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Objective:To investigate the risk factors for recurrence after liver transplantation in patients with hepatitis B virus (HBV) infection-related hepatocellular carcinoma (HCC), and to further construct a predictive model.Methods:The clinical data of 106 patients with HCC undergoing liver transplantation in the First Affiliated Hospital of Hebei North University from January 2015 to May 2020 were retrospec-tively analyzed. The χ2 test was used to analyze the factors influencing HCC recurrence, and multivariate logistic regression was used to analyze the influencing factors of HCC recurrence. According to the selected risk factors, the predictive model of HCC recurrence was constructed, and the receiver operating characteristic (ROC) curve was used to evaluate the predictive model. Results:Of the 106 HCC patients, 23 had recurrence, with a recurrence rate of 21.70%, and 20 died. Tumor differentiation ( χ2=6.066, P=0.014), maximum tumor diameter ( χ2=4.916, P=0.027), with or without envelope invasion ( χ2=5.543, P=0.019), preoperative alpha fetoprotein (AFP) ( χ2=5.458, P=0.019), HBV-DNA ( χ2=5.446, P=0.020), neutrophil lymphocyte ratio (NLR) ( χ2=12.161, P<0.001), the expressions of miR-424 ( χ2=4.400, P=0.036), chromodomain helicase DNA-binding protein 8 (CHD8) ( χ2=10.561, P=0.001), T-cadherin (T-cad) ( χ2=48.723, P<0.001), laminin (LN) ( χ2=18.506, P<0.001) and hepatocyte growth factor (HGF) ( χ2=11.178, P=0.001) were related to the recurrence of HCC. Multivariate logistic regression analysis showed that the maximum tumor diameter≥6.5 cm ( OR=1.69, 95% CI: 1.25-3.17, P=0.002), preoperative AFP>400 ng/ml ( OR=1.38, 95% CI: 1.09-1.92, P=0.038), positive CHD8 ( OR=0.77, 95% CI: 0.52-0.89, P=0.021), positive T-cad ( OR=0.84, 95% CI: 0.68-0.92, P=0.006), positive LN ( OR=1.22, 95% CI: 1.03-1.50, P=0.013) were the risk factors of HCC recurrence. According to the results of logistic analysis, the regression equation logit( P)=0.262+ 0.523 X1+ 0.326 X2-0.259 X3-0.286 X4+ 0.203 X5 was constructed, where X1, X2, X3, X4, X5 were the maximum tumor diameter, AFP, CHD8, T-cad and LN. ROC curve analysis showed that the area under the curve for predicting HCC recurrence was 0.849 (95% CI: 0.763-0.894, P<0.001), the accuracy rate was 83.02%, the sensitivity was 86.96%, the specificity was 81.93%, and the cut-off value was 0.736. According to the logit( P) function model, P=1/(1+ e - Y), where Y=0.262+ 0.523 X1+ 0.326 X2-0.259 X3-0.286 X4+ 0.203 X5. One patient was randomly selected. According to his clinical data, P=0.564, which was less than the cut-off value (0.736). It could be considered that this patient would not have HCC recurrence with an accuracy rate of 83.02%. Conclusion:Tumor maximum diameter, preoperative AFP, CHD8, T-cad, LN expression are related to the recurrence of HCC after liver transplantation. The prediction model constructed based on this can effectively predict the risk of HCC recurrence.
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OBJECTIVE:To prepare Bevacizumab(BEV)multivesicular liposomes(BEV-MVLs)with sustained-effect,and to study their in vitro release characteristics. METHODS:BEV-MVLs were prepared by double emulsion method. Box-Behnken design-response surface methodology was used to optimize the prescription with the concentration of glycerol trioleate(TO)in organic phase,ratio of 1,2-dioleoyl-sn-glycero-3-phosphocholine(DOPC)-cholesterol(CH)(mol/mol),the concentration of L-lysine in external water phase as factors,using encapsulation rate as index. The morphology of BEV-MVLs was observed by inverted fluorescence microscope and SEM;particle size was determined by laser particle size analyzer;the BEV content was determined by HPLC and calculate the encapsulation rate and in vitro accumulative release rate.RESULTS:The optimized prescription was as follows as TO of 2.72 mmol/L in organic phase,DOPC-CH ratio of 0.67(mol/mol)and L-lysine of 40 mmol/L in external water phase. The encapsulation rate of BEV-MVLs was(80.65±4.42)%(n=3),and relative error of it to predicted value was 2.54%. The liposomes were spherical in appearance shape and uniform in size,and they were typical non-concentric vesicle structure with average particle size of 16.80 μm. 30 d in vitro accumulative release rate was about 92%. CONCLUSIONS:Prepared BEV-MVLs show sustained-effect,and their encapsulation rate reaches the expected effect.
