BACKGROUND:Hepatic hypoxia-inducible factor-1(HIF-1) is activated in the progression of hepatocellular carcinoma (HCC).This study aimed to investigate the dynamic alterations of HIF-1αand its gene expression so as to...BACKGROUND:Hepatic hypoxia-inducible factor-1(HIF-1) is activated in the progression of hepatocellular carcinoma (HCC).This study aimed to investigate the dynamic alterations of HIF-1αand its gene expression so as to explore the relationship between HIF-1αexpression and hepatocarcinogenesis at the early stage of HCC. METHODS:A hepatoma model was made with 2-fluorenyl- acetamide(2-FAA)in male Sprague-Dawley rats.Morphological changes of rat hepatocytes were assessed pathologically (HE staining).The dynamic expression of hepatic and circulating HIF-1αwas quantitatively analyzed by ELISA. The gene fragments of hepatic HIF-1αmRNA were amplified by RT-PCR and confirmed by sequencing.The cellular distribution of hepatic HIF-1αexpression was confirmed by immunohistochemistry. RESULTS:Histological examination confirmed granulelike degeneration to atypical hyperplasia and HCC development in rat hepatocytes and progressive increases in the levels of hepatic and circulating HIF-1αand its gene expression during the course.The levels of HIF-1α expression in the liver and blood of rats with hepatoma were significantly higher than those in normal ratsand those with degeneration.Immunohistochemical analysis confirmed the positive expression and hepatocyte distribution of HIF-1αin the development of rat hepatoma. A positive relationship was found between HIF-1α expression in the liver and blood(P<0.01). CONCLUSIONS:The above observations support the hypothesis that the overexpression of HIF-1αand its gene are closely associated with the malignant transformation of hepatocytes and play an important role at the stage of hepatocarcinogenesis.展开更多
The aim of this study was to explore the neuroprotective effect and mechanism of XingNaoJing injections(XNJ) on cerebral ischemia injury and blood-brain barrier(BBB) disruption. Middle cerebral artery occlusion(MCAO) ...The aim of this study was to explore the neuroprotective effect and mechanism of XingNaoJing injections(XNJ) on cerebral ischemia injury and blood-brain barrier(BBB) disruption. Middle cerebral artery occlusion(MCAO) method was applicated to establish the model of cerebral ischemia/reperfusion(I/R) injury in rats. BBB permeability after I/R injury was assessed with the leaking amount of Evans Blue and the expression of occludin and ZO-1. The expression of NOD-like receptor family, pyrin domain containing(NLRP3) was checked to explore the inhibition of inflammation by XNJ. The results showed that XNJ could significantly increase the survival percent, decrease the infarct area and ameliorate neurological deficits and brain damage after I/R injury. Leaking amount of Evans Blue was reduced by XNJ, and the expression of tight junction protein, occludin and ZO-1 was also up-regulated by XNJ, which showed a role of protection on BBB disruption. The expression of NLRP3 was inhibited after exposure of XNJ, which was associated with inhibition of the inflammatory response. In summary, XNJ could suppress NLRP3 inflammasomes and improve BBB disruption and brain damage in rats after cerebral I/R injury, which provided a beneficial insight to further explore XNJ.展开更多
AIM： To investigate the damaging effect of high-intensity focused ultrasound （HIFU） on cancer cells and the inhibitory effect on tumor growth. METHODS： Hurine H22 hepatic cancer cells were treated with HIFU at the...AIM： To investigate the damaging effect of high-intensity focused ultrasound （HIFU） on cancer cells and the inhibitory effect on tumor growth. METHODS： Hurine H22 hepatic cancer cells were treated with HIFU at the same intensity for different lengths of time and at different intensities for the same length oftime in vitro, the dead cancer cells were determined by trypan blue staining. Two groups of cancer cells treated with HIFU at the lowest and highest intensity were inoculated into mice. Tumor masses were removed and weighed after 2 wk, tumor growth in each group was confirmed pathologically.RESULTS： The death rate of cancer cells treated with HIFU at 1 000 W/cm^2 for 0.5, 1, 2, 4, 8, and 12 s was 3.11±1.21%, 13.37±2.56%, 38.84±3.68%, 47.22±5.76%,87.55±7.32%, and 94.33±8.11%, respectively. A positive relationship between the death rates of cancer cells and the length of HIFU treatment time was found （r = 0.96,P〈0.01）. The death rate of cancer cells treated with HIFU at the intensity of 100, 200, 400, 600, 800, and 1 000 W/cm^2 for 8 s was 26.31±3.26%, 31.00±3.87%, 41.97±5.86%,72.23±8.12%, 94.90±8.67%, and 99.30±9.18%, respectively. A positive relationship between the death rates of cancer cells and the intensities of HIFU treatment was confirmed （r= 0.98, P〈0.01）. The cancer cells treated with HIFU at 1 000 W/cm^2 for 8 s were inoculated intomice ed into. The tumor inhibitory rate was 90.35% compared to the control （P〈0.01）. In the experimental group inoculated with the cancer cells treated with HIFU at 1 000 W/cm^2 for 0.5 s, the tumor inhibitory rate was 22.9% （P〈0.01）. By pathological examination, tumor growth was confirmed in 8 out of 14 mice （57.14%, 8/14） inoculated with the cancer cells treated with HIFU at 1 000 W/cm^2 for 8 s, which was significantly lower than that in the control （100%, 15/15, P〈O.05）.CONCLUSION： HIFU is effective on killing or damage of H22 hepatic cancer cells in vitro and on inhibiting tumor growth in mice ex vivo.展开更多
Litchi(Litchi chinensis Sonn.)and longan(Dimocarpus longan Lour.)fruits have a succulent and white aril with a brown seed and are becoming popular worldwide.The two fruits have been used in traditional Chinese medicin...Litchi(Litchi chinensis Sonn.)and longan(Dimocarpus longan Lour.)fruits have a succulent and white aril with a brown seed and are becoming popular worldwide.The two fruits have been used in traditional Chinese medicine as popular herbs in the treatment of neural pain,swelling,and cardiovascular disease.The pericarp and seed portions as the by-products of litchi and longan fruits are estimated to be approximately 30%of the dry weight of the whole fruit and are rich in bioactive constituents.In the recent years,many biological activities,such as tyrosinase inhibitory,antioxidant,anti-inflammatory,immunomodulatory,anti-glycated,and anti-cancer activities,as well as memory-increasing effects,have been reported for the litchi and longan pericarp and seed extracts,indicating a potentially significant contribution to human health.With the increasing production of litchi and longan fruits,enhanced utilization of the two fruit by-products for their inherent bioactive constituents in relation to pharmacological effects is urgently needed.This paper reviews the current advances in the extraction,processing,identification,and biological and pharmacological activities of constituents from litchi and longan by-products.Potential utilization of litchi and longan pericarps and seeds in relation to further research is also discussed.展开更多
BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors. We analyzed the expression of miclear-transcription factor-kappa B (NF-kappa B) during hepatocarcinogenesis in order to evaluate i...BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors. We analyzed the expression of miclear-transcription factor-kappa B (NF-kappa B) during hepatocarcinogenesis in order to evaluate its dynamic expression and its clinical value in the development and diagnosis of HCC. METHODS: Hepatoma models were induced by oral administration of 2-acetamidoflurene (2-FAA) to male Sprague-Dawley rats. Morphological changes were observed after hematoxylin and eosin staining. The cellular distribution of NF-kappa B expression during different stages of cancer development was investigated by immunohistochemistry, and the level of NF-kappa B expression in liver tissues was quantitatively analyzed by ELISA. The gene fragments of hepatic NF-kappa B were amplified by nested-polymerase chain reaction assay. RESULTS: Hepatocytes showed vacuole-like degeneration during the early stages, then had a hyperplastic nodal appearance during the middle stages, and finally progressed to tubercles of cancerous nests with high differentiation. The NF-kappa B-positive material was buff-colored, fine particles localized in the nucleus, and the incidence of NF-kappa B-positive cells was 81.8% in degeneration, 83.3% in precancerous lesions, and 100% in cancerous tissues. All of these values were higher than those in controls (P<0.01). Hepatic NF-kappa B expression and hepatic NF-kappa B-mRNA were also higher during the course of HCC development (P<0.01). CONCLUSION: The NF-kappa B signal transduction pathway is activated during the early stages of HCC development, and its abnormal expression may be associated with the occurrence of HCC.展开更多
