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Objective:Three-dimensional simulation modeling technology was used to conduct three-dimensional reconstruction, classification and measurement for the anatomic structures of colorectal canal, tumor and key blood vessels in patients with rectal cancer before operation. And the accuracy of the data and information obtained for the prediction of anastomotic tension, important types of vascular variant, positioning of anatomical landmarks, etc. in laparoscopic-assisted radical resection of rectal cancer, and the guiding effect of operation was evaluated.Methods:The clinical data of 50 patients with laparoscopic-assisted radical resection of rectal cancer treated in the General Surgery Department, Beijing Ditan Hospital Capital Medical University from January 2019 to February 2021 were analyzed retrospectively, including 31 males and 19 females, aged from 42 to 83 years old, with an average age of (62.72 ±15.21) years. The patients were divided into two groups according to whether the patients underwent three-dimensional simulation reconstruction before operation. The patients who underwent abdomen pelvic enhancement CT and further three-dimensional reconstruction before surgery were taken as reconstruction group ( n=24), and the patients who were only routinely performed abdomen pelvic enhancement CT before operation were taken as control group ( n=26). For the patients in the reconstruction group, the CT images were modeled by Mimics software before operation, and the key data such as the length of colorectal and tumor, the correlation length of rigid structure of pelvic wall, the length of inferior mesenteric artery (IMA) from the bifurcation point of left and right arteria iliaca communis, the type and proportion of IMA variation, the length of left colonic artery (LCA) from the beginning of IMA and the distance between LCA and IMV were measured, and the consistency correlation coefficient (CCC) was analyzed with the actual data obtained during operation. And then the accuracy of three-dimensional simulation modeling technology for surgical guidance was evaluated. MedCalc 19.0 software was used for statistical analysis. Results:In the reconstruction group, regarding the data of each dimension of the model (intestinal tract, pelvic cavity, blood vessels) and the corresponding structural measurements during the operation, the consistent correlation coefficient (CCC) evaluation was more than 0.9. One case was predicted to have free splenic flexure of colon and one case actually had free splenic flexure of colon. The prediction accuracy was 100%. The IMA variants in the reconstruction group were divided into 4 types, all of which were verified by operation. Compared with the control group, the operation time ( P=0.011) and the location time (IMA, P=0.043; LCA, P=0.007; IMV, P=0.034) of each vessel in the reconstruction group were shorter, and the amount of intraoperative blood loss was less ( P=0.017). Conclusion:The application of three-dimensional simulation modeling technology before operation is helpful for the operator to accurately predict the intraoperative anastomotic tension, the type of IMA variation and the related diameter length, based on which the accurate operation plan can be made to guide the operation.
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Objective To investigate the incidence rate of pulmonary infection after laparoscopic surgery and related risk factors in patients with hepatocellular carcinoma (HCC) comorbid with liver cirrhosis and portal hypertension (PHT). Methods A retrospective analysis was performed for the clinical data of 105 HCC patients with liver cirrhosis and PHT who underwent laparoscopic surgery in Beijing Ditan Hospital, Capital Medical University, from January 2017 to February 2022. A total of 30 factors that might cause pulmonary infection were recorded, including general information, disease factors, surgical factors, and postoperative factors. Postoperative recovery was observed and the occurrence of pulmonary infection was recorded. The chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups, and the multivariate logistic regression analysis was used to investigate the independent risk factors for pulmonary infection. Results Among the 105 patients, 66 underwent laparoscopic devascularization combined with hepatectomy and 39 underwent laparoscopic devascularization combined with radiofrequency ablation (RFA). The surgery was successful for all patients, with no case of conversion to laparotomy or unscheduled reoperation. No death was observed within 30 days after surgery and during hospitalization, with a median length of hospital stay of 20 days (range 14-25 days). The incidence rate of pulmonary infection was 25.71% (27/105). Smoking (odds ratio [ OR ]=3.362, 95% confidence interval [ CI ]: 1.282-8.817, P =0.014), MELD score ( OR =3.801, 95% CI : 1.007-14.351, P =0.049), tumor location ( OR =1.937, 95% CI : 1.169-3.211, P =0.010), surgical procedure ( OR =0.006, 95% CI : 0.001-0.064, P =0.000), intraoperative infusion volume ( OR =4.871, 95% CI : 1.211-19.597, P =0.026), and postoperative pleural effusion ( OR =9.790, 95% CI : 1.826-52.480, P =0.008) were independent risk factors for pulmonary infection. Conclusion There is a relatively high risk of pulmonary infection in HCC patients with liver cirrhosis and PHT undergoing laparoscopic surgery. Postoperative pleural effusion is the high risk factor for pulmonary infection, and devascularization combined with RFA can significantly reduce the risk of pulmonary infection. It is recommended to strengthen preoperative rehabilitation, perioperative liver function maintenance, intraoperative damage control, and goal-oriented fluid therapy and reduce postoperative fluid accumulation in the third space, so as to reduce the incidence rate of pulmonary infection.
