Objective To study the data of combined hepatocellular cholangiocarcinoma (CHCC) and to explore its clinical characteristics and prognostic factors. Methods Clinical data of 41 patients with radical resection of CHCC were retrospectively analyzed, and the prognostic factors were analyzed by univariate and multivariate analysis. Results In 36.6% cases of 41 patients with CHCC, the elevated levels of both AFP and CA19-9 were detected. And 78.0% cases got the elevated levels of CK7 and (or) CK19 and Glypcian-3 and (or) hepatocyte. Multiple analysis revealed lymph node involvement was independent prognostic factor for overall survival. Conclusions CHCC is a special type of primary liver cancer and shows some intermediated characteristics between hepatocellular carcinoma and cholangiocarcinoma. The long-term survival of the patients should be affected by the residual of metastasis lymph nodes, and the surgical treatment should be individualized at the present stage.
Objective To investigate the feasibility of imaging of bone marrow mesenchymal stem cells (BMMSCs) labeled with superparamagnetic iron oxide(SPIO) transplanted into coronary artery in vivo using magnetic resonance imaging (MRI), and the redistribution of the cells into other organs. Methods BMMSCs were isolated, cultured from bone marrow of Chinese mini swine, and double labeled with SPIO and CMDiI(Cell TrackerTM C-7001). The labeled cells were injected into left anterior descending coronary artery through a catheter. The injected cells were detected by using MRI at 1 week,3weeks after transplantation. And different organs were harvested and evaluated the redistribution of transplanted cells through pathology. Results The SPIO labeled BMMSCs injected into coronary artery could be detected through MRI and confirmed by pathology and maintained more than 3 weeks. The SPIO labeled cells could be clearly imaged as signal void lesions in the related artery. The pathology showed that the injected cells could be distributed into the area of related artery, and the cells injected into coronary artery could be found in the lung, spleen, kidney, but scarcely in the liver, the structures of these organs remained normal. Conclusion The SPIO labeled BMMSCs injected into coronary artery can be detected by using MRI, the transplanted cells can be redistributed into the non-targeted organs.
Objective To investigate an inhibitive effect of the chitosan nanoparticles with the proliferation cell nuclear antigen （PCNA）-antisense oligo deoxy nucleotides (ASODN) on the intimal cell proliferation after the vein grafting.Methods Fiftyfour male SD rats, weighing 450-600g, were randomly divided in the experimental group and the control group of 27 rats each. In the experimental group, the chitosan nanoparticles with PCNAASODN were infused into the anastomosis segment of the right jugular artery and vein; then, the anastomosis segment was transplanted to the jugular artery on the same side. The rats in the control group were infused with normal saline by the same procedures. There were 24 rats in each group which used to experiment. The hemodynamic data were obtained from the Doppler ultrasound examinations at 1, 2, 3 and 4 weeks. The specimens were taken. Immunohistochemistry, Westernblot, and bloodvesselwall histopathology were performed at the different week points. Results There was no significant difference in the thrombogenesis rate between the experimental group and the control group (3/27 vs. 3/27,P＞0.05). During the 4 week observation, PCNA Westernblot showed that the PCNA level was lower in the grafted vein and the anastomosis segment in the experimental group than in the control group. The indexes of the PCNA postive proliferating cells in the intimal area (0.13%±0.11%，0.79%±0.28%，0.45%±0.29%, 0.43%±0.25%) and the medial area (1.90%± 0.84%，2.11%±0.98%，2.48%±0.77%，2.17%±0.36%) were significantlydecreased at 1,2,3 and 4 weeks in the experimental group when compared with those in the control group（P＜0.05）. The lumen areas in the grafted vein (88.71±16.96，95.98±21.44，88.48±32.81，97.86±34.11 μm 2) and the anastomosis segment (41.49±3.34，45.15±11.65，46.27±8.90，51.62±8.85 μm 2) were significantly greater in the experimental group than in the control group (P＜0.05). The ratios of the initmal area to the medial area in the grafted vein (22.73%±3.11%，32.40%±4.55%，45.14%±3.19%，45.70%±5.01%) and the anastomsis segment (41.49%±3.34%，45.15%±11.65%，46.27%±890%，51.62%±8.85%) were significantly smaller in the experimental group than in the control group（P＜0.05）. The maximum velocities (Vmax) of the blood flow inthe grafted vein and the anastomsis segment were almost the same in the two groups at 1 week, but had different changes at the next 3 weekpoints. In the control group, the Vmax of the blood flow gradually increased and at 3 weeks it reached the peak point; however, at 4 weeks it decreased. In the experimental group,the Vmax of the blood flow gradually decreased, and at 3 weeks it decreased to the lowest point; however, at 4 weeks it increased. So, at 4 weeks the Vmax of the blood flow in the grafted vein and the anastomsis segment was almost the samein the two groups. There was no significant difference in the Vmax of the bloodflow between the two groups (P＞0.05), but in the same group there wasa significant difference at the different time points. Conclusion The chitosan nanoparticles with PCNAASODN can effectively inhibit the intimal cell proliferation after the grafting of the blood vessel, so that the neointimal thickening can be prevented.