Land evaluation factors often contain continuous-, discrete- and nominal-valued attributes. In traditional land evaluation, these different attributes are usually graded into categorical indexes by land resource exper...Land evaluation factors often contain continuous-, discrete- and nominal-valued attributes. In traditional land evaluation, these different attributes are usually graded into categorical indexes by land resource experts, and the evaluation results rely heavily on experts＇ experiences. In order to overcome the shortcoming, we presented a fuzzy neural network ensemble method that did not require grading the evaluation factors into categorical indexes and could evaluate land resources by using the three kinds of attribute values directly. A fuzzy back propagation neural network （BPNN）, a fuzzy radial basis function neural network （RBFNN）, a fuzzy BPNN ensemble, and a fuzzy RBFNN ensemble were used to evaluate the land resources in Guangdong Province. The evaluation results by using the fuzzy BPNN ensemble and the fuzzy RBFNN ensemble were much better than those by using the single fuzzy BPNN and the single fuzzy RBFNN, and the error rate of the single fuzzy RBFNN or fuzzy RBFNN ensemble was lower than that of the single fuzzy BPNN or fuzzy BPNN ensemble, respectively. By using the fuzzy neural network ensembles, the validity of land resource evaluation was improved and reliance on land evaluators＇ experiences was considerably reduced.展开更多
Based on field observation,core description and well logging analysis,the tectonic-sedimentary framework of the Liangshan and Qixia Formations in the northwestern Sichuan Basin,China is deeply discussed.Two long-term ...Based on field observation,core description and well logging analysis,the tectonic-sedimentary framework of the Liangshan and Qixia Formations in the northwestern Sichuan Basin,China is deeply discussed.Two long-term sequence cycles were identified,denoted as LSC1 and LSC2,respectively.The sequence stratigraphic framework was established,suggesting the Liangshan Formation to be not isochronously deposited.Paleogeomorphy before deposition of LSC1 was reconstructed by the impression method.LSC1 was featured by thin,low-energy shoal deposits in the high topography,and thick inter-shoal sea and open sea deposits in the low topography.Meanwhile,paleogeomorphy before deposition of LSC2 was reconstructed using the residual thickness method,which was demonstrated to have primary high-energy,thick shoal deposits in the high topography,and thin inter-shoal and open sea deposits in the low topography.The results show that differential tectonic subsidence has already taken place during the Qixia Period,and thus the Dongwu Movement should occur earlier than previously expected.Meanwhile,pre-depositional paleogeomorphy has obvious controlling effects on the sequence stratigraphic filling and sedimentary facies distribution.Results of this study were expected to provide practical guidance to fine characterization of the sedimentary evolution process and prediction of high-quality reservoir distribution.展开更多
Vehicle emission has been the major source of air pollution in urban areas in the past two decades. This article proposes an artificial neural network model for identifying the taxi gross emitters based on the remote ...Vehicle emission has been the major source of air pollution in urban areas in the past two decades. This article proposes an artificial neural network model for identifying the taxi gross emitters based on the remote sensing data. After carrying out the field test in Guangzhou and analyzing various factors from the emission data, the artificial neural network modeling was proved to be an advisable method of identifying the gross emitters. On the basis of the principal component analysis and the selection of algorithm and architecture, the Back-Propagation neural network model with 8-17-1 architecture was established as the optimal approach for this purpose. It gave a percentage of hits of 93%. Our previous research result and the result from aggression analysis were compared, and they provided respectively the percentage of hits of 81.63% and 75%. This comparison demonstrates the potentiality and validity of the proposed method in the identification of taxi gross emitters.展开更多
Background:Clinical remission is the treatment target in rheumatoid arthritis (RA).This study aimed to investigate clinical remission and related factors in a large cohort of patients with RA.Methods:This study compos...Background:Clinical remission is the treatment target in rheumatoid arthritis (RA).This study aimed to investigate clinical remission and related factors in a large cohort of patients with RA.Methods:This study composed of 342 patients with RA.Data were collected by face-to-face interview of 1049 patients with RA who visited the Department of Rheumatology of three teaching hospitals from September 2015 to May 2016.The patients with RA were clinically assessed by rheumatologists and a four-page questionnaire was completed on site.Subsequently,patients fulfilled remission criteria were further analyzed.The practicability of different definitions of remission of RA was rated by a panel of rheumatologists.Sustained intensive disease modifying anti-rheumatic drug (DMARD) treatment was defined as a combination treatment with two or more DMARDs for at least 6 months.Results:In this cohort of 342 patients with RA,the proportions of patients achieving remission were 38.0%,29.5%,24.9%,21.1%,19.0%,18.1%,and 17.0%,based on criteria of disease activity score in 28 joints (DAS28) using CRP (DAS28-CRP),DAS28 using ESR (DAS28-ESR),routine assessment of patient index data 3 (RAPID-3),Boolean,simplified disease activity index (SDAI),clinical disease activity index,and the newly described clinical deep remission (CliDR),respectively.Boolean and CliDR are the best in practicability scored by rheumatologists (7.5 and 8.0,respectively).Compared with the non-sustained intensive group,sustained intensive treatment with DMARDs yielded higher remission rates of 25.6%,23.8%,and 21.3% in patients with RA based on Boolean (χ^2=3.937,P=0.047),SDAI (χ^2=4.666,P=0.031),and CliDR criteria (χ^2=4.297,P=0.038).The most commonly prescribed conventional synthesized DMARDs (csDMARDs) in patients with RA was leflunomide,followed by methotrexate,and hydroxychloroquine.Compared with the non-remission group,patients achieving remission had a longer median duration of DMARDs (45.0 [22.8–72.3] months,Z=-2.295,P=0.022).Conclusions:The findings in this 展开更多
In order to investigate the effect of the pore air flow in the soil slope stability analysis, a water-air two-phase flow model, based on the multi-phase flow theory, is proposed and with the model, the water-phase and...In order to investigate the effect of the pore air flow in the soil slope stability analysis, a water-air two-phase flow model, based on the multi-phase flow theory, is proposed and with the model, the water-phase and air-phase seepages of the soil slope in the stable seepage and rainfall situations are simulated. The soil slope safety coefficients are obtained according to the simulated pore air pressure and pore water pressure. The calculation results show that in the stable seepage situation, the influence of the pore air pressure on the soil slope stability can be neglected, while in the rainfall situation, the pore air pressure generated in the unsaturated zone will reduce the safety coefficient, and the larger the distance between the slip surface and the underground water level is, the greater the influence of the pore air pressure on the soil slope stability will be.展开更多
