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Objective:To investigate the risk factors for acute cholangitis after endoscopic retrograde cholangiopancreatography (ERCP) and to construct its nomogram.Methods:Clinical data of patients who underwent ERCP for common bile duct stones in the First Hospital of Lanzhou University from January 2014 to December 2019 were retrospectively analyzed. A total of 95 patients with acute cholangitis after the operation (the acute cholangitis group) were included and 285 patients without acute cholangitis after the operation (the non-acute cholangitis group) were selected by random sampling at 1∶3 via the software. Logistic regression analysis was used to evaluate the risk factors for acute cholangitis after ERCP. A nomogram model was established to predict the incidence of acute cholangitis after ERCP based on the results of multivariate analysis.Results:Univariate analysis showed that there were significant differences in age, combination with diabetes, levels of alanine aminotransferase, alkaline phosphatase and glucose, roughness in gallbladder wall, bile duct diameter, stenosis in lower bile duct, proportion of patients who underwent endoscopic retrograde biliary drainage and endoscopic nasobiliary drainage between the two groups ( P<0.05). Logistic multivariate regression analysis showed that advanced age ( OR=1.108, 95% CI:1.079-1.138, P<0.001), combination with diabetes ( OR=4.524, 95% CI:1.299-15.758, P=0.018), roughness in gallbladder wall ( OR=2.495, 95% CI:1.106-5.630, P=0.028), increased bile duct diameter ( OR=1.303, 95% CI:1.181-1.437, P<0.001), and stenosis in lower bile duct ( OR=4.192, 95% CI:2.508-7.005, P<0.001) were independent risk factors for acute cholangitis after ERCP. Based on the results of multivariate analysis, the nomogram of acute cholangitis after ERCP was established. The area under the receiver operator characteristic curve was 0.887. Conclusion:Advanced age, combination with diabetes, rough gallbladder wall, increased diameter of bile duct and stenosis in lower bile duct are independent risk factors for acute cholangitis after ERCP. Clinicians can make clinical intervention based on the nomogram of risk factors above to improve the prognosis of patients.
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Objective:To investigate the value of delta radiomics based on longitudinal changes of dynamic contrast enhanced MRI (DCE-MRI) in predicting pathological complete response (pCR) after neoadjuvant therapy (NAT) for breast cancer.Methods:The clinicopathological and imaging data of 117 patients with breast cancer confirmed by surgical pathology from April 2019 to November 2021 at Jiangxi Cancer Hospital were analyzed retrospectively. All patients were female with 23?74 (48±10) years old. The patients were randomly divided into training (81 cases) and test sets (36 cases) at the ratio of 7∶3 according to the number of random seeds in the software. All patients underwent DCE-MRI before and after early NAT (2 courses). The maximum diameter relative regression value of breast tumors before and after early NAT (D%) was calculated and used to construct a conventional imaging model. The delta radiomic features were extracted based on pre-NAT and early-NAT (2 courses) DCE-MRI and selected by redundancy analysis and least absolute shrinkage and selection operator algorithm. A ten-fold cross-validation method was used to construct the delta radiomic model and Radscore was calculated for each patient. All patients were classified into pCR group and non-pCR group according to the surgical pathology after NAT. Significant clinicopathological variables were selected by univariate analysis and stepwise regression method. They were integrated with D% and Radscore to build the combined model and nomogram. The model performance in predicting pCR after NAT in breast cancer was evaluated by the receiver operating characteristic curve and the area under the curve (AUC), and the clinical utility of the models was compared by using clinical decision curves.Results:The combined model had the best diagnostic performance among the three models, with an AUC of 0.90 in the training set and 0.87 in the test set. The Radscore had the highest weight in the nomogram. In the training set, the diagnostic performance of the combined model and delta radiomics model were better than that of the conventional imaging model ( Z=?3.48, P=0.001; Z=2.54, P=0.011). The clinical decision curves showed an overall greater clinical benefit of the combined model compared with the conventional imaging model and delta radiomic model. Conclusions:The addition of significant clinicopathological variables and Radscore of delta radiomic model which represents the longitudinal changes in tumor heterogeneity to the conventional imaging model may improve the predictive ability of pCR. The delta radiomic may serve as a noninvasive biomarker for early prediction of NAT response.