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ObjectiveTo evaluate the quality of Mori Cortex from different producing areas by the entropy weight-technique for order preference by similarity to an ideal solution（TOPSIS）， and to provide a new evaluation method for the quality control of Mori Cortex. MethodAccording to the five key indexes of color， thickness， texture， powdery and cortex remain， a subjective scoring table was designed to evaluate the appearance of Mori Cortex. High performance liquid chromatography（HPLC） was used to determine the fingerprint and the contents of multiple components（mulberroside A， chlorogenic acid， oxyresveratrol， mulberroside C， sanggenone D， sanggenone C， morusin）， and chemometrics was used to explore the differential components of Mori Cortex from different habitats. On this basis， TOPSIS was used to comprehensively evaluate the quality of Mori Cortex from different habitats， and SPSS 22.0 software was used to carry out bivariate correlation analysis between thickness and appearance color with contents of seven components of Mori Cortex. ResultThose with lighter color， thicker root bark， tougher texture， sufficient powder and less cortex remain scored higher， and the top five were all from Anhui. The established fingerprint and determination methods were stable and reliable. Partial least squares-discriminant analysis（PLS-DA） screened three components with the variable importance in the projection（VIP） value>1（mulberroside A， sanggenone D， sanggenone C）， which made an important contribution to the difference in the origin of Mori Cortex. Correlation analysis showed that there was a significantly positive correlation between mulberroside C with lightness value（L*） and total chromaticity value（E*ab） and mulberroside A with yellow-blue value（b*）（P<0.05， P<0.01）， a significantly negative correlation between sanggenone C with b* and between morusin with L*（P<0.05， P<0.01）. And there was a significantly negative correlation between mulberroside A， chlorogenic acid， and morusin with thickness（P<0.01）， a clearly negative correlation between sanggenone D with thickness（P<0.05）， a significantly positive correlation between sanggenone C with thickness（P<0.01）. TOPSIS comprehensive scores showed that the samples from Anhui had a good score and ranked high. ConclusionThere are great differences in the quality of Mori Cortex from different habitats， and those with the close habitats show similar characteristics in appearance and component content， and lighter color and less cortex were positively correlated with the quality. Among them， the quality of Mori Cortex from Anhui is relatively good.
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Objective:To study the risk factors of early postoperative portal vein thrombosis (PVT) after salvage devascularization for failed endoscopic therapy.Methods:A retrospective analysis was conducted on the clinical data of 525 cirrhotic patients who underwent pericardial devascularization for portal hypertension and esophagogastric variceal bleeding at the Department of General Surgery, Beijing Ditan Hospital, Capital Medical University from January 2012 to January 2022. There were 435 males and 90 females, aged 47(37, 58) years old. These patients were divided into two groups based on whether PVT occurred after devascularization: the PVT group ( n=225) and the non-PVT group ( n=300). Clinical data including gender, age, portal vein diameter and postoperative platelet elevation level (PPEL) were studied and the related factors of PVT were analyzed by univariate analysis. Factors with statistically significant differences were included in logistic regression analysis. Results:Univariate analysis showed that the significant risk factors of PVT were the scores of the model of end-stage liver disease, platelets, portal vein diameter, endoscopic therapy, operation duration, surgical bleeding volume, intraoperative blood transfusion and PPEL on the first and third postoperative days (all P<0.05). Multivariate analysis showed that portal vein diameter ≥13 mm ( OR=6.000, 95% CI: 3.418-10.533), endoscopic injection ( OR=1.894, 95% CI: 1.196-2.998), operation duration ≥ 180 min ( OR=8.520, 95% CI: 5.333-13.554), PPEL ≥ 20×10 9/L on the first postoperative day ( OR=2.125, 95% CI: 1.306-3.456) and PPEL≥50×10 9/L on the third postoperative day ( OR=1.925, 95% CI: 1.192-3.109) increased the risk of PVT (all P<0.05). Conclusion:The diameter of portal vein, endoscopic treatment, operation duration and PPEL on the first and third days after operation were independent risk factors of early postoperative PVT development.