BACKGROUND Tracheobronchial tuberculosis(TBTB)is a common subtype of pulmonary tuberculosis.Concomitant diseases often obscure the diagnosis of senile TBTB.AIM To characterize senile patients with TBTB and to identify...BACKGROUND Tracheobronchial tuberculosis(TBTB)is a common subtype of pulmonary tuberculosis.Concomitant diseases often obscure the diagnosis of senile TBTB.AIM To characterize senile patients with TBTB and to identify the potential causes of misdiagnosis.METHODS One hundred twenty patients with senile TBTB who were admitted to the Anhui Chest hospital between May 2017 and May 2019 were retrospectively analyzed.Patients were classified as diagnosed group(n=58)and misdiagnosed group(n=62).Clinical manifestations,laboratory results,radiographic data,and endoscopic findings were compared between the two groups.RESULTS Patients in the misdiagnosed group were most commonly diagnosed as pulmonary tuberculosis(non-TBTB,29/62,46.8%),general pneumonia(9/62,14.5%),chronic obstructive pulmonary disease(8/62,12.9%),and tracheobronchial carcinoma(7/62,11.3%).The time elapsed between disease onset and confirmation of diagnosis was significantly longer in the misdiagnosed group[median(first quartile,third quartile):6.32(4.94,16.02)mo vs 3.73(2.37,8.52)mo].The misdiagnosed group had lower proportion of patients who underwent bronchoscopy[33.87%(21/62)vs 87.93%(51/58)],chest computed tomography(CT)scan[69.35%(43/62)vs 98.28%(57/58)],and those who showed CT signs of tuberculosis[27.91%(12/62)vs 50%(29/58)]as compared to that in the diagnosed group(P<0.05).There were no significant between-group differences with respect to age,gender,occupation,clinical manifestations,or prevalence of comorbid chronic diseases(P>0.05).CONCLUSION Insufficient or inaccurate radiographic or bronchoscopic assessment was the predominant cause of delayed diagnosis of TBTB.Increased implementation and better interpretation of CT scan and early implementation of bronchoscopy can help reduce misdiagnosis of senile TBTB.展开更多
BACKGROUND There is currently a shortage of accurate,efficient,and precise predictive instruments for rectal neuroendocrine neoplasms(NENs).AIM To develop a predictive model for individuals with rectal NENs(R-NENs)usi...BACKGROUND There is currently a shortage of accurate,efficient,and precise predictive instruments for rectal neuroendocrine neoplasms(NENs).AIM To develop a predictive model for individuals with rectal NENs(R-NENs)using data from a large cohort.METHODS Data from patients with primary R-NENs were retrospectively collected from 17 large-scale referral medical centers in China.Random forest and Cox proportional hazard models were used to identify the risk factors for overall survival and progression-free survival,and two nomograms were constructed.RESULTS A total of 1408 patients with R-NENs were included.Tumor grade,T stage,tumor size,age,and a prognostic nutritional index were important risk factors for prognosis.The GATIS score was calculated based on these five indicators.For overall survival prediction,the respective C-indexes in the training set were 0.915(95%confidence interval:0.866-0.964)for overall survival prediction and 0.908(95%confidence interval:0.872-0.944)for progression-free survival prediction.According to decision curve analysis,net benefit of the GATIS score was higher than that of a single factor.The time-dependent area under the receiver operating characteristic curve showed that the predictive power of the GATIS score was higher than that of the TNM stage and pathological grade at all time periods.CONCLUSION The GATIS score had a good predictive effect on the prognosis of patients with R-NENs,with efficacy superior to that of the World Health Organization grade and TNM stage.展开更多
Plants that grow in extreme environments represent unique sources of stress-resistance genes and mechanisms.Ammopiptanthus mongolicus(Leguminosae)is a xerophytic evergreen broadleaf shrub native to semi-arid and deser...Plants that grow in extreme environments represent unique sources of stress-resistance genes and mechanisms.Ammopiptanthus mongolicus(Leguminosae)is a xerophytic evergreen broadleaf shrub native to semi-arid and desert regions;however,its drought-tolerance mechanisms remain poorly understood.Here,we report the assembly of a reference-grade genome for A.mongolicus,describe its evolutionary history within the legume family,and examine its drought-tolerance mechanisms.The assembled genome is 843.07 Mb in length,with 98.7%of the sequences successfully anchored to the nine chromosomes of A.mongolicus.The genome is predicted to contain 47611 protein-coding genes,and 70.71%of the genome is composed of repetitive sequences;these are dominated by transposable elements,particularly longterminal-repeat retrotransposons.Evolutionary analyses revealed two whole-genome duplication(WGD)events at 130 and 58 million years ago(mya)that are shared by the genus Ammopiptanthus and other legumes,but no species-specific WGDs were found within this genus.Ancestral genome reconstruction revealed that the A.mongolicus genome has undergone fewer rearrangements than other genomes in the legume family,confirming its status as a"relict plant".Transcriptomic analyses demonstrated that genes involved in cuticular wax biosynthesis and transport are highly expressed,both under normal conditions and in response to polyethylene glycol-induced dehydration.Significant induction of genes related to ethylene biosynthesis and signaling was also observed in leaves under dehydration stress,suggesting that enhanced ethylene response and formation of thick waxy cuticles are two major mechanisms of drought tolerance in A.mongolicus.Ectopic expression of AmERF2,an ethylene response factor unique to A.mongolicus,can markedly increase the drought tolerance of transgenic Arabidopsis thaliana plants,demonstrating the potential for application of A.mongolicus genes in crop improvement.展开更多
BACKGROUND The necessity of additional gastrectomy for early gastric cancer (EGC) patients who do not meet curative criteria after endoscopic submucosal dissection (ESD) is controversial. AIM To examine the clinicopat...BACKGROUND The necessity of additional gastrectomy for early gastric cancer (EGC) patients who do not meet curative criteria after endoscopic submucosal dissection (ESD) is controversial. AIM To examine the clinicopathologic characteristics of patients who underwent additional laparoscopic gastrectomy after ESD and to determine the appropriate strategy for treating those after noncurative ESD. METHODS We retrospectively studied 45 patients with EGC who underwent additional laparoscopic gastrectomy after noncurative ESD from January 2013 to January 2019 at the Cancer Hospital of the Chinese Academy of Medical Sciences. We analyzed the patients’ clinicopathological data and identified the predictors of residual cancer (RC) and lymph node metastasis (LNM). RESULTS Surgical specimens showed RC in ten (22.2%) patients and LNM in five (11.1%).Multivariate analysis revealed that positive horizontal margin [odds ratio (OR)=13.393, 95% confidence interval (CI): 1.435-125, P=0.023] and neural invasion (OR=14.714, 95%CI: 1.087-199, P=0.043) were independent risk factors for RC. Undifferentiated type was an independent risk factor for LNM (OR=12.000, 95%CI: 1.197-120, P=0.035). Tumors in all patients with LNM showed submucosal invasion more than 500 μm. Postoperative complications after additional laparoscopic gastrectomy occurred in five (11.1%) patients, and no deaths occurred among patients with complications. CONCLUSION Gastrectomy is necessary not only for patients who have a positive margin after ESD, but also for cases with neural invasion, undifferentiated type, and submucosal invasion more than 500 μm. Laparoscopic gastrectomy is a safe, minimally invasive, and feasible procedure for additional surgery after noncurative ESD. However, further studies are needed to apply these results to clinical practice.展开更多