Objective To investigate the clinical value of peripheral serum cell-free DNA/neutrophil extracellular traps (cf-DNA/NETs) level in diagnosis and severity assessment of sepsis patients. Methods Forty patients with sepsis and 40 patients with non-infectious systemic inflammatory response syndrome (nf-SIRS) were enrolled in this study. The cf-DNA/NETs level in serum of all subjects were measured. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic ability of the cf-DNA/NETs, white blood cell count (WBC), procalcitonin (PCT) and interleukin-6 (IL-6). The sepsis patients were stratified into a survival group and a death group according to the prognosis. Sequential organ failure (SOFA) score were recorded in the sepsis patients, and the correlations between SOFA and cf-DNA/NETs, PCT, WBC, IL-6 were analyzed. Results Compared with the nf-SIRS group, cf-DNA/NETs and PCT levels were significantly higher in the sepsis group (both P<0.05). WBC and IL-6 showed no significant differences between the two groups (bothP>0.05). The area under the ROC curve (AUC) of cf-DNA/NETs was 0.884 for diagnosis of sepsis, and it was higher than the AUC of PCT (0.803). The cf-DNA/NETs showed better sensitivity (81.2% and 79.2%) and specificity (81.0% and 82.4%) than PCT. cf-DNA/NETs and PCT were significantly higher in the death group than those in the survival group. Bivariate collection analysis revealed positive correlations between SOFA score and the two biomarkers of cf-DNA/NETs and PCT (r1=0.573, r2=0.518; both P<0.01). Conclusions cf-DNA/NETs and PCT have certain value in early diagnosis of sepsis, and cf-DNA/NETs shows better diagnostic value in distinguishing sepsis from nf-SIRS than PCT. cf-DNA/NETs can be used as a routine monitoring index to help assess disease severity in sepsis.
ObjectiveTo systematically review vitamin D nutritional status among children and adolescents in China.MethodsCNKI, CBM, WanFang Data, VIP and PubMed databases were electronically searched to collect cross-sectional studies on vitamin D nutritional status among children and adolescents in China from inception to September, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by using Stata 11.0 software.ResultsA total of 23 cross-sectional studies involving 38 047 total sample size were included.The results of meta-analysis showed that the combined vitamin D deficiency rate was 27.9% (95%CI 21.9% to 33.8%), and the inadequate rate was 31.6% (95%CI 25.7% to 37.6%).Subgroup analysis showed that vitamin D deficiency rate of females was higher than that of males (25.3% vs. 22.5%). The vitamin D deficiency rate of children aged 10 to 18 was higher than those aged 6 to 9 (44.9% vs. 32.9%). The vitamin D deficiency rate of children in the north was higher than that in south (36.1% vs. 14.8%). The vitamin D deficiency rate from 2015 to 2018 was higher than that from 2011 to 2014 (34.9% vs. 17.6%). In addition, the vitamin D deficiency rate ofurban children was higher than that of rural children (29.9% vs. 24.9%).ConclusionsThe incidence of vitamin D deficiency among children and adolescents is high in China. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
Working memory is an important foundation for advanced cognitive function. The paper combines the spatiotemporal advantages of electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) to explore the neurovascular coupling mechanism of working memory. In the data analysis, the convolution matrix of time series of different trials in EEG data and hemodynamic response function (HRF) and the blood oxygen change matrix of fNIRS are extracted as the coupling characteristics. Then, canonical correlation analysis (CCA) is used to calculate the cross correlation between the two modal features. The results show that CCA algorithm can extract the similar change trend of related components between trials, and fNIRS activation of frontal pole region and dorsolateral prefrontal lobe are correlated with the delta, theta, and alpha rhythms of EEG data. This study reveals the mechanism of neurovascular coupling of working memory, and provides a new method for fusion of EEG data and fNIRS data.
Objective To investigate the expressions of aldehyde dehydrogenase 1 (ALDH1) and sex determining region Y-box protein 2 (SOX2) in breast cancer tissues and their clinical significance. Methods Immunohistochemistry was used to detect the expressions of ALDH1 and SOX2 protein in cancerous and its paracancer tissues of 80 patients with breast cancer treated in our hospital from 2017 to 2019, and to analyze the correlation between the expressions of ALDH1 and SOX2 protein, as well as the relationship between their expression and clinicopathological characteristics and prognosis of breast cancer patients. Results The positive expression rates of ALDH1 and SOX2 protein in breast cancer tissues were 75.0% and 62.5%, respectively. The positive expression rates of ALDH1 and SOX2 protein in paracancer tissues were 30.0% and 21.3%, respectively. The positive rates of ALDH1 and SOX2 protein expressions in breast cancer tissues were higher than those in paracancer tissues, and the difference was statistically significant (P<0.05). The expressions of ALDH1 and SOX2 proteins in breast cancer tissues were correlated with histological grade, TNM stage and axillary lymph node status of breast cancer (P<0.05). By Spearman correlation analysis, ALDH1 was positively correlated with SOX2 expression (rs=0.507, P<0.001). The univariate analysis of statistically significant indicators and the combination of clinical characteristics of the logistic regression multivariate analysis found that, breast cancer tumor size, histological grade, TNM stage, axillary lymph node status and ALDH1 protein and SOX2 protein expressions were not significantly correlated with those reaching disease-free survival (DFS) after follow-up (P>0.05, which may be affected by small sample size and small number of endpoint events). The Kaplan-Meier method was used to plot survival curves, and log-rank test results showed that the cumulative DFS rates of patients with positive ALDH1 and SOX2 protein expression were lower than those of with negative expression (P<0.05). Conclusions ALDH1 and SOX2 proteins are highly expressed in breast cancer tissues, and they are positively correlated. Survival curves show that positive ALDH1 and SOX2 proteins in breast cancer tissues tend to have a poorer prognosis.
