In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a n...In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development;we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control(including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.展开更多
Background:Human infections with zoonotic coronaviruses(CoVs),including severe acute respiratory syndrome(SARS)-CoV and Middle East respiratory syndrome(MERS)-CoV,have raised great public health concern globally.Here,...Background:Human infections with zoonotic coronaviruses(CoVs),including severe acute respiratory syndrome(SARS)-CoV and Middle East respiratory syndrome(MERS)-CoV,have raised great public health concern globally.Here,we report a novel batorigin CoV causing severe and fatal pneumonia in humans.Methods:We collected clinical data and bronchoalveolar lavage(BAL)specimens from five patients with severe pneumonia from Wuhan Jinyintan Hospital,Hubei province,China.Nucleic acids of the BAL were extracted and subjected to next-generation sequencing.Virus isolation was carried out,and maximum-likelihood phylogenetic trees were constructed.Results:Five patients hospitalized from December 18 to December 29,2019 presented with fever,cough,and dyspnea accompanied by complications of acute respiratory distress syndrome.Chest radiography revealed diffuse opacities and consolidation.One of these patients died.Sequence results revealed the presence of a previously unknownβ-CoV strain in all five patients,with 99.8%to 99.9%nucleotide identities among the isolates.These isolates showed 79.0%nucleotide identity with the sequence of SARS-CoV(GenBank NC_004718)and 51.8%identity with the sequence of MERS-CoV(GenBank NC_019843).The virus is phylogenetically closest to a bat SARS-like CoV(SL-ZC45,GenBank MG772933)with 87.6%to 87.7%nucleotide identity,but is in a separate clade.Moreover,these viruses have a single intact open reading frame gene 8,as a further indicator of bat-origin CoVs.However,the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV,indicating that these viruses might use the same receptor.Conclusion:A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans.展开更多
Background and Aims:Hepatitis B surface antigen(HBsAg)loss is seldom achieved with nucleos(t)ide analog(NA)therapy in chronic hepatitis B patients but may be enhanced by switching to finite pegylated-interferon(Peg-IF...Background and Aims:Hepatitis B surface antigen(HBsAg)loss is seldom achieved with nucleos(t)ide analog(NA)therapy in chronic hepatitis B patients but may be enhanced by switching to finite pegylated-interferon(Peg-IFN)alfa-2a.We assessed HBsAg loss with 48-and 96-week Peg-IFN alfa-2a in chronic hepatitis B patients with partial response to a previous NA.Methods:Hepatitis B e antigen(HBeAg)-positive patients who achieved HBeAg loss and hepatitis B virus DNA<200 IU/mL with previous adefovir,lamivudine or entecavir treatment were randomized 1:1 to receive Peg-IFN alfa-2a for 48(n=153)or 96 weeks(n=150).The primary endpoint of this study was HBsAg loss at end of treatment.The ClinicalTrials.gov identifier is NCT01464281.Results:At the end of 48 and 96 weeks'treatment,14.4%(22/153)and 20.7%(31/150)of patients,respectively,who switched from NA to Peg-IFN alfa-2a cleared HBsAg.Rates were similar irrespective of prior NA or baseline HBeAg seroconversion.Among those who cleared HBsAg by the end of 48 and 96 weeks'treatment,77.8%(14/18)and 71.4%(20/28),respectively,sustained HBsAg loss for a further 48 weeks.Baseline HBsAg<1500 IU/mL and week 24 HBsAg<200 IU/mL were associated with the highest rates of HBsAg loss at the end of both 48-and 96-week treatment(51.4%and 58.7%,respectively).Importantly,extending treatment from 48 to 96 weeks enabled 48.3%(14/29)more patients to achieve HBsAg loss.Conclusions:Patients on long-term NA who are unlikely to meet therapeutic goals can achieve high rates of HBsAg loss by switching to Peg-IFN alfa-2a.HBsAg loss rates may be improved for some patients by extending treatment from 48 to 96 weeks,although the differences in our study cohort were not statistically significant.Baseline and on-treatment HBsAg may predict HBsAg loss with Peg-IFN alfa-2a.展开更多
Importance:Approximately half of newly-diagnosed hepatocellular carcinoma(HCC)cases in the world occur in China,with hepatitis B virus(HBV)infection being the predominant risk factor.Recently,the guidelines for the ma...Importance:Approximately half of newly-diagnosed hepatocellular carcinoma(HCC)cases in the world occur in China,with hepatitis B virus(HBV)infection being the predominant risk factor.Recently,the guidelines for the management of Chinese HCC patients were updated.Objective:The past decade has witnessed a great improvement in the management of hepatocellular carcinoma(HCC).This study reviews the recommendations in the 2019 Chinese guidelines and makes comparison with the practices from the Western world.Evidence Review:The updated recommendations on the surveillance,diagnosis,and treatment algorithm of HCC in the 2019 Chinese guidelines were summarized,and comparisons among the updated Chinese guidelines,the European Association for the Study of the Liver(EASL)and the American Association for the Study of Liver Diseases(AASLD)guidelines were made.Findings:Besides imaging and pathological diagnoses,novel biomarkers like the seven-micro-RNA panel are advocated for early diagnoses and therapeutic efficacy evaluation in the updated Chinese guidelines.The China liver cancer(CNLC)staging system,proposed in the 2017 guidelines,continues to be the standard model for patient classification,with subsequent modifications and updates being made in treatment allocations.Compared to the Barcelona Clinic Liver Cancer(BCLC)system,the CNLC staging system employs resection,transplantation,and transarterial chemoembolization(TACE)for more progressed HCC.TACE in combination with other regional therapies like ablation or with systemic therapies like sorafenib are also encouraged in select patients in China.The systemic treatments for HCC have evolved considerably since lenvatinib,regorafenib,carbozantinib,ramucirumab and immune checkpoint inhibitors(ICIs)were first prescribed as first-line or second-line agents.Conclusions and Relevances:Novel biomarkers,imaging and operative techniques are recommended in the updated Chinese guideline.More aggressive treatment modalities are suggested for more progressed HBV-related HCC in China.展开更多