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Objective:To study the feasibility of combining hepatectomy with splenectomy in hepatocellular carcinoma patients with severe thrombocytopenia (platelet count ≤30×10 9/L). Methods:The data of 46 patients with primary hepatocellular carcinoma with thrombocytopenia treated at Beijing Ditan Hospital, Capital Medical University from January 2016 to January 2021 were analyzed retrospectively. There were 32 males and 14 females, aged (55.0±7.9) years. According to the platelet count one day before operation, the patients were divided into the study group (20×10 9/L < platelet count ≤30×10 9/L, n=20) and the control group (30×10 9/L<platelet count <100×10 9/L, n=26). All patients underwent hepatectomy combined with splenectomy or hepatectomy combined with splenectomy and pericardial devascularization. The liver function (aspartate aminotransferase, alanine aminotransferase, albumin), platelet count, daily abdominal drainage within 3 days after operation, drop in hemoglobin (the difference between hemoglobin on the day after operation versus 1 day before operation) and hospital stay were compared between the two groups. Rebleeding and portal vein thrombosis were studied. Results:There was no significant difference in liver function between the two groups 2 weeks after operation (all P>0.05). The platelet count on the 1st, 3rd and 5th day after operation in the study group was significantly lower than that in the control group (all P<0.05). The platelet count in the study group and the control group returned to the normal range on the 5th and 3rd day after operation, respectively. The daily abdominal drainage volume, drop in hemoglobin and hospital stay in the control group were (407.3±124.2) ml, (31.1±8.6) g and (13.7±3.3) d, respectively, which were significantly better than those in the study group (647.5±209.5) ml, (38.3±12.8) g, (16.9±3.7) d. There were 3 patients (15.0%) who developed esophageal and gastric fundus vein rebleeding and 10 patients (50.0%) with portal vein thrombosis in the study group, versus 2 patients (7.7%) and 12 patients (46.2%) respectively in the control group. There were no significant differences between the two groups (both P>0.05). Conclusion:Severe thrombocytopenia was not an absolute contraindication of combining hepatectomy and splenectomy in patients with hepatocellular carcinoma. After sufficient and reasonable preoperative adjustment and evaluation, the operation was still safe and feasible.
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Objective To investigate the significance of the three-dimensional visualization ablation planning system in radiofrequency ablation for liver cancer. Methods A total of 71 patients who received radiofrequency ablation for hepatocellular carcinoma in Beijing Ditan Hospital, Capital Medical University from July 2017 to December 2020 were enrolled as subjects. The 34 patients in the three-dimensional group used the three-dimensional visualization ablation planning system for radiofrequency protocol planning before surgery and the 37 patients in the two-dimensional group used the two-dimensional image for radiofrequency protocol planning before surgery. The two groups were compared in terms of the indices such as the first-attempt success rate of puncture, complete tumor ablation rate, and tumor-free survival. The Fisher's exact test, the chi-square test of continuous correction, or the Pearson chi-square test was used for comparison of categorical data between two groups; the t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. The Kaplan-Meier method was used to plot survival curves, and the Log-rank (Mantel-Cox) test was used for comparison of tumor recurrence and survival; the Cox proportional-hazards regression model analysis was used to investigate the influencing factors for tumor-free survival. Results Compared with the two-dimensional group, the three-dimensional group had a significantly higher first-attempt success rate of puncture (94.12% vs 75.68%, Pearson χ 2 =4.183, P =0.041) and a significantly shorter median time of puncture (5 minutes vs 7 minutes, Z =-2.407, P =0.013). There was no significant difference in complete ablation rate between the three-dimensional group and the two-dimensional group (97.06% vs 91.89%, continuous correction χ 2 =0.183, P =0.669). There were significant differences in the 1-, 2-, and 4-year cumulative tumor-free survival rates between the three-dimensional group and the two-dimensional group (90.8%/78.8%/72.8% vs 61.5%/55.9%/44.7%, χ 2 =5.073, P =0.024). The multivariate Cox regression analysis showed that preoperative planning method, complete or incomplete ablation, and alpha-fetoprotein at 1 month after surgery were independent influencing factors for the tumor-free survival of patients with liver cancer after radiofrequency ablation (all P < 0.05). Conclusion Radiofrequency ablation planning via the three-dimensional visualization ablation planning system can ensure the therapeutic effect of radiofrequency ablation, reduce the recurrence rate of liver cancer, and prolong the tumor-free survival of patients.