Seawater drowning leads to acute lung tissue structure injury, lung ventilation and air exchange dysfunction, acute pulmonary edema, and even acute respiratory failure. The pathogenesis of seawater induced acute lung injury is complex, involving inflammatory response, pulmonary edema, pulmonary surfactant, oxidative stress, apoptosis and autophagy. Timely and effective treatment is the key to reduce the mortality and disability rate of patients with seawater induced acute lung injury. This article summarizes the research progress in the pathogenic mechanism and treatment strategy of seawater induced acute lung injury, aiming to provide reference for the comprehensive treatment of seawater induced acute lung injury patients in clinical work and subsequent related research.
Objective To evaluate the diagnostic value of analyzing the pattern of gallbladder wall enhancement on MDCT to identify the different causes of acute cholecystitis. Methods In January 2009 to December 2012， 169 patients diagnosed with acute cholecystitis caused by various pathologic conditions were performed MDCT scans， the images of portal venous phase and clinical data were retrospectively reviewed by two blinded radiologists. There were 146 cases in non-hepatopathy cholecystitis group and 23 cases in hepatopathy cholecystitis group. The other 5 normal gallbladder cases diagnosed by MDCT scans were retrospectively reviewed as contrast group. Using five patterns according to the enhancement pattern of flat gallbladder wall thickening on MDCT. The study cases were then divided into five patterns and the thickness of the mucous membrane were measured. The occurrence rate of each pattern and the thickness of the mucous membrane between the groups were compared respectively. Results In the non-hepatopathy cholecystitis group， there were typeⅡin 102 cases （69.9%）， typeⅢin 5 cases （3.4%）， typeⅣ in 30 cases （20.5%）， and typeⅤ in 9 cases （6.2%）. In the hepatopathy cholecystitis group， there were typeⅡin 2 cases （8.7%）， typeⅢ in 11 cases （47.9%）， typeⅣin 5 cases （21.7%）， and typeⅤin 5 cases （21.7%）. The occurrence rate of typeⅡin the non-hepatopathy cholecystitis group was significialtly higher than that in the hepatopathy cholecystitis group （P＜0.005）. The occurrence rate of typeⅢ and typeⅤ in the hepatopathy cholecystitis group were significialtly higher than those in the non-hepatopathy cholecystitis group（P＜0.005， P＜0.05）. The occurrence rate of type Ⅳ between the two groups had no significant difference （P＞0.05）. TypeⅠonly present in the contrast group. The non-hepatopathy group’s mean mucous membrane thickness was （2.61±1.30） mm ， which was thicker than the hepatopathy group’s （2.02±0.52） mm（t=2.22， P＜0.05）. Conclusion Analyzing the enhancement pattern of a thickened gallbladder wall on MDCT is helpful in identifying the causes of acute cholecystitis， and the gallbladder perforation or not.
Objective To explore the risk factors of postoperative anxiety in patients with pancreatic cancer undergoing total pancreatectomy. Methods A total of 31 patients who underwent total pancreatectomy for pancreatic cancer between July 2011 and December 2016 were collected and analyzed in this retrospective study. The patients’ postoperative Self-Rating Anxiety Scale scores were collected, and the exposure factors were analyzed to identify the risk factors of postoperative anxiety through univariate analysis and multiple logistic regression analysis by SPSS 21.0 statistical software. Results In the 31 patients, there were 17 males and 14 females, with an average age of (66.16±9.09) years, an average body mass index of (21.11±3.10) kg/m2, and an average postoperative hospital stay of (14.58±7.47) days. There were 23 patients (74.2%) with postoperative anxiety, and 30 patients (96.8%) with hyperglycosemia required insulin therapy. The total perioperative mortality was 3.2%. In the univariate analysis, age (P=0.012), smoking history (P=0.043), preoperative diabetes mellitus (P=0.012), postoperative bile leakage (P=0.043), and postoperative abdominal infection (P=0.026) were related factors of the postoperative anxiety. In the multiple logistic regression analysis, patients without preoperative diabetes was an independent risk factor of postoperative anxiety (P=0.013). Conclusions For patients undergoing total pancreatectomy, it is needed to pay attention to the patients’ postoperative psychological conditions and assess the postoperative anxiety, especially for those without preoperative diabetes. To improve the life quality and long-term survival of these patients, health education and psychological intervention are needed.