BACKGROUND The prognosis of hepatocellular carcinoma(HCC)remains poor and relapse occurs in more than half of patients within 2 years after hepatectomy.In terms of recent studies,microvascular invasion(MVI)is one of t...BACKGROUND The prognosis of hepatocellular carcinoma(HCC)remains poor and relapse occurs in more than half of patients within 2 years after hepatectomy.In terms of recent studies,microvascular invasion(MVI)is one of the potential predictors of recurrence.Accurate preoperative prediction of MVI is potentially beneficial to the optimization of treatment planning.AIM To develop a radiomic analysis model based on pre-operative magnetic resonance imaging(MRI)data to predict MVI in HCC.METHODS A total of 113 patients recruited to this study have been diagnosed as having HCC with histological confirmation,among whom 73 were found to have MVI and 40 were not.All the patients received preoperative examination by Gd-enhanced MRI and then curative hepatectomy.We manually delineated the tumor lesion on the largest cross-sectional area of the tumor and the adjacent two images on MRI,namely,the regions of interest.Quantitative analyses included most discriminant factors(MDFs)developed using linear discriminant analysis algorithm and histogram analysis with MaZda software.Independent significant variables of clinical and radiological features and MDFs for the prediction of MVI were estimated and a discriminant model was established by univariate and multivariate logistic regression analysis.Prediction ability of the above-mentioned parameters or model was then evaluated by receiver operating characteristic(ROC)curve analysis.Five-fold cross-validation was also applied via R software.RESULTS The area under the ROC curve(AUC)of the MDF(0.77-0.85)outperformed that of histogram parameters(0.51-0.74).After multivariate analysis,MDF values of the arterial and portal venous phase,and peritumoral hypointensity in the hepatobiliary phase were identified to be independent predictors of MVI(P<0.05).The AUC value of the model was 0.939[95%confidence interval(CI):0.893-0.984,standard error:0.023].The result of internal five-fold cross-validation(AUC:0.912,95%CI:0.841-0.959,standard error:0.0298)also showed favorable predictive efficacy.CONC展开更多
BACKGROUND Management of chronic refractory wounds is one of the toughest clinical challenges for surgeons.Because of poor blood supply,less tissue coverage,and easy exposure,the lower leg is a common site for chronic...BACKGROUND Management of chronic refractory wounds is one of the toughest clinical challenges for surgeons.Because of poor blood supply,less tissue coverage,and easy exposure,the lower leg is a common site for chronic refractory wounds.The current therapeutic regimens often lead to prolonged hospital stay and higher healthcare costs.Concentrated growth factor(CGF)is a novel blood extract that contains various growth factors,platelets,and fibrins to promote wound healing process.However,there has been little research reported on the treatment of lower extremity wounds with CGF.CASE SUMMARY A 37-year-old man,without any past medical history,presented an ulcerated chronic wound on his right lower leg.The skin defect exhibited clear boundaries,with a size of 2.0 cm×3.5 cm.The depth of wound was up to the layer of deep fascia.Staphylococcus aureus was detected by bacterial culture.The final diagnosis was right lower extremity ulcers with infection.Cefathiamidine,silver sulfadiazine,and mupirocin cream were applied to control the infection.CGF gel was prepared from the patient’s blood sample,and was used to cover the wound after thorough debridement.The skin wound was successfully healed after three times of CGF treatment.CONCLUSION CGF displays an excellent wound healing promoting effect in patients with lowerextremity chronic refractory wounds.展开更多
AIM:To investigate osteopontin expression and its association with hepatopathologic changes in BALB/C mice infected with Schistosoma japonicum.METHODS:The schistosomal hepatopathologic mouse model was established by a...AIM:To investigate osteopontin expression and its association with hepatopathologic changes in BALB/C mice infected with Schistosoma japonicum.METHODS:The schistosomal hepatopathologic mouse model was established by abdominal infection with schistosomal cercaria.Liver samples were obtained from mice sacrif iced at 6,8,10,14,and 18 wk after in-fection.Liver histopathological changes were observed with hematoxylin-eosin and Masson trichrome staining.The expression of osteopontin was determined with im-munohistochemistry,reverse transcription-polymerase chain reaction,and Western blotting.The expressionof α-smooth muscle actin(α-SMA)and transforming growth factor-β1(TGF-β1)were determined by im-munohistochemistry.Correlations of osteopontin ex-pression with other variables(α-SMA,TGF-β1,hepato-pathologic features including granuloma formation and degree of liver f ibrosis)were analyzed.RESULTS:Typical schistosomal hepatopathologic changes were induced in the animals.Dynamic changes in the expression of osteopontin were observed at week 6.The expression increased,peaked at week 10(P<0.01),and then gradually decreased.Positive correla-tions between osteopontin expression and α-SMA(r=0.720,P<0.01),TGF-β1(r=0.905,P <0.01),granu-loma formation(r=0.875,P<0.01),and degree of liver f ibrosis(r=0.858,P<0.01)were also observed.CONCLUSION:Osteopontin may play an important role in schistosomal hepatopathology and may promote granuloma formation and liver fi brosis through an un-explored mechanism.展开更多
Objective： To comparatively analyze the medical records of patients with limb fractures as well as rescue strategy in Wenchuan and Yushu earthquakes so as to provide references for post-earthquake rescue. Methods： ...Objective： To comparatively analyze the medical records of patients with limb fractures as well as rescue strategy in Wenchuan and Yushu earthquakes so as to provide references for post-earthquake rescue. Methods： We retrospectively investigated 944 patients sustaining limb fractures, including 891 in Wenchuan earthquake and 53 in Yushu earthquake, who were admitted to West China Hospital （WCH） of Sichuan University. Results： In Wenchuan earthquake, WCH met its three peaks of limb fracture patients influx, on post-earthquake day （PED） 2, 8 and 14 respectively. Between PED 3-14, 585 patients were transferred from WCH to other hospitals out- side the Sichuan Province. In Yushu earthquake, the maxi- mum influx of limb fracture patients happened on PED 3, and no one was shifted to other hospitals. Both in Wenchuan and Yushu earthquakes, most limb fractures were caused by blunt strike and crush/burying. In Wenchuan earthquake, there were 396 （396/942, 42.0%） open limb fractures, includ- ing 28 Gustilo I, 201 Gustilo II and 167 Gustilo III injuries. But in Yushu earthquake, the incidence of open limb fracture was much lower （6/61, 9.8%）. The percent of patients with acute complications in Wenchuan earthquake （167/891,18.7%） was much higher than that in Yushu earthquake （5/53, 3.8%）. In Wenchuan earthquake rescue, 1 018 surgeries were done, composed of debridement in 376, internal fixation in 283, external fixation in 119, and vacuum sealing drainage in 117, etc. While among the 64 surgeries in Yushu earthquake rescue, the internal fixation for limb fracture was mostly adopted. All patients received proper treatment and sur- vived except one who died due to multiple organs failure in Wenchuan earthquake. Conclusion： Provision of suitable and sufficient medi- cal care in a catastrophe can only be achieved by construc- tion of sophisticated national disaster medical system, pre- diction of the injury types and number of injuries, and con- flrmation of participating hospitals＇ exact rol展开更多
基金supported by grants-in-aid from the 333 Project(No.2007099)Project of the Health Department,Jiangsu Province,China(H200523)
文摘BACKGROUND:Hepatic hypoxia-inducible factor-1(HIF-1) is activated in the progression of hepatocellular carcinoma (HCC).This study aimed to investigate the dynamic alterations of HIF-1αand its gene expression so as to explore the relationship between HIF-1αexpression and hepatocarcinogenesis at the early stage of HCC. METHODS:A hepatoma model was made with 2-fluorenyl- acetamide(2-FAA)in male Sprague-Dawley rats.Morphological changes of rat hepatocytes were assessed pathologically (HE staining).The dynamic expression of hepatic and circulating HIF-1αwas quantitatively analyzed by ELISA. The gene fragments of hepatic HIF-1αmRNA were amplified by RT-PCR and confirmed by sequencing.The cellular distribution of hepatic HIF-1αexpression was confirmed by immunohistochemistry. RESULTS:Histological examination confirmed granulelike degeneration to atypical hyperplasia and HCC development in rat hepatocytes and progressive increases in the levels of hepatic and circulating HIF-1αand its gene expression during the course.The levels of HIF-1α expression in the liver and blood of rats with hepatoma were significantly higher than those in normal ratsand those with degeneration.Immunohistochemical analysis confirmed the positive expression and hepatocyte distribution of HIF-1αin the development of rat hepatoma. A positive relationship was found between HIF-1α expression in the liver and blood(P<0.01). CONCLUSIONS:The above observations support the hypothesis that the overexpression of HIF-1αand its gene are closely associated with the malignant transformation of hepatocytes and play an important role at the stage of hepatocarcinogenesis.