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Kadsura belongs to the Schisandroideae subfamily of Magnoliaceae. Plants from genus Kadsura are widely distributed in the South and Southwest of China. The plants of the genus are widely used as folk medicine for a long time in history, with the functions of relieving pain, promoting ‘qi’ circulation, activating blood resolve stasis, and applications in the treatment of rheumatoid arthritis and gastroenteric disorders. Lignans are the primary characteristic constituents with various biological activities of plants from genus Kadsura. This paper summarized 81 lignans isolated from the plants of genus Kadsura over the past eight years (from 2014 to 2021), which belong to five types: dibenzocyclooctadienes, spirobenzofuranoid dibenzocyclooctadienes, aryltetralins, diarylbutanes and tetrahydrofurans. Each type of these lignans possess typical characteristics in proton magnetic resonance (
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Objective:To study the efficacy and safety of Hassab operation combined with either radiofrequency ablation(RFA) or liver resection in treatment of liver cancer associated with portal hypertension.Methods:A retrospective analysis was conducted on the clinical data of patients with primary liver cancer associated with portal hypertension operated at the Department of General Surgery of Beijing Ditan Hospital from June 2013 to June 2015. These patients were divided into the RFA combined with Hassab operation group and the liver resection combined with Hassab operation group according to the surgical procedures. The general patient information, operation time, intraoperative blood loss, intraoperative blood transfusion, postoperative hospital stay, postoperative complications and the 1-, 3-, and 5-years cumulative survival rates and recurrence-free survival rates were compared.Results:Of 53 patients who were included in the study, 30 patients were in the RFA combined with Hassab operation group (including 28 males and 2 females, average age 46.3 (27.0~64.0) years, and 23 patients in the liver resection combined with Hassab operation group (including 20 males and 3 females), average age 44.7(33.0~59.0) years. There were no significant differences in the general patient information including age, gender, maximum tumor diameter, preoperative laboratory tests (including blood routine, liver function, tumor markers), and Child-Pugh classification between the two groups (all P>0.05). Intraoperative blood loss in the RFA combined with Hassab operation group was significantly less than those in the liver resection combined with Hassab operation group [(401.67±183.12) ml vs (552.17±333.88) ml, P<0.05]. There were also no significant differences between the two groups in operation time, blood transfusion during operation, postoperative hospital stay, and postoperative complications ( P>0.05). The incidence of severe postoperative complications (Clavein-Dindo grade ≥ IIIb) in the liver resection combined with Hassab operation group was 47.8% (11/23), which was significantly higher than the 20.0% (6/30) in the RFA combined with Hassab operation group ( P<0.05). The 1-, 3-, and 5-year cumulative survival rates of patients in the RFA combined with Hassab operation group were 82.8%, 49.9%, and 33.2%, respectively, while the corresponding survival rates of patients in the liver resection combined with Hassab operation group were 81.0%, 58.2%, 43.7%, respectively. There was no significant difference between the two groups ( P>0.05). The recurrence-free survival rates of patients in the RFA combined with Hassab operation group at 1-, 3-, and 5-years after surgery were 79.2%, 38.8%, and 21.6%, respectively. The corresponding recurrence-free survival rates of patients in the liver resection combined with Hassab operation group were 76.4%, 41.7%, and 27.8%, respectively, and there was no significant difference between the two groups ( P>0.05). Conclusion:RFA combined with Hassab operation was safe and efficacious to treat primary liver cancer associated with portal hypertension.