Mesenchymal stem cells (MSCs) have great potential for treating various diseases, especially those related to tissue damage involving immune reactions. Various studies have demonstrated that MSCs are strongly immuno...Mesenchymal stem cells (MSCs) have great potential for treating various diseases, especially those related to tissue damage involving immune reactions. Various studies have demonstrated that MSCs are strongly immunosuppressive in vitro and in vivo. Our recent studies have shown that un-stimulated MSCs are indeed incapable of immunosuppression; they become potently immunosuppressive upon stimulation with the supernatant of activated lymphocytes, or with combinations of IFN-γ, with TNF-α, IL-1α or IL-1β. This observation revealed that under certain circumstances, inflammatory cytokines can actually become immunosuppressive. We showed that there is a species variation in the mechanisms of MSC-mediated immunosuppression: immunosuppression by cytokine-primed mouse MSCs is mediated by nitric oxide (NO), whereas immunosuppression by cytokine-primed human MSCs is executed through indoleamine 2, 3-dioxygenase (IDO). Additionally, upon stimulation with the inflammatory cytokines, both mouse and human MSCs secrete several leukocyte chemokines that apparently serve to attract immune cells into the proximity with MSCs, where NO or IDO is predicted to be most active. Therefore, immunosuppression by inflammatory cytokine-stimulated MSCs occurs via the concerted action of chemokines and immune-inhibitory NO or IDO produced by MSCs. Thus, our results provide novel information about the mechanisms of MSC-mediated immunosuppression and for better application of MSCs in treating tissue injuries induced by immune responses.展开更多
Multi-functional Al-matrix composites with high volume fraction (55%-57%) of SiC particles are produced with the new pressureless infiltration fabrication technology. X-ray detection and microscopic observation disp...Multi-functional Al-matrix composites with high volume fraction (55%-57%) of SiC particles are produced with the new pressureless infiltration fabrication technology. X-ray detection and microscopic observation display the composites which are macroscopically homogeneous without porosity. The investigation further reveals that the SiC/Al composites possess low density (2.94 g/cm^3), high elastic modulus (220 GPa), prominent thermal management function as a result of low coefficient of thermal expansion (8 × 10^4 K^-1) and high thermal conductivity (235 W/(m.K)) as well as unique preventability of resonance vibration. By adopting a series of developed techniques, the multi-functional SiC/Al composites have managed to be made into near-net-shape parts. Many kinds of precision components of space-based optomechanical structures and airborne optoelectronic platform have been turned out. Of them, several typical products are being under test in practices.展开更多
Background Coronary heart diseases (CHD) have been identified as one of topmost diseases affecting the Chinese population.However,depression in CHD has not been reported and there are limited high quality empirical ...Background Coronary heart diseases (CHD) have been identified as one of topmost diseases affecting the Chinese population.However,depression in CHD has not been reported and there are limited high quality empirical studies in China focused on the prevalence of the comorbidity.This study aimed to estimate the pooled prevalence of depression with CHD in China.Methods Systematic review and meta-analysis of published epidemiologic studies on the depression in CHD patients in China were conducted.The research findings dated before 30 September 2013 were obtained from Ovid Medline,EMBASE and two Chinese electronic publication libraries WANFANG and CNKI.We used "cardiovascular disease","depression" and "China" as the search themes in Ovid Medline and EMBASE and "cardiovascular disease" and "depression" in WANFANG and CNKI.Random-effects meta-analysis was used to estimate the prevalence of depression in CHD patients.Results Twenty-seven studies were included in the review.Twenty-three studies had 5 236 participants who were hospitalized and four studies had 1 353 participants from community.The overall prevalence of depression in CHD from hospital was 51% (95% CI:0.43,0.58; Ⅰ-squared=97%,P=-0.000).The prevalence of depression in CHD from community ranged between 34.6% to 45.8%,and the severe depression was found ranging between 3.1% to 11.2%.Conclusions On comparing data with other countries,the prevalence of depression in CHD among admitted patients in China was found to be high.The physicians and healthcare providers should pay more attention to the "physical-mental" health of the CHD patients.展开更多
INTRODUCTIONDiscovery of the spectrum ofautoimmune encephalitis (ALE) is among the most attractive events of neurology in the past decade. AIE includes a heterogeneous group of encephalitic syndromes, which generall...INTRODUCTIONDiscovery of the spectrum ofautoimmune encephalitis (ALE) is among the most attractive events of neurology in the past decade. AIE includes a heterogeneous group of encephalitic syndromes, which generally include two major categories: classic paraneoplastic limbic encephalitis (LE) associated with the so-called well-characterized onconeural autoantibodies against intracellular neuronal antigens (e.g., Hu, Ma2, etc.) and new-type AIE associated with autoantibodies to the neuronal surface or synaptic antigens.展开更多
OBJECTIVE: To review the pharmacological effects and mechanisms of action of Astragaloside IV in Huangqi (Radix Astragali Mongolici). METHODS: Aticles focusing on Astragaloside IV in English and Chinese in databases w...OBJECTIVE: To review the pharmacological effects and mechanisms of action of Astragaloside IV in Huangqi (Radix Astragali Mongolici). METHODS: Aticles focusing on Astragaloside IV in English and Chinese in databases were collected and reviewed in order to summarize the latest extraction separation, pharmacokinetics, and the pharmacological effects of astrageloside IV. RESULTS: Protective effects of Astrageloside IV on the cardiovascular system, immune, digestive, nervous system were identified, and the action mechanisms were associated with regulation of the calcium balance, anti-oxydant, antiapoptosis, antivirus, and so on. CONCLUSION: Astrageloside IV has broad application prospects, especially in cardiovascular diseases, digestive diseases, cancer and other modern high incidence, high-risk diseases, and could be developed as a medicine.展开更多
AIM: To identify whether JTE-522 can induce apoptosis in AGS cells and ROS also involved in the process, and to investigate the changes in NF-kB, p53, bcl-2 and caspase in the apoptosis process. METHODS: Cell culture,...AIM: To identify whether JTE-522 can induce apoptosis in AGS cells and ROS also involved in the process, and to investigate the changes in NF-kB, p53, bcl-2 and caspase in the apoptosis process. METHODS: Cell culture, MTT, Electromicroscopy, agarose gel electrophoresis, lucigenin, Western blot and electrophoretic mobility shift assay (EMSA) analysis were employed to investigate the effect of JTE-522 on cell proliferation and apoptosis in AGS cells and related molecular mechanisms. RESULTS: JTE-522 inhibited the growth of AGS cells and induced the apoptosis. Lucigenin assay showed the generation of ROS in cells under incubation with JTE-522. The increased ROS generation might contribute to the induction of AGS cells to apoptosis. EMSA and Western blot revealed that NF-kB activity was almost completely inhibited by preventing the degradation of IkBalpha. Additionally, by using Western blot we confirmed that the level of bcl-2 was decreased, whereas p53 showed a great increase following JTE-522 treatment. Their changes were in a dose-dependent manner. CONCLUSION: These findings suggest that reactive oxygen species, NF-kB, p53, bcl-2 and caspase-3 may play an important role in the induction of apoptosis in AGS cells after treatment with JTE-522.展开更多