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Objective To investigate the possible risk factors for prognosis of diffuse alveolar hemorrhage (DAH) in children and to improve the recognition of the disease.Methods The study included 62 DAH pediatric patients hospitalized from January, 2006 to January, 2016. Clinical data were retrospectively analyzed. According to the basic diseases, children were divided into immune associated DAH and non-immune associated DAH to explore the effect of early glucocorticoid treatment on the two groups of DAH. Based on the prognosis, the patients were divided into the death group and the survival group to analyze its related risk factors.Results Of the 62 patients, 20 were of immune associated DAH, 42 of non-immune associated DAH. There was no signiflcant difference of early treatment with glucocorticoid between the two groups (P>0.05). In our cohort, 30 patients died, the total mortality was 48.4% (30/62). Pediatric critical illness score may be the independent risk factor for DAH mortality.Conclusions DAH is an acute, life-threatening event, the lower the pediatric critical illness score, the higher risk of death.
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Objective To determine the thermal conductivity under different temperatures and concentrations, and specific heat capacity under different concentrations of water extracts of Salvia Miltiorrhiza Radix et Rhizoma; To establish the mathematical model of thermal conductivity-temperature, thermal conductivity-concentration, thermal conductivity-temperature-concentration and specific heat capacity-concentration of water extracts of Salvia Miltiorrhiza Radix et Rhizoma. Methods Thermal conductivity and specific heat capacity were measured by the instantaneous double hot wire thermal conductivity meter and the electrothermal specific heat capacity meter. Excel, 1stOpt and MATLAB were used to analyze the experimental data. Results The method of using brix to facilitate and accurately characterize the concentration was established. The relationship between the thermal conductivity and the temperature and the concentration of water extracts of Salvia Miltiorrhiza Radix et Rhizoma were all linearly negative (λ=a-bT, λ=a-bC), and the influence of temperature and concentration on the thermal conductivity had a certain interaction. λ=a-bC-cT-dCT could be used as the temperature and the concentration on the thermal conductivity of the integrated role model. And the specific heat capacity of the extract was negatively correlated with the concentration (cp=a-bC). Conclusion The thermal conductivity and the specific heat capacity of the extract of water extracts of Salvia Miltiorrhiza Radix et Rhizoma are different at different temperatures and concentrations, and the model can be used to characterize the changing law of thermodynamics of the extracts. It can provide guidance significance for the thermal characteristics analysis in TCM pharmaceutical process and TCM production equipment selection and design, and production process control.
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Objectives To analyze the clinical manifestation of pulmonary injury in children with systemic lupus erythematosus (SLE).Methods The clinical data of 8 SLE children with onset of respiratory symptoms as the first sign were retrospectively analyzed from January 2011 to December 2015.Results In these 8 children (4 females and 4 males) aged 6-15 years old.All of them presented cough,and 7 cases had fever,5 cases had anhelation,3 cases had hemoptysis,3 cases had stethalgia,3 cases had dyspnea and 3 cases had cyanosis.The types of pulmonary injury were pleural efthsion in 5 cases (62.5％),acute lupus pneurnonitis in 4 cases (50.0％),chronic interstitial pneumonia in 2 cases (25.0％),and pneumorrhagia in 2 cases (25.0％).In 7 children who performed chest high resolution CT examination,it showed that 5 cases had ground-glass shadow,5 cases had pleural effusion,5 cases had enlargement of mediastinum or lymph nodes,and 4 cases had segmental pulmonary consolidation.After treatment of the primary disease,the respiratory symptoms and pulmonary images were improved rapidly in 7 cases,and one case died of pneumorrhagia.Conclusion The clinical ministrations in SLE children with onset of respiratory symptoms as the first sign were not specific,and it was usually confused with respiratory infection.However,it usually had other organs involved and the chest imaging was more commonly showed groundglass shadow,segmental pulmonary consolidation,and pleural effusion.
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Objective To analyze the characteristics of serum vancomycin concentrations and its clinical therapeutic effects. Methods Serum vancomycin concentrations of 59 children diagnosed with severe Gram positive cocci pneumonia and treated with vancomycin were retrospectively analyzed. Vancomycin concentrations, biochemical values and disease status of patients were analyzed. Results The serum vancomycin concentrations of severe Gram positive cocci pneumonia children accompanied by acyanotic congenital heart disease was significantly higher than those without congenital heart disease, ( 12 . 12 mg/L vs 7 . 76 mg/L, P=0 . 008 ). The therapeutic effect of 40-60 mg/(kg·d) dosage group was signiifcantly higher than that of?60 mg/(kg·d) dosage group. Acute liver function damage and moderate/severe anemia may be risk factors for poor therapeutic effects to severe Gram positive cocci pneumonia children (P?
