MEIS2C/D) knockdown with small hairpin RNAs in vitro and in vivo. Chromatin immunoprecipitation (ChIP) was performed to identify MEIS2 binding site. Immunoprecipitation and immunofluorescence assays were employed to detect proteins regulated by MEIS2. Results The expression of MEIS2C/D was increased in the HCC specimens when compared with the adjacent noncancerous liver (ANL) tissues. Moreover, MEIS2C/D expression negatively correlated with the prognosis of HCC patients. On the other hand, knockdown of MEIS2C/D could inhibit proliferation and diminish migration and invasion of hepatoma cells in vitro and in vivo. Mechanistically, MESI2C activated Wnt/β-catenin pathway in cooperation with Parafibromin (CDC73), while MEIS2D suppressed Hippo pathway by promoting YAP nuclear translocation via miR-1307-3p/LATS1 axis. Notably, CDC73 could directly either interact with MEIS2C/β-catenin or MEIS2D/YAP complex, depending on its tyrosine-phosphorylation status. Conclusions Our studies indicate that MEISC/D promote HCC development via Wnt/β-catenin and Hippo/YAP signaling pathways, highlighting the complex molecular network of MEIS2C/D in HCC pathogenesis. These results suggest that MEISC/D may serve as a potential novel therapeutic target for HCC.https://deepblue.lib.umich.edu/bitstream/2027.42/152244/1/13046_2019_Article_1417.pd

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Research and practice on the training mode of the core competence about the application-oriented electrical information engineering undergraduate

Nowadays, the method of cultivating talents in colleges and universities is out of line with the social demand on the training goal of electrical information talents in local application-oriented colleges and universities. To solve this problem, this paper put forward the concept of “five view” about the engineering education (practice) and the engineering core competence, systematically solved the key problems such as the training mode of application-oriented undergraduate, positioning, teaching system, training methods, evaluation methods and criteria, thus making that the application-oriented undergraduate students can meet the needs and target of enterprise after graduation

An epidemiological survey of alcoholic liver disease among staff of Yanchang Oilfield

ObjectiveTo investigate the prevalence of alcoholic liver disease (ALD) among the staff of Yanchang Oilfield and related risk factors. MethodsThe physical examination data were collected from the staff of Yanchang Oilfield in June 2016, and all the staff underwent anthropometric measurement (body height, body weight, and blood pressure), laboratory examinations (routine blood test, liver function, blood lipids, blood glucose, and viral markers), and upper abdominal ultrasound and completed the questionnaire. The chi-square test was used for comparison of categorical data between groups, and logistic regression was used for multivariate analysis. ResultsA total of 6723 employees participated in the study, among whom 397 had ALD, and the prevalence rate of ALD was 5.91%. Compared with female staff, male staff had significantly higher drinking rate (65.07% vs 15.75%, χ2=1107.48, P＜0.001) and prevalence rate of ALD (720% vs 1.11%, χ2=75.34, P＜0.001). Male population was the major group for alcohol consumption. There was a significant difference in the prevalence rate of ALD between the staff with different degrees of education (χ2=86.598, P＜0.001). The obese group had a significantly higher prevalence rate of ALD than the non-obese group (17.70% vs 9.27%, χ2=40.698, P＜0.001). With the increases in drinking volume and drinking years, the prevalence rate of ALD gradually increased, and there was a significant difference in the prevalence rate of ALD between the staff with different daily drinking volumes and drinking years (χ2=1147.428 and 116.542, both P＜0001). With the increase in daily drinking volume, the abnormal rates of gamma-glutamyl transpeptidase (GGT), alanine aminotransferase, and aspartate aminotransferase (AST) gradually increased (χ2=250.013, 199.027, and 151.459, all P＜0.001); with the increase in drinking years, the abnormal rates of GGT and AST gradually increased, with a significant increase in the abnormal rate of GGT (χ2=27.158, P＜0.001). There were significant differences between the drinking group and the control group in the abnormal rates of liver function, blood pressure, blood lipids, body mass index, and mean corpuscular volume (χ2=51.272, 9.988, 316.430, 80.675, and 13.570, all P＜0.05). The multivariate analysis showed that age, male sex, obesity, daily drinking volume, drinking pattern, degree of education, GGT, AST, and mean corpuscular volume were closely associated with the development of ALD (all P＜0.05). ConclusionThere is a high prevalence rate of ALD among the staff of Yanchang Oilfield. Sex, age, degree of education, drinking volume, drinking pattern, and obesity are major influencing factors for ALD in adults in this region