Based on the cross-dated tree-ring samples collected from the middle Qilian Moun- tain, a standard ring-width chronology had been developed, which covered the period AD 1000 to 2000. The correlations between the chron...Based on the cross-dated tree-ring samples collected from the middle Qilian Moun- tain, a standard ring-width chronology had been developed, which covered the period AD 1000 to 2000. The correlations between the chronology and climatic records from the nearby meteorological stations indicated that temperature was the dominant climatic factor for tree growth at upper timberline, and the most important climatic factor for the tree growth in the area was the mean temperature from previous December to current April. The temperature variations recovered from the ring-width data showed a cold period during the “Little Ice Age” and the con- tinuous warming during the twentieth century. Comparison between the ring-width chronology and δ18O records from the Dunde ice core in the Qilian Mountain indicated that there was a con- sistent trend in both time series. A significant correlation existed between our ring-width chro- nology and the Northern Hemispheric temperature, suggesting that the climate changes in the Qilian Mountain were not only driven by regional factors, but also responsive to the global cli- mate.展开更多
Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy (CSP). Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, i...Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy (CSP). Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, including age, interval from the last cesarean delivery to diagnosis, clinical presentation, location of the lesion, process of diagnosis and treatment, outcome, and follow-up, were retrospectively analyzed. Re, salts CSP constituted 1.05 % of all ectopic pregnancies, and the ratio of CSP to pregnancy was 1 : 1 221. The mean age of the group was 31.4 years. Twenty-six women had only one prior cesarean delivery. The interval from the last cesarean delivery to diagnosis ranged from 4 months to 15 years. The most common presenting symptoms of CSP were amenorrhoea and vaginal bleeding. Seventeen cases were misdiagnosed as early intrauterine pregnancies and 2 were misdiagnosed as gestational trophoblastic tumor. The other 9 were diagnosed definitely before treatment. The diagnosis was made based on cesarean delivery history, gynecologic examination, ultrasound, and magnetic resonance imaging (MRI). The treatment of CSP included systemic or local methotrexate administration, conservative surgery, and hysterectomy. The conservative treatment was successful in 24 cases. All of the 28 women were cured through individual therapies. Conclusions CSP is rare and usually misdiagnosed as other diseases. Ultrasound is valuable for diagnosing CSP, and MRI can be used as an adjunct to ultrasound scan. Early diagnosis offers the options of conservative treatment and greatly improves the outcome of patients. Individual therapy is strongly recommended.展开更多
AIM: To investigate the causes of missed diagnosis of early gastric cancer (EGC) or high-grade intraepithelial neoplasia (HGIN) in Chongqing, China. METHODS: The present study summarizes 103 cases of EGC/HGIN detected...AIM: To investigate the causes of missed diagnosis of early gastric cancer (EGC) or high-grade intraepithelial neoplasia (HGIN) in Chongqing, China. METHODS: The present study summarizes 103 cases of EGC/HGIN detected by esophagogastroduodenos-copy (EGD) and pathological analysis from January 2010 to December 2011. Dimethyl silicone oil was administrated orally 15 min before the EGD procedures. The stomach was cleaned by repeated washing with saline when the gastroscope entered the stomach cavity. Suspected EGC lesions were subject to conventional biopsy sampling and pathological examinations. The correlation between lesion locations, endoscopic morphology of cancerous sites, training level of the examiners, pathological biopsies, and missed diagnosis was analyzed. RESULTS: Twenty-three cases were missed among the 103 cases (22.23%) of EGC/HGIN. The rate of missed EGC in the gastroesophageal junction (8/19, 42.1%) was significantly higher than at other sites (15/84, 17.86%) (χ2 = 5.253, P = 0.022). In contrast, the rate of missed EGC in the lower stomach body (2/14, 14.29%) was lower than at other sites (21/89,23.6%), but there were no significant differences (χ2 = 0.289, P = 0.591). The rate of missed EGC in the gastric antrum (5/33, 15.15%) was lower than at other sites (18/70, 25.71%), but there were no significant differences (χ2 = 1.443, P = 0.230). Endoscopists from less prestigious hospitals were more prone to not diagnosing EGC than those from more prestigious hospitals (χ2 = 4.261, P = 0.039). When the number of biopsies was < 4, the rate of missed diagnosis was higher (20/23, 89.96%) than for when there were > 4 biopsies (3/23, 13.04%) (P < 0.001). In addition, there was no significant difference in the rate of missed diagnosis in patients with 1-3 biopsy specimens (χ2 = 0.141, P = 0.932). CONCLUSION: Endoscopists should have a clear understanding of the anatomical characteristics of the esophagus/stomach, and endoscopic identification of early lesions increases with the number of biopsies.展开更多
The theoretical studies of bionics of machinery have great scientific significance, and the development of bionic machines has large practical values in the field of engineering and technology. Through the rigorous se...The theoretical studies of bionics of machinery have great scientific significance, and the development of bionic machines has large practical values in the field of engineering and technology. Through the rigorous selection process of evolution, the survived living organisms have successfully developed outstanding abilities to adapt to their surroundings and to reproduce their offspring. In this review,we interpreted the fundamental principles of anti-adhesion and anti-resistance of soil animals by reviewing the current status in this research field and summarizing the work of the research group at Jilin University of China in the past decades. The principles and technologies used in morphology bionics,electric-osmosis bionics,flexibility bionics,configuration bionics and coupling bionics were examined.Finally,the applications of the engineering bionics and their extensive prospects were introduced.展开更多