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Objective To analyze the clinical feature and common etiology of diffuse alveolar hemorrhage (DAH) in children. Methods Clinical data from 138 children with initially diagnosed DAH were retrospectively analyzed. The etiology, diagnosis, treatment, and prognosis had been summarized. Results Among 138 children, 76 were male and 62 were female. The clinical features are pallor ( 130 cases, 94 . 2%), cough ( 86 cases, 62 . 3%), fever ( 74 cases, 53 . 6%), anhelation ( 67 cases, 48 . 6%), hemoptysis ( 59 cases, 42 . 8%) and dyspnea ( 43 cases, 31 . 2%). Chest imaging changes were mainly patch shadow and ground glass shadow. Moreover, the detection rate of hemosiderin cells in sputum, gastric juice and bronchoalveolar lavage lfuid was 90 . 8%( 79/87 ). The common underlying diseases that caused DAH were idiopathic pulmonary hemosiderosis ( 65 cases), hematological system disease ( 22 cases), vascular inlfammatory diseases ( 15 cases), infectious diseases ( 14 cases) and cardiovascular disease ( 5 cases). The mortality rate in acute phase of DHA was 23 . 2%( 32/138 ). Conclusions DHA is a life-threatening clinical emergency disease, its cause was complex and diverse, and the acute mortality rate is high. Glucocorticoid is the ifrst choice of treatment for majority of patients.
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Objective To observe the changes in transfer rates of epigoitrin, forsythoside A and forsythin in Ganmao Tuire Granules prescription medicinal materials by water decoction extraction, vacuum concentration and atmospheric concentration.Methods Prescription medicinal materials fromGanmao Tuire Granules were decocted in water and the decoction was condensed by vacuum and atmospheric concentration process. The contents of epigoitrin, forsythoside A and forsythin at different states were measured by HPLC for transfer rates.Results The transfer rates of epigoitrin, forsythoside A and forsythin were 72.97%, 29.27%, 72.84%, respectively after decocted in water. The RSD of epigoitrin, forsythoside A and forsythin were less than 2% in the process of vacuum concentration. The transfer rates of epigoitrin, forsythoside A and forsythin by atmospheric concentration decreased by 13.51%, 7.38% and 4.24% respectively compared with vacuum concentration when concentrated to the same state.Conclusion The method for simultaneous determination of epigoitrin, forsythoside A and forsythin by HPLC has been established. A more suitable extraction and concentration process should be chosen for the preparation ofGanmao Tuire Granules.
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Objective To explore the clinical characteristics and prognosis of congenital pulmonary artery sling (PAS) in children. MethodsThe clinical data of 38 children diagnosed with PAS during June 2009 and February 2015 were retrospectively analyzed. ResultsIn 38 PAS children, 35 cases (89.47%) were hospitalized for varying degrees of respiratory manifestations with recurrent cough (89.47%) and wheezing (84.21%) being the most common. The remaining 3 cases were found abnormal in routine preoperative examination and the diagnosis was confirmed after further examination. All 38 children were performed computer tomography angiography (CTA). Thirty-seven cases were diagnosed of PAS and diagnostic rate was 97.37%. One case was suspected of pulmonary dysplasia and diagnosed of PAS after operation. Twenty-six children received surgical treatment, of whom 25 children had pulmonary artery reconstruction (LPA). Seven children died during/after operation and 18 survived. The remaining 12 children received non-surgical treatment, of whom 9 died and 3 survived.ConclusionCardiac uhrasonography may reveal PAS in the early stage, while CTA is the best method for conifrmed diagnosis. LPA reconstruction is an important means of relieving left pulmonary artery oppression.
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ObjectiveTo establish a method for content determination of total iridoid compounds and baldrinal and 11-ethoxyviburtinal from Valerianae Jatamansi Rhizoma et Radix; To determine the contents of total iridoid compounds and baldrinal and 11-ethoxyviburtinal in Valerianae Jatamansi Rhizoma et Radix from three medicinal origins.Methods UV spectrophotometry was applied, 11-ethoxyviburtinal (cyclopentane-pyran-7-formaldehyde, 4-ethoxy methyl) was set as the reference substance, and the content of total iridoid compounds was determined at 288 nm. HPLC method was used to simultaneously determine the contents of baldrinal and 11-ethoxyviburtinal. The HPLC analysis was performed on a Phenomenex Luna C18 column (250 mm×4.6 mm, 5μm). The mobile phase was composed of acetonitrile-water in gradient elution at a flow rate of 0.95 mL/min. The detection wavelength was 288 nm and the column temperature was 30℃.Results The total iridoid compounds, baldrinal and 11-ethoxyviburtinal were in good linearity within the ranges of 2.088–14.616μg/μL, 74.88–224.64μg, and 41.6–249.6μg, respectively. This method was precise, and with good repeatability, stability and recovery rate.Conclusion The method is accurate, simple, rapid, which can be used for the quality control of Valerianae Jatamansi Rhizoma et Radix.