基金surported by the National Natural Science Foundation of China(No.81803608)the Administration of Traditional Chinese Medicine of Jilin Province,China(No.2019133)
文摘The aim of this study was to explore the neuroprotective effect and mechanism of XingNaoJing injections(XNJ) on cerebral ischemia injury and blood-brain barrier(BBB) disruption. Middle cerebral artery occlusion(MCAO) method was applicated to establish the model of cerebral ischemia/reperfusion(I/R) injury in rats. BBB permeability after I/R injury was assessed with the leaking amount of Evans Blue and the expression of occludin and ZO-1. The expression of NOD-like receptor family, pyrin domain containing(NLRP3) was checked to explore the inhibition of inflammation by XNJ. The results showed that XNJ could significantly increase the survival percent, decrease the infarct area and ameliorate neurological deficits and brain damage after I/R injury. Leaking amount of Evans Blue was reduced by XNJ, and the expression of tight junction protein, occludin and ZO-1 was also up-regulated by XNJ, which showed a role of protection on BBB disruption. The expression of NLRP3 was inhibited after exposure of XNJ, which was associated with inhibition of the inflammatory response. In summary, XNJ could suppress NLRP3 inflammasomes and improve BBB disruption and brain damage in rats after cerebral I/R injury, which provided a beneficial insight to further explore XNJ.
基金Supported by the Grant from National Economic Trade Committee, No. 2000-312-2
文摘AIM： To investigate the damaging effect of high-intensity focused ultrasound （HIFU） on cancer cells and the inhibitory effect on tumor growth. METHODS： Hurine H22 hepatic cancer cells were treated with HIFU at the same intensity for different lengths of time and at different intensities for the same length oftime in vitro, the dead cancer cells were determined by trypan blue staining. Two groups of cancer cells treated with HIFU at the lowest and highest intensity were inoculated into mice. Tumor masses were removed and weighed after 2 wk, tumor growth in each group was confirmed pathologically.RESULTS： The death rate of cancer cells treated with HIFU at 1 000 W/cm^2 for 0.5, 1, 2, 4, 8, and 12 s was 3.11±1.21%, 13.37±2.56%, 38.84±3.68%, 47.22±5.76%,87.55±7.32%, and 94.33±8.11%, respectively. A positive relationship between the death rates of cancer cells and the length of HIFU treatment time was found （r = 0.96,P〈0.01）. The death rate of cancer cells treated with HIFU at the intensity of 100, 200, 400, 600, 800, and 1 000 W/cm^2 for 8 s was 26.31±3.26%, 31.00±3.87%, 41.97±5.86%,72.23±8.12%, 94.90±8.67%, and 99.30±9.18%, respectively. A positive relationship between the death rates of cancer cells and the intensities of HIFU treatment was confirmed （r= 0.98, P〈0.01）. The cancer cells treated with HIFU at 1 000 W/cm^2 for 8 s were inoculated intomice ed into. The tumor inhibitory rate was 90.35% compared to the control （P〈0.01）. In the experimental group inoculated with the cancer cells treated with HIFU at 1 000 W/cm^2 for 0.5 s, the tumor inhibitory rate was 22.9% （P〈0.01）. By pathological examination, tumor growth was confirmed in 8 out of 14 mice （57.14%, 8/14） inoculated with the cancer cells treated with HIFU at 1 000 W/cm^2 for 8 s, which was significantly lower than that in the control （100%, 15/15, P〈O.05）.CONCLUSION： HIFU is effective on killing or damage of H22 hepatic cancer cells in vitro and on inhibiting tumor growth in mice ex vivo.
基金supported by the National Natural Science Foundation of China(No.31770726)the National Key Research and Development Program of China(No.2016YFD0400904)
文摘Litchi(Litchi chinensis Sonn.)and longan(Dimocarpus longan Lour.)fruits have a succulent and white aril with a brown seed and are becoming popular worldwide.The two fruits have been used in traditional Chinese medicine as popular herbs in the treatment of neural pain,swelling,and cardiovascular disease.The pericarp and seed portions as the by-products of litchi and longan fruits are estimated to be approximately 30%of the dry weight of the whole fruit and are rich in bioactive constituents.In the recent years,many biological activities,such as tyrosinase inhibitory,antioxidant,anti-inflammatory,immunomodulatory,anti-glycated,and anti-cancer activities,as well as memory-increasing effects,have been reported for the litchi and longan pericarp and seed extracts,indicating a potentially significant contribution to human health.With the increasing production of litchi and longan fruits,enhanced utilization of the two fruit by-products for their inherent bioactive constituents in relation to pharmacological effects is urgently needed.This paper reviews the current advances in the extraction,processing,identification,and biological and pharmacological activities of constituents from litchi and longan by-products.Potential utilization of litchi and longan pericarps and seeds in relation to further research is also discussed.