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With the increasing incidence of hepatobiliary diseases, it is particularly important to understand the role of molecular, cellular and physiological factors in the clinical diagnosis and treatment with traditional Chinese medicine(TCM) in the development of liver disease. Appropriate animal models can help us identify the possible mechanisms of relevant diseases. Danio rerio(zebrafish) model was traditionally used to study embryonic development, and has been gradually used in screening and evaluation of liver diseases and relevant drug in recent years. Zebrafish embryos develop rapidly and the digestive organs of 5-day-old juvenile fish are all mature. At this stage, they may develop hepatobiliary diseases induced by developmental defects or compounds. Zebrafish liver is similar to human liver in cell composition, function, signal transduction, response to injury and cell process mediating liver disease. Furthermore, due to the high conservation of genes and proteins between humans and zebrafish, zebrafish becomes an alternative system for studying basic mechanisms of liver disease. Therefore, genetic screening could be performed to identify new genes involving specific disease processes, and chemical screening could be made for drugs in specific processes. This paper briefly introduced the experimental properties of zebrafish as model system, emphasized the study progress of zebrafish models for pathological mechanism of liver diseases, especially fatty liver, and drug screening and evaluation, so as to provide ideas and techniques for the future liver toxicity assessment of TCM.
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Animals , Humans , Drug Evaluation, Preclinical , Liver , Liver Diseases/genetics , Medicine, Chinese Traditional , Zebrafish/geneticsABSTRACT
In recent years, immunotherapy for hepatocellular carcinoma has gradually become a hot spot in clinical research. The characteristic of its immunotherapy is to stimulate specific immune response, enhance the immune rejection of tumors, inhibit and kill tumor cells, thereby reducing the possibility of tumor recurrence and metastasis. A large number of previous experimental studies have shown that immunotherapy has the potential advantages of monotherapy or combination therapy in the treatment of primary liver cancer. As we all know, whether it is to kill tumor cells in the short term or to control tumor recurrence in the long term, the necessary condition for immune drugs to work is a healthy immune environment. This article reviews the immune microenvironment in patients with liver cancer and the changes in the tumor immune microenvironment after various operations or treatments. It provides references for exploring mutually synergistic treatment plans for liver cancer, and hopes to help improve the prognosis of these patients.
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Prematurity is a common complication in the field of obstetrics. The incidence of prematurity increased yearly. Premature birth occurred in advance trend. Early preterm birth refers to the delivery occurred at 28-31+6 week of gestational age. For unavoidable early preterm birth, the prognoses of mothers and infants have become the focus of perinatal medicine. It is particularly significant to ameliorate the prognoses of mothers and infants. Therefore, this paper mainly reviewed mental and psychological problems, organic complications of mothers with early preterm deliveries，and physical growth, cognition，behaviors，quality of life in early preterm infants at home and abroad, in order to provide a reference for further optimization of their prognosis.
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Objective To investigate the effect of mesenchymal stem cells (MSCs) combined with low-dose cyclosporin A ( CsA) on corneal transplantation rejection and its mechanism. Methods A fully allogeneic rat cornea transplant model (Wistar rats to Lewis rats) was created. Thirty-six model rats were divided into MSCs group, CsA group and MSCs+CsA group randomly by using the random number table method,with 12 rats for each group. In each group,six rats were used for the evalution of symptom observation and six for the assay of immune factor. Three days after corneal transplantation,slit lamp microscope was used to observe and record the vascularization,edema and opacity scores of corneal graft. After 18 days,spleen T helper cell(Th)1 and Th2 cytokines were measured by enzyme linked immunosorbent assay ( ELISA ). The use and care of the animals complied with Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission. This study protocol was approved by Ethic Committee of Tianjin Medical University Eye Hospital (No. TMUaMEC2017028). Results The survival time of corneal grafts in MSCs+CsA group was prolonged in comparison with the MSCs group and CsA group,with significant differences between them([21.3±3.9]days vs. (14.8±2.4)days; [21.3±3.9]days vs. [16.0±1.1]days) (P=0.003,0.004). Eighteen days after corneal transplantation,corneal opacity scores were 3.17±0.17, 3.00±0.00 and 2.17±0.17,corneal neovascularization scores were 2.67 ± 0.21,2.33 ± 0.21 and 1.83 ± 0.21, respectively in the MSCs group, CsA group and MSCs+ CsA group, showing significant differences among the three groups (F=15.500,P<0.01; F=4.524,P=0.029). The corneal opacity scores and corneal neovascularization scores in the MSCs+ CsA group were significantly lower than those in the MSCs group and CsA group(all at P<0.05). Interleukin(IL)-2,IL-4,IL-10,and interferon-γ (IFN-γ) concentrations were all significantly different among the MSCs group,CsA group and MSCs+ CsA group (F=15.000,12.810,10.720,17.960,all at P< 0.01). Compared with the MSCs group and CsA group,Th1 subsets cytokines IFN-γ and IL-2 concentrations in the MSCs+CsA group were significantly lower,and Th2 subsets cytokines IL-4 and IL-10 concentrations were significantly increased in the MSCs+CsA group in comparison with the MSCs group and CsA group ( all at P<0.05 ). Conclusions The combination of MSCs with low-dose CsA can effectively ameliorate immunological rejection by the modulation of the balance of Th1/Th2.