Background: Common bile duct (CBD) stones may occur in up to 3%–14.7% of all patients with cholecystectomy.Various approaches of laparoscopic CBD exploration plus primary duct closure (PDC) are the most commonly...Background: Common bile duct (CBD) stones may occur in up to 3%–14.7% of all patients with cholecystectomy.Various approaches of laparoscopic CBD exploration plus primary duct closure (PDC) are the most commonly used and the best methods to treat CBD stone. This systematic review was to comparethe effectiveness and safety of the various approaches of laparoscopic CBD exploration plus PDC forcholedocholithiasis展开更多
AIM: To study the antitumor effect of matrine in human hepatoma G2 (HepG2) cells and its molecular mechanism involved in antineoplastic activities. METHODS: 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide...AIM: To study the antitumor effect of matrine in human hepatoma G2 (HepG2) cells and its molecular mechanism involved in antineoplastic activities. METHODS: 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to detect viability of HepG2 cells. The effect of matrine on cell cycle was detected by flow cytometry. Annexin-V-FITC/PI double staining assay was used to detect cellular apoptosis. Cellular morphological changes were observed under an inverted phase contrast microscope. Transmission electron microscopy was performed to further examine ultrastructural structure of the cells treatedwith matrine. Monodansylcadaverine (MDC) staining was used to detect autophagy. Whether autophagy is blocked by 3-methyladenine (3-MA), an autophagy inhibitor, was evaluated. Expression levels of Bax and Beclin 1 in HepG2 cells were measured by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR).RESULTS: Matrine signif icantly inhibited the proliferation of HepG2 cells in a dose- and time-dependent manner, and induced G1-phase cell cycle arrest and apoptosis of HepG2 cells in a dose-dependent manner. The total apoptosis rate was 0.14% for HepG2 cells not treated with matrine. In contrast, the apoptosis rate was 28.91%, 34.36% and 38.80%, respectively, for HepG2 cells treated with matrine at the concentration of 0.5, 1.0 and 2.0 mg/mL. The remarkable morphological changes were observed under an inverted phase contrast microscope. Abundant cytoplasmic vacuoles with varying sizes were observed in HepG2 cells treated with matrine. Furthermore, vacuolization in cytoplasm progressively became larger and denser when the concentration of matrine was increased. Electron microscopy demonstrated formation of abundant autophagic vacuoles in HepG2 cells after matrine treatment. When the specif ic autophagic inhibitor, 3-MA, was applied, the number of autophagic vacuoles greatly decreased. MDC staining showed that the fluorescent density was higher and the number of MDC-labeled particles展开更多
China’s population has rapidly aged over the recent decades of social and economic development as neurodegenerative disorders have proliferated,especially Alzheimer’s disease(AD)and related dementias(ADRD).AD’s inc...China’s population has rapidly aged over the recent decades of social and economic development as neurodegenerative disorders have proliferated,especially Alzheimer’s disease(AD)and related dementias(ADRD).AD’s incidence rate,morbidity,and mortality have steadily increased to make it presently the fifth leading cause of death among urban and rural residents in China and magnify the resulting financial burdens on individuals,families and society.The‘Healthy China Action’plan of 2019-2030 promotes the transition from disease treatment to health maintenance for this expanding population with ADRD.This report describes related epidemiological trends,evaluates the economic burden of the disease,outlines current clinical diagnosis and treatment status and delineates existing available public health resources.More specifically,it examines the public health impact of ADRD,including prevalence,mortality,costs,usage of care,and the overall effect on caregivers and society.In addition,this special report presents technical guidance and supports for the prevention and treatment of AD,provides expertise to guide relevant governmental healthcare policy development and suggests an information platform for international exchange and cooperation.展开更多
On May 21,2021,a local case of coronavirus disease 2019(COVID-19)was confirmed in a 75-year-old woman(experienced onset of symptoms on May 18)in Liwan District,Guangzhou City,Guangdong Province,China.The number of inf...On May 21,2021,a local case of coronavirus disease 2019(COVID-19)was confirmed in a 75-year-old woman(experienced onset of symptoms on May 18)in Liwan District,Guangzhou City,Guangdong Province,China.The number of infections has increased in the following 10 days and led to 5 generations of transmission.展开更多
AIM To investigate the correlation of iodine concentration(IC) generated by spectral computed tomography(CT) with micro-vessel density(MVD) and vascular endothelial growth factor(VEGF) expression in patients with adva...AIM To investigate the correlation of iodine concentration(IC) generated by spectral computed tomography(CT) with micro-vessel density(MVD) and vascular endothelial growth factor(VEGF) expression in patients with advanced gastric carcinoma(GC).METHODS Thirty-four advanced GC patients underwent abdominal enhanced CT in the gemstone spectral imaging mode. The IC of the primary lesion in the arterial phase(AP) and venous phase(VP) were measured, and were then normalized against that in the aorta to provide the normalized IC(nI C). MVD and VEGF were detected by immunohistochemical assays, using CD34 and VEGF-A antibodies, respectively. Correlations of nI C with MVD, VEGF, and clinical-pathological features were analyzed.RESULTS Both nI Cs correlated linearly with MVD and were higher in the primary lesion site than in the normal control site, but were not correlated with VEGF expression. After stratification by clinical-pathological subtypes, nI C-AP showed a statistically significant correlation with MVD, particularly in the group with tumors at stage T4, without nodular involvement, of a mixed Lauren type, where the tumor was located at the antrum site, and occurred in female individuals. nI C-VP showed a positive correlation with MVD in the group with the tumor at stage T4 and above, had nodular involvement, was poorly differentiated, was located at the pylorus site, of a mixed and diffused Lauren subtype, and occurred in male individuals. nI C-AP and nI C-VP showed significant differences in terms of histological differentiation and Lauren subtype.CONCLUSION The IC detected by spectral CT correlated with the MVD. n IC-AP and n IC-VP can reflect angiogenesis in different pathological subgroups of advanced GC.展开更多
基金supported(in part)by the Entrusted Project of National Center for Medical Service Administration,National Health and Family Planning Commission China(No.[2019]099)the First Level Funding of the Second Medical Leading Talent Project in Hubei Provincethe Special Project for Emergency of the Ministry of Science and Technology(2020YFC0841300)。
文摘In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development;we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control(including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.