基金supported by grants from the Project of Elitist Peak in Six Fields(No.2006-B-063)the Projectof Medical Sciences(H200727),the Bureau of Health,Jiangsu Province,China
文摘BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors. We analyzed the expression of miclear-transcription factor-kappa B (NF-kappa B) during hepatocarcinogenesis in order to evaluate its dynamic expression and its clinical value in the development and diagnosis of HCC. METHODS: Hepatoma models were induced by oral administration of 2-acetamidoflurene (2-FAA) to male Sprague-Dawley rats. Morphological changes were observed after hematoxylin and eosin staining. The cellular distribution of NF-kappa B expression during different stages of cancer development was investigated by immunohistochemistry, and the level of NF-kappa B expression in liver tissues was quantitatively analyzed by ELISA. The gene fragments of hepatic NF-kappa B were amplified by nested-polymerase chain reaction assay. RESULTS: Hepatocytes showed vacuole-like degeneration during the early stages, then had a hyperplastic nodal appearance during the middle stages, and finally progressed to tubercles of cancerous nests with high differentiation. The NF-kappa B-positive material was buff-colored, fine particles localized in the nucleus, and the incidence of NF-kappa B-positive cells was 81.8% in degeneration, 83.3% in precancerous lesions, and 100% in cancerous tissues. All of these values were higher than those in controls (P<0.01). Hepatic NF-kappa B expression and hepatic NF-kappa B-mRNA were also higher during the course of HCC development (P<0.01). CONCLUSION: The NF-kappa B signal transduction pathway is activated during the early stages of HCC development, and its abnormal expression may be associated with the occurrence of HCC.
基金the National Natural Science Foundation of China (No.40671145)the Natural Science Foundation of Guangdong Province (Nos.04300504 and 05006623)and the Science and Technology Plan Foundation of Guangdong Province (Nos.2005B20701008,2005B10101028,and 2004B20701006).
文摘Land evaluation factors often contain continuous-, discrete- and nominal-valued attributes. In traditional land evaluation, these different attributes are usually graded into categorical indexes by land resource experts, and the evaluation results rely heavily on experts＇ experiences. In order to overcome the shortcoming, we presented a fuzzy neural network ensemble method that did not require grading the evaluation factors into categorical indexes and could evaluate land resources by using the three kinds of attribute values directly. A fuzzy back propagation neural network （BPNN）, a fuzzy radial basis function neural network （RBFNN）, a fuzzy BPNN ensemble, and a fuzzy RBFNN ensemble were used to evaluate the land resources in Guangdong Province. The evaluation results by using the fuzzy BPNN ensemble and the fuzzy RBFNN ensemble were much better than those by using the single fuzzy BPNN and the single fuzzy RBFNN, and the error rate of the single fuzzy RBFNN or fuzzy RBFNN ensemble was lower than that of the single fuzzy BPNN or fuzzy BPNN ensemble, respectively. By using the fuzzy neural network ensembles, the validity of land resource evaluation was improved and reliance on land evaluators＇ experiences was considerably reduced.
基金Project(41802147)supported by the National Natural Science Foundation of ChinaProject(2016ZX05007-004)supported by the National Major Science and Technology Projects of China。
文摘Based on field observation,core description and well logging analysis,the tectonic-sedimentary framework of the Liangshan and Qixia Formations in the northwestern Sichuan Basin,China is deeply discussed.Two long-term sequence cycles were identified,denoted as LSC1 and LSC2,respectively.The sequence stratigraphic framework was established,suggesting the Liangshan Formation to be not isochronously deposited.Paleogeomorphy before deposition of LSC1 was reconstructed by the impression method.LSC1 was featured by thin,low-energy shoal deposits in the high topography,and thick inter-shoal sea and open sea deposits in the low topography.Meanwhile,paleogeomorphy before deposition of LSC2 was reconstructed using the residual thickness method,which was demonstrated to have primary high-energy,thick shoal deposits in the high topography,and thin inter-shoal and open sea deposits in the low topography.The results show that differential tectonic subsidence has already taken place during the Qixia Period,and thus the Dongwu Movement should occur earlier than previously expected.Meanwhile,pre-depositional paleogeomorphy has obvious controlling effects on the sequence stratigraphic filling and sedimentary facies distribution.Results of this study were expected to provide practical guidance to fine characterization of the sedimentary evolution process and prediction of high-quality reservoir distribution.
基金Project supported by the Key Technologies Research and Development Program of Guangdong Province Foundation (No. 2003A3040301).
文摘Vehicle emission has been the major source of air pollution in urban areas in the past two decades. This article proposes an artificial neural network model for identifying the taxi gross emitters based on the remote sensing data. After carrying out the field test in Guangzhou and analyzing various factors from the emission data, the artificial neural network modeling was proved to be an advisable method of identifying the gross emitters. On the basis of the principal component analysis and the selection of algorithm and architecture, the Back-Propagation neural network model with 8-17-1 architecture was established as the optimal approach for this purpose. It gave a percentage of hits of 93%. Our previous research result and the result from aggression analysis were compared, and they provided respectively the percentage of hits of 81.63% and 75%. This comparison demonstrates the potentiality and validity of the proposed method in the identification of taxi gross emitters.
基金the grants from the National Natural Science Foundation of China (No.31530020 and No.81401329)Beijing Sci-Tech Program (No.Z171100000417007).
文摘Background:Clinical remission is the treatment target in rheumatoid arthritis (RA).This study aimed to investigate clinical remission and related factors in a large cohort of patients with RA.Methods:This study composed of 342 patients with RA.Data were collected by face-to-face interview of 1049 patients with RA who visited the Department of Rheumatology of three teaching hospitals from September 2015 to May 2016.The patients with RA were clinically assessed by rheumatologists and a four-page questionnaire was completed on site.Subsequently,patients fulfilled remission criteria were further analyzed.The practicability of different definitions of remission of RA was rated by a panel of rheumatologists.Sustained intensive disease modifying anti-rheumatic drug (DMARD) treatment was defined as a combination treatment with two or more DMARDs for at least 6 months.Results:In this cohort of 342 patients with RA,the proportions of patients achieving remission were 38.0%,29.5%,24.9%,21.1%,19.0%,18.1%,and 17.0%,based on criteria of disease activity score in 28 joints (DAS28) using CRP (DAS28-CRP),DAS28 using ESR (DAS28-ESR),routine assessment of patient index data 3 (RAPID-3),Boolean,simplified disease activity index (SDAI),clinical disease activity index,and the newly described clinical deep remission (CliDR),respectively.Boolean and CliDR are the best in practicability scored by rheumatologists (7.5 and 8.0,respectively).Compared with the non-sustained intensive group,sustained intensive treatment with DMARDs yielded higher remission rates of 25.6%,23.8%,and 21.3% in patients with RA based on Boolean (χ^2=3.937,P=0.047),SDAI (χ^2=4.666,P=0.031),and CliDR criteria (χ^2=4.297,P=0.038).The most commonly prescribed conventional synthesized DMARDs (csDMARDs) in patients with RA was leflunomide,followed by methotrexate,and hydroxychloroquine.Compared with the non-remission group,patients achieving remission had a longer median duration of DMARDs (45.0 [22.8–72.3] months,Z=-2.295,P=0.022).Conclusions:The findings in this
基金supported by the China-Austria scientific and technological cooperative project of National Science and Technology Ministry (Grant No.CN 01/2007)the Ministry of Water Resources' 948 plan,namely technical innovation and transformation projects (Grant No.CT200515)
文摘In order to investigate the effect of the pore air flow in the soil slope stability analysis, a water-air two-phase flow model, based on the multi-phase flow theory, is proposed and with the model, the water-phase and air-phase seepages of the soil slope in the stable seepage and rainfall situations are simulated. The soil slope safety coefficients are obtained according to the simulated pore air pressure and pore water pressure. The calculation results show that in the stable seepage situation, the influence of the pore air pressure on the soil slope stability can be neglected, while in the rainfall situation, the pore air pressure generated in the unsaturated zone will reduce the safety coefficient, and the larger the distance between the slip surface and the underground water level is, the greater the influence of the pore air pressure on the soil slope stability will be.