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Objective To explore the impact of family single room practices in NICU on maternal anxiety and breastfeeding status and neuropsychological development in preterm infants. Methods One-hundred NICU-born preterm infants were divided into the experimental group (n= 48) and the control group (n=52) according to random number table. Neonates in the experimental group were guaranteed parental care in the family ward for at least 4 hours a day during hospitalization in NICU, while the control group used a traditional video-based approach for daily scheduled visits. Finally, the results of exclusive breastfeeding, nosocomial infection, maternal anxiety, parental satisfaction, and full-term NBNA score after correction of gestational age were collected and recorded. Results The rates of exclusive breastfeeding were 82.50%(33/40),42.50%(17/40)during hospitalization and six months old in the experimental group, and 17.07%(7/41),12.20%(5/41)in the control group. The difference between the two groups was statistically significant during hospitalization and at 6 months of age (χ2=32.25, 9.40,P <0.01). The score of maternal anxiety was 33.00(31.00, 41.75)in the experimental group, and 43.00(34.50, 46.00)in the control group. The difference between the two groups was statistically significant (Z=-2.97, P =0.003).The NBNA score in the experimental group was 38.50(38.00, 40.00), and 37.00(36.00, 39.00)in the control group. The difference between the two groups was statistically significant(Z=-2.86, P<0.01). Conclusions The development of family ward is conducive to raising the rate of exclusive breastfeeding, reducing the incidence of nosocomial infection, relieving the anxiety of mother-infant separation and enhancing the satisfaction of parents, which can promote the behavioral and neuropsychological development of preterm infants.
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The fluoritum is used for gynecology frequently and it's for those diseases: kidney yang deficiency, Gong cold sterility, palpitation due to fright, insomnia and dreaminess and cold cough. It's ruled in Chinese Pharmacopoeia (1985 edition) that the fluoritum originates from fluorite which belongs to fluoride minerals. Its main content is CaF2. The colors are of differents grades with purple or green. In the market, there are large differences in quality and it has various colors. Besides of the ruled color of purple and green, white and yellow are also common colors. By digging into and analysis the relevant research literature of fluorite which belongs to fluoride minerals, colors and coloration mechanism of fluorite are summarized in this paper.Natural fluorite is the mineral which has the most species of colors in nature. The different colors of fluorite are mainly caused by the impurity elements. At present, there are mainly about the coloration mechanism of fluorite: rare earth ions (4fN ions), color center, inclusions, crystalline domains or sub microscopic inclusions. The green of fluorite is produced by 570 nm and 305 nm absorption peaks which are caused by Sm2+ and compensated ions Na+ centers generated color center. The yellow of fluorite is produced by the joining of transition element, resulting in the formation of charge transfer between the crystal ions and the formation of O2-O32- ion molecule.The black of fluorite, mainly was attributed to the existence of a higher degree of evolution of organic matter. In this passage,suggestions for modification of the properties of fluoritum in Chinese Pharmacopoeia are put forward.