基金This study was supported by grants from the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(No.2016-I2M-1-014)the National Major Science&Technology Project for Control and Prevention of Major Infectious Diseases in China(Nos.2017ZX10103004,2018ZX10305409,2017ZX10204401)the National Natural Science Foundation(No.81930063)
文摘Background:Human infections with zoonotic coronaviruses(CoVs),including severe acute respiratory syndrome(SARS)-CoV and Middle East respiratory syndrome(MERS)-CoV,have raised great public health concern globally.Here,we report a novel batorigin CoV causing severe and fatal pneumonia in humans.Methods:We collected clinical data and bronchoalveolar lavage(BAL)specimens from five patients with severe pneumonia from Wuhan Jinyintan Hospital,Hubei province,China.Nucleic acids of the BAL were extracted and subjected to next-generation sequencing.Virus isolation was carried out,and maximum-likelihood phylogenetic trees were constructed.Results:Five patients hospitalized from December 18 to December 29,2019 presented with fever,cough,and dyspnea accompanied by complications of acute respiratory distress syndrome.Chest radiography revealed diffuse opacities and consolidation.One of these patients died.Sequence results revealed the presence of a previously unknownβ-CoV strain in all five patients,with 99.8%to 99.9%nucleotide identities among the isolates.These isolates showed 79.0%nucleotide identity with the sequence of SARS-CoV(GenBank NC_004718)and 51.8%identity with the sequence of MERS-CoV(GenBank NC_019843).The virus is phylogenetically closest to a bat SARS-like CoV(SL-ZC45,GenBank MG772933)with 87.6%to 87.7%nucleotide identity,but is in a separate clade.Moreover,these viruses have a single intact open reading frame gene 8,as a further indicator of bat-origin CoVs.However,the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV,indicating that these viruses might use the same receptor.Conclusion:A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans.
基金The authors would like to thank the patients and their families for their contribution to this studyThis study was supported by the National Science and Technology Major Project of China(2008ZX10002-006,2012ZX10002007001,2017ZX10202203-007,2017ZX10202203-008)+2 种基金the National Natural Science Foundation of China(81171561,30972584)This study was also supported in part by Shanghai Roche Pharmaceuticals LtdWriting assistance was provided by Stefanie Chuah,from Mudskipper Business Ltd,funded by F Hoffmann-La Roche
文摘Background and Aims:Hepatitis B surface antigen(HBsAg)loss is seldom achieved with nucleos(t)ide analog(NA)therapy in chronic hepatitis B patients but may be enhanced by switching to finite pegylated-interferon(Peg-IFN)alfa-2a.We assessed HBsAg loss with 48-and 96-week Peg-IFN alfa-2a in chronic hepatitis B patients with partial response to a previous NA.Methods:Hepatitis B e antigen(HBeAg)-positive patients who achieved HBeAg loss and hepatitis B virus DNA<200 IU/mL with previous adefovir,lamivudine or entecavir treatment were randomized 1:1 to receive Peg-IFN alfa-2a for 48(n=153)or 96 weeks(n=150).The primary endpoint of this study was HBsAg loss at end of treatment.The ClinicalTrials.gov identifier is NCT01464281.Results:At the end of 48 and 96 weeks'treatment,14.4%(22/153)and 20.7%(31/150)of patients,respectively,who switched from NA to Peg-IFN alfa-2a cleared HBsAg.Rates were similar irrespective of prior NA or baseline HBeAg seroconversion.Among those who cleared HBsAg by the end of 48 and 96 weeks'treatment,77.8%(14/18)and 71.4%(20/28),respectively,sustained HBsAg loss for a further 48 weeks.Baseline HBsAg<1500 IU/mL and week 24 HBsAg<200 IU/mL were associated with the highest rates of HBsAg loss at the end of both 48-and 96-week treatment(51.4%and 58.7%,respectively).Importantly,extending treatment from 48 to 96 weeks enabled 48.3%(14/29)more patients to achieve HBsAg loss.Conclusions:Patients on long-term NA who are unlikely to meet therapeutic goals can achieve high rates of HBsAg loss by switching to Peg-IFN alfa-2a.HBsAg loss rates may be improved for some patients by extending treatment from 48 to 96 weeks,although the differences in our study cohort were not statistically significant.Baseline and on-treatment HBsAg may predict HBsAg loss with Peg-IFN alfa-2a.
基金This work was supported by the National Natural Science Foundation of China(no.91859105,no.8196112802)the Basic Research Project from the Technology Commission of Shanghai Municipality(no.17JC1402200)the Shanghai Municipal Key Clinical Specialty.