基金China's 13th Five-Year Major Science and Technology Project,No.2018ZX10302-302.
文摘BACKGROUND Tracheobronchial tuberculosis(TBTB)is a common subtype of pulmonary tuberculosis.Concomitant diseases often obscure the diagnosis of senile TBTB.AIM To characterize senile patients with TBTB and to identify the potential causes of misdiagnosis.METHODS One hundred twenty patients with senile TBTB who were admitted to the Anhui Chest hospital between May 2017 and May 2019 were retrospectively analyzed.Patients were classified as diagnosed group(n=58)and misdiagnosed group(n=62).Clinical manifestations,laboratory results,radiographic data,and endoscopic findings were compared between the two groups.RESULTS Patients in the misdiagnosed group were most commonly diagnosed as pulmonary tuberculosis(non-TBTB,29/62,46.8%),general pneumonia(9/62,14.5%),chronic obstructive pulmonary disease(8/62,12.9%),and tracheobronchial carcinoma(7/62,11.3%).The time elapsed between disease onset and confirmation of diagnosis was significantly longer in the misdiagnosed group[median(first quartile,third quartile):6.32(4.94,16.02)mo vs 3.73(2.37,8.52)mo].The misdiagnosed group had lower proportion of patients who underwent bronchoscopy[33.87%(21/62)vs 87.93%(51/58)],chest computed tomography(CT)scan[69.35%(43/62)vs 98.28%(57/58)],and those who showed CT signs of tuberculosis[27.91%(12/62)vs 50%(29/58)]as compared to that in the diagnosed group(P<0.05).There were no significant between-group differences with respect to age,gender,occupation,clinical manifestations,or prevalence of comorbid chronic diseases(P>0.05).CONCLUSION Insufficient or inaccurate radiographic or bronchoscopic assessment was the predominant cause of delayed diagnosis of TBTB.Increased implementation and better interpretation of CT scan and early implementation of bronchoscopy can help reduce misdiagnosis of senile TBTB.
基金Supported by National Natural Science Foundation of China,No.82072736 and No.81874184the Key Project of Hubei Health Commission,No.WJ2019Q030.
文摘BACKGROUND There is currently a shortage of accurate,efficient,and precise predictive instruments for rectal neuroendocrine neoplasms(NENs).AIM To develop a predictive model for individuals with rectal NENs(R-NENs)using data from a large cohort.METHODS Data from patients with primary R-NENs were retrospectively collected from 17 large-scale referral medical centers in China.Random forest and Cox proportional hazard models were used to identify the risk factors for overall survival and progression-free survival,and two nomograms were constructed.RESULTS A total of 1408 patients with R-NENs were included.Tumor grade,T stage,tumor size,age,and a prognostic nutritional index were important risk factors for prognosis.The GATIS score was calculated based on these five indicators.For overall survival prediction,the respective C-indexes in the training set were 0.915(95%confidence interval:0.866-0.964)for overall survival prediction and 0.908(95%confidence interval:0.872-0.944)for progression-free survival prediction.According to decision curve analysis,net benefit of the GATIS score was higher than that of a single factor.The time-dependent area under the receiver operating characteristic curve showed that the predictive power of the GATIS score was higher than that of the TNM stage and pathological grade at all time periods.CONCLUSION The GATIS score had a good predictive effect on the prognosis of patients with R-NENs,with efficacy superior to that of the World Health Organization grade and TNM stage.
基金supported by the National Natural Science Foundation of China(NSFC)(no.91125027)GRF grants(CUHK codes 14148916 and 14104521)+4 种基金AoE grants(AoE/M-05/12 and AoE/M-403/16)from the Research Grants Council(RGC)of Hong Kongthe NSFC-RGC Joint Scheme(N_CUHK452/17)the National Key Research and Development Program,Key Innovative and Collaborative Science and Technology Scheme for Hong Kong,Macao,and Taiwan(2017YFE0191100)direct grants from the Chinese University of Hong Kongand the China Postdoctoral Science Foundation(2023M741234).
文摘Plants that grow in extreme environments represent unique sources of stress-resistance genes and mechanisms.Ammopiptanthus mongolicus(Leguminosae)is a xerophytic evergreen broadleaf shrub native to semi-arid and desert regions;however,its drought-tolerance mechanisms remain poorly understood.Here,we report the assembly of a reference-grade genome for A.mongolicus,describe its evolutionary history within the legume family,and examine its drought-tolerance mechanisms.The assembled genome is 843.07 Mb in length,with 98.7%of the sequences successfully anchored to the nine chromosomes of A.mongolicus.The genome is predicted to contain 47611 protein-coding genes,and 70.71%of the genome is composed of repetitive sequences;these are dominated by transposable elements,particularly longterminal-repeat retrotransposons.Evolutionary analyses revealed two whole-genome duplication(WGD)events at 130 and 58 million years ago(mya)that are shared by the genus Ammopiptanthus and other legumes,but no species-specific WGDs were found within this genus.Ancestral genome reconstruction revealed that the A.mongolicus genome has undergone fewer rearrangements than other genomes in the legume family,confirming its status as a"relict plant".Transcriptomic analyses demonstrated that genes involved in cuticular wax biosynthesis and transport are highly expressed,both under normal conditions and in response to polyethylene glycol-induced dehydration.Significant induction of genes related to ethylene biosynthesis and signaling was also observed in leaves under dehydration stress,suggesting that enhanced ethylene response and formation of thick waxy cuticles are two major mechanisms of drought tolerance in A.mongolicus.Ectopic expression of AmERF2,an ethylene response factor unique to A.mongolicus,can markedly increase the drought tolerance of transgenic Arabidopsis thaliana plants,demonstrating the potential for application of A.mongolicus genes in crop improvement.
基金the National Natural Science Foundation of China,No.81772642Beijing Municipal Science and Technology Commission,No.Z161100000116045Capital’s Funds for Health Improvement and Research,No.CFH 2018-2-4022
文摘BACKGROUND The necessity of additional gastrectomy for early gastric cancer (EGC) patients who do not meet curative criteria after endoscopic submucosal dissection (ESD) is controversial. AIM To examine the clinicopathologic characteristics of patients who underwent additional laparoscopic gastrectomy after ESD and to determine the appropriate strategy for treating those after noncurative ESD. METHODS We retrospectively studied 45 patients with EGC who underwent additional laparoscopic gastrectomy after noncurative ESD from January 2013 to January 2019 at the Cancer Hospital of the Chinese Academy of Medical Sciences. We analyzed the patients’ clinicopathological data and identified the predictors of residual cancer (RC) and lymph node metastasis (LNM). RESULTS Surgical specimens showed RC in ten (22.2%) patients and LNM in five (11.1%).Multivariate analysis revealed that positive horizontal margin [odds ratio (OR)=13.393, 95% confidence interval (CI): 1.435-125, P=0.023] and neural invasion (OR=14.714, 95%CI: 1.087-199, P=0.043) were independent risk factors for RC. Undifferentiated type was an independent risk factor for LNM (OR=12.000, 95%CI: 1.197-120, P=0.035). Tumors in all patients with LNM showed submucosal invasion more than 500 μm. Postoperative complications after additional laparoscopic gastrectomy occurred in five (11.1%) patients, and no deaths occurred among patients with complications. CONCLUSION Gastrectomy is necessary not only for patients who have a positive margin after ESD, but also for cases with neural invasion, undifferentiated type, and submucosal invasion more than 500 μm. Laparoscopic gastrectomy is a safe, minimally invasive, and feasible procedure for additional surgery after noncurative ESD. However, further studies are needed to apply these results to clinical practice.