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Objective:To explore the impact of stress perception on depression and the potential mediating role of resilience in medical staff.Methods:A total of 606 medical staff were recruited and investigated by self-designed questionnaire, the perceived stress scale (PSS-10), the 10-item Connor-Davidson resilience scale (CD-RISC-10), and the patient health questionnaire-9 (PHQ-9) from February to March, 2020.SPSS 26.0 software was used to execute Pearson or Spearman correlation analysis, common method biases test, and multicollinearity test.Model 4 in PROCESS 3.2 macro program and Bootstrap method were used for mediating effects analysis.Results:There was a positive correlation between stress perception score(16.93±6.65) and depression score (5.00(2.00, 9.00))( r=0.551, P<0.01), and a negative correlation between stress perception score and resilience score (27.08±8.68) ( r=-0.285, P<0.01) among 606 medical staff.There was a negative correlation between resilience score and depression score ( r=-0.474, P<0.01). Mesometric effect examination showed that resilience played a partial mediating role in the relationship between stress perception and depression, and the mediating effect accounted for 10.87% of the total effect. Conclusion:Stress perception can directly or indirectly influence depression scores, and resilience partially mediates the relationship between stress perception and depression.Depression can be reduced clinically by reducing stress perception or enhancing the resilience of medical personnel.
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Objective To explore the value of preoperative LAR combined with AFP in evaluating the prognosis of patients with HCC. Methods We retrospectively analyzed the clinical data of 106 patients with HCC. Kaplan-Meier method was used to draw the survival curve. Univariate analysis was used to analyze possible variables affecting LAR. Cox risk regression model was used to evaluate the clinical value of preoperative LAR and AFP on the prognosis of HCC patients. Results The DFS and OS of the high LAR group and the high AFP group were shorter than those of the low LAR group and the low AFP group (P < 0.05). LAR≥4.58, AFP≥400μg/L and T3-T4 were independent risk factors affecting DFS and OS of HCC patients (P < 0.05). Postoperative interventional surgery was an independent factor influencing OS prolongation (P < 0.05). The DFS and OS were the shortest in the high LAR and high AFP group, and the DFS and OS were the longest in the low LAR and low AFP group (P < 0.05). Conclusion Preoperative LAR and AFP are independent poor prognostic factors of HCC. Preoperative LAR combined with AFP has a certain value in judging the prognosis of HCC patients.
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Objective To investigate the antagonistic effect of ω-3PUFAs on cognitive impairment in MK-801-induced schizophrenia (SZ) rats and its mechanism.Methods Rat model of schizophrenia was induced by MK-801.Morris water maze was used to detect the change of cognitive function in rats.The number of neonatal neurons in hippocampus was detected by Brdu staining.CREB,p-CREB,BDNF,TrkB and p-TrkB levels were detected by Weston Blot.Results MK-801 induced schizophrenia-like cognitive impairment (the escape latency in the water maze test was (6.51±3.10)s for Ctr group,(15.27±6.20)s for Mod group;acrossing times was (4.63±1.06) times for Ctr group,(2.00±1.15) times for Mod group),reduced the number of neonatal neurons in hippocampus (the relative level of neonatal neuron number per unit area,Mod/Ctr was 0.656±0.066) and impaired the CREB/BDNF/TrkB pathway (the relative level of gray value,Mod/Ctr:CREB was 0.393±0.065,p-CREB was 0.591±0.015,BDNF was 0.716±0.115,TrkB was 0.787±0.029,p-TrkB was 0.586±0.013).ω-3PUFAs improved the CREB/BDNF/TrkB pathway activity by increasing CREB and TrKB level and their phosphorylation (the relative level of gray value,Pre/Ctr:CREB was 1.139±0.111,p-CREB was 0.845±0.243,BDNF was 0.864±0.133,TrkB was 0.916±0.022,p-TrkB was 0.952±0.047),and then recovered the number of neonatal neurons in hippocampus (the relative level of neonatal neuron number per unit area,Pre/ Ctr was 1.183±0.101),thereby reduced the cognitive dysfunction in schizophrenia rats(the escape latency in the water maze was (7.44±4.55)s for Pre;acrossing times was (3.86±1.68) times for Pre).Conclusion ω-3PUFAs can relieve the MK-801-induced schizophrenia-like cognitive impairment.