文摘Importance:Approximately half of newly-diagnosed hepatocellular carcinoma(HCC)cases in the world occur in China,with hepatitis B virus(HBV)infection being the predominant risk factor.Recently,the guidelines for the management of Chinese HCC patients were updated.Objective:The past decade has witnessed a great improvement in the management of hepatocellular carcinoma(HCC).This study reviews the recommendations in the 2019 Chinese guidelines and makes comparison with the practices from the Western world.Evidence Review:The updated recommendations on the surveillance,diagnosis,and treatment algorithm of HCC in the 2019 Chinese guidelines were summarized,and comparisons among the updated Chinese guidelines,the European Association for the Study of the Liver(EASL)and the American Association for the Study of Liver Diseases(AASLD)guidelines were made.Findings:Besides imaging and pathological diagnoses,novel biomarkers like the seven-micro-RNA panel are advocated for early diagnoses and therapeutic efficacy evaluation in the updated Chinese guidelines.The China liver cancer(CNLC)staging system,proposed in the 2017 guidelines,continues to be the standard model for patient classification,with subsequent modifications and updates being made in treatment allocations.Compared to the Barcelona Clinic Liver Cancer(BCLC)system,the CNLC staging system employs resection,transplantation,and transarterial chemoembolization(TACE)for more progressed HCC.TACE in combination with other regional therapies like ablation or with systemic therapies like sorafenib are also encouraged in select patients in China.The systemic treatments for HCC have evolved considerably since lenvatinib,regorafenib,carbozantinib,ramucirumab and immune checkpoint inhibitors(ICIs)were first prescribed as first-line or second-line agents.Conclusions and Relevances:Novel biomarkers,imaging and operative techniques are recommended in the updated Chinese guideline.More aggressive treatment modalities are suggested for more progressed HBV-related HCC in China.
文摘Mesenchymal stem cells (MSCs) have great potential for treating various diseases, especially those related to tissue damage involving immune reactions. Various studies have demonstrated that MSCs are strongly immunosuppressive in vitro and in vivo. Our recent studies have shown that un-stimulated MSCs are indeed incapable of immunosuppression; they become potently immunosuppressive upon stimulation with the supernatant of activated lymphocytes, or with combinations of IFN-γ, with TNF-α, IL-1α or IL-1β. This observation revealed that under certain circumstances, inflammatory cytokines can actually become immunosuppressive. We showed that there is a species variation in the mechanisms of MSC-mediated immunosuppression: immunosuppression by cytokine-primed mouse MSCs is mediated by nitric oxide (NO), whereas immunosuppression by cytokine-primed human MSCs is executed through indoleamine 2, 3-dioxygenase (IDO). Additionally, upon stimulation with the inflammatory cytokines, both mouse and human MSCs secrete several leukocyte chemokines that apparently serve to attract immune cells into the proximity with MSCs, where NO or IDO is predicted to be most active. Therefore, immunosuppression by inflammatory cytokine-stimulated MSCs occurs via the concerted action of chemokines and immune-inhibitory NO or IDO produced by MSCs. Thus, our results provide novel information about the mechanisms of MSC-mediated immunosuppression and for better application of MSCs in treating tissue injuries induced by immune responses.
基金Foundation items: High-technology Research and Development Programme of China (2007AA03Z544) Aeronautical Science Foundation of China (20075221001)
文摘Multi-functional Al-matrix composites with high volume fraction (55%-57%) of SiC particles are produced with the new pressureless infiltration fabrication technology. X-ray detection and microscopic observation display the composites which are macroscopically homogeneous without porosity. The investigation further reveals that the SiC/Al composites possess low density (2.94 g/cm^3), high elastic modulus (220 GPa), prominent thermal management function as a result of low coefficient of thermal expansion (8 × 10^4 K^-1) and high thermal conductivity (235 W/(m.K)) as well as unique preventability of resonance vibration. By adopting a series of developed techniques, the multi-functional SiC/Al composites have managed to be made into near-net-shape parts. Many kinds of precision components of space-based optomechanical structures and airborne optoelectronic platform have been turned out. Of them, several typical products are being under test in practices.
文摘Background Coronary heart diseases (CHD) have been identified as one of topmost diseases affecting the Chinese population.However,depression in CHD has not been reported and there are limited high quality empirical studies in China focused on the prevalence of the comorbidity.This study aimed to estimate the pooled prevalence of depression with CHD in China.Methods Systematic review and meta-analysis of published epidemiologic studies on the depression in CHD patients in China were conducted.The research findings dated before 30 September 2013 were obtained from Ovid Medline,EMBASE and two Chinese electronic publication libraries WANFANG and CNKI.We used "cardiovascular disease","depression" and "China" as the search themes in Ovid Medline and EMBASE and "cardiovascular disease" and "depression" in WANFANG and CNKI.Random-effects meta-analysis was used to estimate the prevalence of depression in CHD patients.Results Twenty-seven studies were included in the review.Twenty-three studies had 5 236 participants who were hospitalized and four studies had 1 353 participants from community.The overall prevalence of depression in CHD from hospital was 51% (95% CI:0.43,0.58; Ⅰ-squared=97%,P=-0.000).The prevalence of depression in CHD from community ranged between 34.6% to 45.8%,and the severe depression was found ranging between 3.1% to 11.2%.Conclusions On comparing data with other countries,the prevalence of depression in CHD among admitted patients in China was found to be high.The physicians and healthcare providers should pay more attention to the "physical-mental" health of the CHD patients.
文摘INTRODUCTIONDiscovery of the spectrum ofautoimmune encephalitis (ALE) is among the most attractive events of neurology in the past decade. AIE includes a heterogeneous group of encephalitic syndromes, which generally include two major categories: classic paraneoplastic limbic encephalitis (LE) associated with the so-called well-characterized onconeural autoantibodies against intracellular neuronal antigens (e.g., Hu, Ma2, etc.) and new-type AIE associated with autoantibodies to the neuronal surface or synaptic antigens.
文摘OBJECTIVE: To review the pharmacological effects and mechanisms of action of Astragaloside IV in Huangqi (Radix Astragali Mongolici). METHODS: Aticles focusing on Astragaloside IV in English and Chinese in databases were collected and reviewed in order to summarize the latest extraction separation, pharmacokinetics, and the pharmacological effects of astrageloside IV. RESULTS: Protective effects of Astrageloside IV on the cardiovascular system, immune, digestive, nervous system were identified, and the action mechanisms were associated with regulation of the calcium balance, anti-oxydant, antiapoptosis, antivirus, and so on. CONCLUSION: Astrageloside IV has broad application prospects, especially in cardiovascular diseases, digestive diseases, cancer and other modern high incidence, high-risk diseases, and could be developed as a medicine.