基金Supported by Joint Funds for the Innovation of Science and Technology,Fujian Province (CN),No. 2019Y9125
文摘BACKGROUND The prognosis of hepatocellular carcinoma(HCC)remains poor and relapse occurs in more than half of patients within 2 years after hepatectomy.In terms of recent studies,microvascular invasion(MVI)is one of the potential predictors of recurrence.Accurate preoperative prediction of MVI is potentially beneficial to the optimization of treatment planning.AIM To develop a radiomic analysis model based on pre-operative magnetic resonance imaging(MRI)data to predict MVI in HCC.METHODS A total of 113 patients recruited to this study have been diagnosed as having HCC with histological confirmation,among whom 73 were found to have MVI and 40 were not.All the patients received preoperative examination by Gd-enhanced MRI and then curative hepatectomy.We manually delineated the tumor lesion on the largest cross-sectional area of the tumor and the adjacent two images on MRI,namely,the regions of interest.Quantitative analyses included most discriminant factors(MDFs)developed using linear discriminant analysis algorithm and histogram analysis with MaZda software.Independent significant variables of clinical and radiological features and MDFs for the prediction of MVI were estimated and a discriminant model was established by univariate and multivariate logistic regression analysis.Prediction ability of the above-mentioned parameters or model was then evaluated by receiver operating characteristic(ROC)curve analysis.Five-fold cross-validation was also applied via R software.RESULTS The area under the ROC curve(AUC)of the MDF(0.77-0.85)outperformed that of histogram parameters(0.51-0.74).After multivariate analysis,MDF values of the arterial and portal venous phase,and peritumoral hypointensity in the hepatobiliary phase were identified to be independent predictors of MVI(P<0.05).The AUC value of the model was 0.939[95%confidence interval(CI):0.893-0.984,standard error:0.023].The result of internal five-fold cross-validation(AUC:0.912,95%CI:0.841-0.959,standard error:0.0298)also showed favorable predictive efficacy.CONC
基金Supported by Shenzhen Longhua District Science and Innovation Bureau for Key Laboratory Construction,No.20160919A0410022Shenzhen Longhua District Science and Innovation Bureau Fund for Medical Institutions,No.2020038 and No.2017136。
文摘BACKGROUND Management of chronic refractory wounds is one of the toughest clinical challenges for surgeons.Because of poor blood supply,less tissue coverage,and easy exposure,the lower leg is a common site for chronic refractory wounds.The current therapeutic regimens often lead to prolonged hospital stay and higher healthcare costs.Concentrated growth factor(CGF)is a novel blood extract that contains various growth factors,platelets,and fibrins to promote wound healing process.However,there has been little research reported on the treatment of lower extremity wounds with CGF.CASE SUMMARY A 37-year-old man,without any past medical history,presented an ulcerated chronic wound on his right lower leg.The skin defect exhibited clear boundaries,with a size of 2.0 cm×3.5 cm.The depth of wound was up to the layer of deep fascia.Staphylococcus aureus was detected by bacterial culture.The final diagnosis was right lower extremity ulcers with infection.Cefathiamidine,silver sulfadiazine,and mupirocin cream were applied to control the infection.CGF gel was prepared from the patient’s blood sample,and was used to cover the wound after thorough debridement.The skin wound was successfully healed after three times of CGF treatment.CONCLUSION CGF displays an excellent wound healing promoting effect in patients with lowerextremity chronic refractory wounds.
基金Supported by Grants from the National Natural Science Foundation of China,No.81072038/H1617
文摘AIM:To investigate osteopontin expression and its association with hepatopathologic changes in BALB/C mice infected with Schistosoma japonicum.METHODS:The schistosomal hepatopathologic mouse model was established by abdominal infection with schistosomal cercaria.Liver samples were obtained from mice sacrif iced at 6,8,10,14,and 18 wk after in-fection.Liver histopathological changes were observed with hematoxylin-eosin and Masson trichrome staining.The expression of osteopontin was determined with im-munohistochemistry,reverse transcription-polymerase chain reaction,and Western blotting.The expressionof α-smooth muscle actin(α-SMA)and transforming growth factor-β1(TGF-β1)were determined by im-munohistochemistry.Correlations of osteopontin ex-pression with other variables(α-SMA,TGF-β1,hepato-pathologic features including granuloma formation and degree of liver f ibrosis)were analyzed.RESULTS:Typical schistosomal hepatopathologic changes were induced in the animals.Dynamic changes in the expression of osteopontin were observed at week 6.The expression increased,peaked at week 10(P<0.01),and then gradually decreased.Positive correla-tions between osteopontin expression and α-SMA(r=0.720,P<0.01),TGF-β1(r=0.905,P <0.01),granu-loma formation(r=0.875,P<0.01),and degree of liver f ibrosis(r=0.858,P<0.01)were also observed.CONCLUSION:Osteopontin may play an important role in schistosomal hepatopathology and may promote granuloma formation and liver fi brosis through an un-explored mechanism.
文摘Objective： To comparatively analyze the medical records of patients with limb fractures as well as rescue strategy in Wenchuan and Yushu earthquakes so as to provide references for post-earthquake rescue. Methods： We retrospectively investigated 944 patients sustaining limb fractures, including 891 in Wenchuan earthquake and 53 in Yushu earthquake, who were admitted to West China Hospital （WCH） of Sichuan University. Results： In Wenchuan earthquake, WCH met its three peaks of limb fracture patients influx, on post-earthquake day （PED） 2, 8 and 14 respectively. Between PED 3-14, 585 patients were transferred from WCH to other hospitals out- side the Sichuan Province. In Yushu earthquake, the maxi- mum influx of limb fracture patients happened on PED 3, and no one was shifted to other hospitals. Both in Wenchuan and Yushu earthquakes, most limb fractures were caused by blunt strike and crush/burying. In Wenchuan earthquake, there were 396 （396/942, 42.0%） open limb fractures, includ- ing 28 Gustilo I, 201 Gustilo II and 167 Gustilo III injuries. But in Yushu earthquake, the incidence of open limb fracture was much lower （6/61, 9.8%）. The percent of patients with acute complications in Wenchuan earthquake （167/891,18.7%） was much higher than that in Yushu earthquake （5/53, 3.8%）. In Wenchuan earthquake rescue, 1 018 surgeries were done, composed of debridement in 376, internal fixation in 283, external fixation in 119, and vacuum sealing drainage in 117, etc. While among the 64 surgeries in Yushu earthquake rescue, the internal fixation for limb fracture was mostly adopted. All patients received proper treatment and sur- vived except one who died due to multiple organs failure in Wenchuan earthquake. Conclusion： Provision of suitable and sufficient medi- cal care in a catastrophe can only be achieved by construc- tion of sophisticated national disaster medical system, pre- diction of the injury types and number of injuries, and con- flrmation of participating hospitals＇ exact rol