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Objective To investigate the features of cognitive deficits of elderly depression,to evaluate the metabolite changes using MRS,and to assess the correlation between abnormal metabolite ratio of MRS and the scores of MoCA.Methods The samples contained 20 elderly depression patients and 20 healthy controls.All the patients were assessed by Montreal Cognitive Assessment(MoCA).MRS data were acquired by point-resolved echo spin spectroscopy(PRESS)sequence of single vowel 1-hydrogen MRS.The software automatically completed metabolite content measurement,giving the ratio of all metabolite using Cr as reference,including NAA/Cr,Cho/Cr.Results (1)Compared with the controls,the patients depressed had lower scores in attention,executive function,words,delayed recall and total scores(P0.01);(3)The scores in executive function(r=0.71,0.62),words(r=0.79,0.77),delayed recall(r=0.62,0.61)and total scores(r=0.72,0.68)correlated with NAA/Cr in frontal lobe,the scores in delayed recall correlated with NAA/Cr in hippocampus(r=0.81,0.76).Conclusions The cognition function of patients with elderly depression can be generally impaired.The patients depressed had lower ratio of NAA/Cr in both frontal lobe and hippocampus.The cognitive deficits of geriatric depression correlated 1H-MRS changes in its frontal lobe and hippocampus.
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In order to enhance the anticoagulant properties of decellularized biological materials as scaffolds for tissue engineering research via heparinized process, the decellularized porcine liver scaffolds were respectively immobilized with heparin through layer-by-layer self-assembly technique (LBL), multi-point attachment (MPA) or end-point attachment (EPA). The effects of heparinization and anticoagulant ability were tested. The results showed that the three different scaffolds had different contents of heparin. All the three kinds of heparinized scaffolds gained better performance of anticoagulant than that of the control scaffold. The thrombin time (TT), prothrombin time (PT) and activated partial thromboplastin time (APTT) of EPA scaffold group were longest in all the groups, and all the three times exceeded the measurement limit of the instrument. In addition, EPA scaffolds group showed the shortest prepared time, the slowest speed for heparin release and the longest recalcification time among all the groups. The decellularized biological materials for tissue engineering acquire the best effect of anticoagulant ability in vitro via EPA heparinized technique.
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Animals , Anticoagulants , Chemistry , Biocompatible Materials , Chemistry , Heparin , Chemistry , Liver , Swine , Tissue Engineering , Tissue ScaffoldsABSTRACT
Objective To study the effects of Jianwei Yuyang granule on TGF-? 1 expression in the healing process of rat gastric ulcer induced by acetic acid. Methods Animal model of gastric ulcer in rat was set up with the modified Okabe's method, and the TGF-? 1 expression in the gastric ulcerated tissues was detected by immunohistochemical technique. Results TGF-? 1 expression in gastric ulcerated tissues during the healing process in Jianwei Yuyang group significantly increased compared with the normal, model and famotidine treatment groups. Conclusion TGF-? 1 expression in gastric ulcerated tissues induced by acetic acid during the healing process significantly increased,especially in Jianwei Yuyang group. Jianwei Yuyang granule may accelerate gastric ulcer healing by increasing TGF-? 1 expression in gastric ulcerated tissues.