基金National Natural Science Foundation of China,No.39770300,30070873the Overseas Chinese Affairs Office of the State Council Foundation,No.98-33
文摘AIM: To identify whether JTE-522 can induce apoptosis in AGS cells and ROS also involved in the process, and to investigate the changes in NF-kB, p53, bcl-2 and caspase in the apoptosis process. METHODS: Cell culture, MTT, Electromicroscopy, agarose gel electrophoresis, lucigenin, Western blot and electrophoretic mobility shift assay (EMSA) analysis were employed to investigate the effect of JTE-522 on cell proliferation and apoptosis in AGS cells and related molecular mechanisms. RESULTS: JTE-522 inhibited the growth of AGS cells and induced the apoptosis. Lucigenin assay showed the generation of ROS in cells under incubation with JTE-522. The increased ROS generation might contribute to the induction of AGS cells to apoptosis. EMSA and Western blot revealed that NF-kB activity was almost completely inhibited by preventing the degradation of IkBalpha. Additionally, by using Western blot we confirmed that the level of bcl-2 was decreased, whereas p53 showed a great increase following JTE-522 treatment. Their changes were in a dose-dependent manner. CONCLUSION: These findings suggest that reactive oxygen species, NF-kB, p53, bcl-2 and caspase-3 may play an important role in the induction of apoptosis in AGS cells after treatment with JTE-522.
基金supported by the Major Knowiedge Innovation Project of the Chinese Aademy of Sciences(Gant Nos.KZCX1-1002 and KZCX1-1009)the opening fund of the Key Laboratory of Ice-core and Cold-regions Environment,Cold and Arid Regions Environment and Engineering Research Insti tute,Chinese Academy ofSciences(Grant No.210506)..
文摘Based on the cross-dated tree-ring samples collected from the middle Qilian Moun- tain, a standard ring-width chronology had been developed, which covered the period AD 1000 to 2000. The correlations between the chronology and climatic records from the nearby meteorological stations indicated that temperature was the dominant climatic factor for tree growth at upper timberline, and the most important climatic factor for the tree growth in the area was the mean temperature from previous December to current April. The temperature variations recovered from the ring-width data showed a cold period during the “Little Ice Age” and the con- tinuous warming during the twentieth century. Comparison between the ring-width chronology and δ18O records from the Dunde ice core in the Qilian Mountain indicated that there was a con- sistent trend in both time series. A significant correlation existed between our ring-width chro- nology and the Northern Hemispheric temperature, suggesting that the climate changes in the Qilian Mountain were not only driven by regional factors, but also responsive to the global cli- mate.
文摘Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy (CSP). Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, including age, interval from the last cesarean delivery to diagnosis, clinical presentation, location of the lesion, process of diagnosis and treatment, outcome, and follow-up, were retrospectively analyzed. Re, salts CSP constituted 1.05 % of all ectopic pregnancies, and the ratio of CSP to pregnancy was 1 : 1 221. The mean age of the group was 31.4 years. Twenty-six women had only one prior cesarean delivery. The interval from the last cesarean delivery to diagnosis ranged from 4 months to 15 years. The most common presenting symptoms of CSP were amenorrhoea and vaginal bleeding. Seventeen cases were misdiagnosed as early intrauterine pregnancies and 2 were misdiagnosed as gestational trophoblastic tumor. The other 9 were diagnosed definitely before treatment. The diagnosis was made based on cesarean delivery history, gynecologic examination, ultrasound, and magnetic resonance imaging (MRI). The treatment of CSP included systemic or local methotrexate administration, conservative surgery, and hysterectomy. The conservative treatment was successful in 24 cases. All of the 28 women were cured through individual therapies. Conclusions CSP is rare and usually misdiagnosed as other diseases. Ultrasound is valuable for diagnosing CSP, and MRI can be used as an adjunct to ultrasound scan. Early diagnosis offers the options of conservative treatment and greatly improves the outcome of patients. Individual therapy is strongly recommended.
文摘AIM: To investigate the causes of missed diagnosis of early gastric cancer (EGC) or high-grade intraepithelial neoplasia (HGIN) in Chongqing, China. METHODS: The present study summarizes 103 cases of EGC/HGIN detected by esophagogastroduodenos-copy (EGD) and pathological analysis from January 2010 to December 2011. Dimethyl silicone oil was administrated orally 15 min before the EGD procedures. The stomach was cleaned by repeated washing with saline when the gastroscope entered the stomach cavity. Suspected EGC lesions were subject to conventional biopsy sampling and pathological examinations. The correlation between lesion locations, endoscopic morphology of cancerous sites, training level of the examiners, pathological biopsies, and missed diagnosis was analyzed. RESULTS: Twenty-three cases were missed among the 103 cases (22.23%) of EGC/HGIN. The rate of missed EGC in the gastroesophageal junction (8/19, 42.1%) was significantly higher than at other sites (15/84, 17.86%) (χ2 = 5.253, P = 0.022). In contrast, the rate of missed EGC in the lower stomach body (2/14, 14.29%) was lower than at other sites (21/89,23.6%), but there were no significant differences (χ2 = 0.289, P = 0.591). The rate of missed EGC in the gastric antrum (5/33, 15.15%) was lower than at other sites (18/70, 25.71%), but there were no significant differences (χ2 = 1.443, P = 0.230). Endoscopists from less prestigious hospitals were more prone to not diagnosing EGC than those from more prestigious hospitals (χ2 = 4.261, P = 0.039). When the number of biopsies was < 4, the rate of missed diagnosis was higher (20/23, 89.96%) than for when there were > 4 biopsies (3/23, 13.04%) (P < 0.001). In addition, there was no significant difference in the rate of missed diagnosis in patients with 1-3 biopsy specimens (χ2 = 0.141, P = 0.932). CONCLUSION: Endoscopists should have a clear understanding of the anatomical characteristics of the esophagus/stomach, and endoscopic identification of early lesions increases with the number of biopsies.
基金Supported by the Key Program of the National Natural Science Foundation of China (Grant Nos.50635030 and 59835200)the Chinese National Programs for Science and Technology Development (Grant No.2005BA429C)the Key Proliferation Project for Scientific and Technological Fruits of China (Grant No.2005EC000119)
文摘The theoretical studies of bionics of machinery have great scientific significance, and the development of bionic machines has large practical values in the field of engineering and technology. Through the rigorous selection process of evolution, the survived living organisms have successfully developed outstanding abilities to adapt to their surroundings and to reproduce their offspring. In this review,we interpreted the fundamental principles of anti-adhesion and anti-resistance of soil animals by reviewing the current status in this research field and summarizing the work of the research group at Jilin University of China in the past decades. The principles and technologies used in morphology bionics,electric-osmosis bionics,flexibility bionics,configuration bionics and coupling bionics were examined.Finally,the applications of the engineering bionics and their extensive prospects were introduced.
基金supported by a grant from the Research Program for Health Care of Lanzhou Science and Technology Bureau(No.2013-3-37)
文摘Background: Common bile duct (CBD) stones may occur in up to 3%–14.7% of all patients with cholecystectomy.Various approaches of laparoscopic CBD exploration plus primary duct closure (PDC) are the most commonly used and the best methods to treat CBD stone. This systematic review was to comparethe effectiveness and safety of the various approaches of laparoscopic CBD exploration plus PDC forcholedocholithiasis
基金Supported by National Natural Science Foundation of China, No. 30870364Science and Technology Support Program of Gansu Province, China, No. 0708NKCA129
文摘AIM: To study the antitumor effect of matrine in human hepatoma G2 (HepG2) cells and its molecular mechanism involved in antineoplastic activities. METHODS: 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to detect viability of HepG2 cells. The effect of matrine on cell cycle was detected by flow cytometry. Annexin-V-FITC/PI double staining assay was used to detect cellular apoptosis. Cellular morphological changes were observed under an inverted phase contrast microscope. Transmission electron microscopy was performed to further examine ultrastructural structure of the cells treatedwith matrine. Monodansylcadaverine (MDC) staining was used to detect autophagy. Whether autophagy is blocked by 3-methyladenine (3-MA), an autophagy inhibitor, was evaluated. Expression levels of Bax and Beclin 1 in HepG2 cells were measured by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR).RESULTS: Matrine signif icantly inhibited the proliferation of HepG2 cells in a dose- and time-dependent manner, and induced G1-phase cell cycle arrest and apoptosis of HepG2 cells in a dose-dependent manner. The total apoptosis rate was 0.14% for HepG2 cells not treated with matrine. In contrast, the apoptosis rate was 28.91%, 34.36% and 38.80%, respectively, for HepG2 cells treated with matrine at the concentration of 0.5, 1.0 and 2.0 mg/mL. The remarkable morphological changes were observed under an inverted phase contrast microscope. Abundant cytoplasmic vacuoles with varying sizes were observed in HepG2 cells treated with matrine. Furthermore, vacuolization in cytoplasm progressively became larger and denser when the concentration of matrine was increased. Electron microscopy demonstrated formation of abundant autophagic vacuoles in HepG2 cells after matrine treatment. When the specif ic autophagic inhibitor, 3-MA, was applied, the number of autophagic vacuoles greatly decreased. MDC staining showed that the fluorescent density was higher and the number of MDC-labeled particles
基金This report was supported by a grant from Brain Science and Brain-Like Intelligence Technology of the Ministry of Science and Technology of China(2021ZD0201804).
文摘China’s population has rapidly aged over the recent decades of social and economic development as neurodegenerative disorders have proliferated,especially Alzheimer’s disease(AD)and related dementias(ADRD).AD’s incidence rate,morbidity,and mortality have steadily increased to make it presently the fifth leading cause of death among urban and rural residents in China and magnify the resulting financial burdens on individuals,families and society.The‘Healthy China Action’plan of 2019-2030 promotes the transition from disease treatment to health maintenance for this expanding population with ADRD.This report describes related epidemiological trends,evaluates the economic burden of the disease,outlines current clinical diagnosis and treatment status and delineates existing available public health resources.More specifically,it examines the public health impact of ADRD,including prevalence,mortality,costs,usage of care,and the overall effect on caregivers and society.In addition,this special report presents technical guidance and supports for the prevention and treatment of AD,provides expertise to guide relevant governmental healthcare policy development and suggests an information platform for international exchange and cooperation.
基金The Key-Area Research and Development Program of Guangdong Province(2019B111103001,2020B111107001)The National Natural Science Foundation of China(No.82041030).
文摘On May 21,2021,a local case of coronavirus disease 2019(COVID-19)was confirmed in a 75-year-old woman(experienced onset of symptoms on May 18)in Liwan District,Guangzhou City,Guangdong Province,China.The number of infections has increased in the following 10 days and led to 5 generations of transmission.
基金Supported by the National Natural Science Foundation of China,No.81271573
文摘AIM To investigate the correlation of iodine concentration(IC) generated by spectral computed tomography(CT) with micro-vessel density(MVD) and vascular endothelial growth factor(VEGF) expression in patients with advanced gastric carcinoma(GC).METHODS Thirty-four advanced GC patients underwent abdominal enhanced CT in the gemstone spectral imaging mode. The IC of the primary lesion in the arterial phase(AP) and venous phase(VP) were measured, and were then normalized against that in the aorta to provide the normalized IC(nI C). MVD and VEGF were detected by immunohistochemical assays, using CD34 and VEGF-A antibodies, respectively. Correlations of nI C with MVD, VEGF, and clinical-pathological features were analyzed.RESULTS Both nI Cs correlated linearly with MVD and were higher in the primary lesion site than in the normal control site, but were not correlated with VEGF expression. After stratification by clinical-pathological subtypes, nI C-AP showed a statistically significant correlation with MVD, particularly in the group with tumors at stage T4, without nodular involvement, of a mixed Lauren type, where the tumor was located at the antrum site, and occurred in female individuals. nI C-VP showed a positive correlation with MVD in the group with the tumor at stage T4 and above, had nodular involvement, was poorly differentiated, was located at the pylorus site, of a mixed and diffused Lauren subtype, and occurred in male individuals. nI C-AP and nI C-VP showed significant differences in terms of histological differentiation and Lauren subtype.CONCLUSION The IC detected by spectral CT correlated with the MVD. n IC-AP and n IC-VP can reflect angiogenesis in different pathological subgroups of advanced GC.