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<p><b>OBJECTIVE</b>To analyze the non-invasive indexes for predicting esophageal varices (EV) in liver cirrhosis, and to establish a model for predicting the degree of EV.</p><p><b>METHODS</b>A total of 294 patients with liver cirrhosis and portal hypertension were divided into the following groups according to EV grade as assessed by endoscopy: non-EV and grade I EV, grade II EV and grade III EV. The non-invasive EV predictive measures of liver stiffness (LS), platelet (PLT) count, spleen thickness (ST), PLT/ST ratio, portal vein diameter, portal vein flow velocity and Child-Pugh score (CPS) were assessed by univariate analysis and multivariate logistic regression analysis, and used to generate a predictive model. The t-test, chi-square test, logistic analysis and receiver operating characteristic (ROC) curve were used in statistical analyses.</p><p><b>RESULTS</b>The area under the ROC for the new model was 0.990. The best cutoff value for the score was 0.898, as defined from the ROC. The sensitivity of the model was 96.5%, and the specificity was 99.2%.</p><p><b>CONCLUSIONS</b>The model for predicting EV was composed of LS, PLT count, ST, PLT/ST and CPS, which was accurate and sensitive, and could be used to predict EV in clinic.</p>
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Humans , Endoscopy, Digestive System , Esophageal and Gastric Varices , Hypertension, Portal , Liver Cirrhosis , Platelet Count , ROC Curve , SpleenABSTRACT
Objective To determine the role of human serum albumin therapy in the post-operative management of patients with hepatocellular carcinoma (HCC) associated with cirrhosis.Methods Between January 2011 and December 2012,we treated 171 consecutive cirrhotic patients with HCC.88 patients were treated with 5％ human serum albumin for 48 hours followed by 20％ human serum albumin in the post-operative period (the observer group) ; 81 patients were only treated with 20％ human serum albumin during the same time duration (the control group).The prognosis,complications,average amount of human serum albumin and plasma used as well as the in-hospital stay were observed.Results There were no deaths or major complications in either of these 2 groups.After treatment,the observer group was lower than the control group in the amount of intravenous fluid infused,the volume of peritoneal drainage,the amount of human serum albumin and plasma used as well as the mean post-operative hospitalization days (P ＜ 0.05).At the same time,the daily urine output,the central venous pressure and the mean arterial pressure within 48 hours after surgery were higher in the observer group than the control group.Furthermore the observer group had a smoother post-operative recovery in liver function,and the difference was significant between the two groups (P ＜ 0.05).Conclusion Not only did treatment with 5 ％ and 20％ human serum albumin gave the advantages of a more stable blood circulation,better organ perfusion and improved liver function recovery but it also reduced the amount of consumption of human serum albumin and plasma and shortened the hospital stay.
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<p><b>OBJECTIVE</b>To evaluate the feasibility, efficacy and safety of the percutaneous coronary intervention (PCI)guided by computed tomography (CT) coronary angiography derived roadmap and magnetic navigation system (MNS).</p><p><b>METHODS</b>During June 2011 and May 2012, thirty consecutive patients receiving elective PCI were enrolled, coronary artery disease was primarily diagnosed by dual-source CT coronary angiography (DSCT-CA) at outpatient clinic and successively proved by coronary artery angiography in the hospital. Target vessels from pre-procedure DSCT-CA were transferred to the magnetic navigation system, and consequently edited, reconstructed, and projected onto the live fluoroscopic screen as roadmap. Parameters including characters of the target lesions, time, contrast volume, radiation dosage for guidewire crossing, and complications of the procedure were recorded.</p><p><b>RESULTS</b>Thirty patients with 36 lesions were recruited and intervened by PCI. Among the target lesions, sixteen were classified as type A, 11 as type B1, 8 as type B2, 1 as type C. The average length of the target lesions was (22.0 ± 9.8) mm, and the average stenosis of the target lesions was (81.3 ± 10.3)%. Under the guidance of CT roadmap and MNS, 36 target lesions were crossed by the magnetic guidewires, with a lesion crossing ratio of 100%. The time of placement of the magnetic guidewires was 92.5 (56.6 - 131.3) seconds. The contrast volume and the radiation dosage for guidewire placement were 0.0 (0.0 - 3.0) ml and 235.0 (123.5 - 395.1) µGym(2)/36.5 (21.3 - 67.8) mGy, respectively. Guidewires were successfully placed in 21 (58.3%) lesions without contrast agent. All enrolled vessels were successfully treated, and there were no MNS associated complications.</p><p><b>CONCLUSIONS</b>It is feasible, effective and safe to initiate PCI under the guidance of CT derived roadmap and MNS. This method might be helpful for the guidewire placement in the treatment of total occlusions.</p>
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Aged , Female , Humans , Male , Middle Aged , Coronary Angiography , Methods , Magnetics , Percutaneous Coronary Intervention , Tomography, X-Ray ComputedABSTRACT
<p><b>OBJECTIVE</b>Dendritic cells play an important role in the pathogenesis of atherosclerosis. To explore the effects of hyperglycemia on the maturation and immune function of human monocyte derived dendritic cells (MDCs).</p><p><b>METHODS</b>Immature MDCs were cultured in RPMI1640 medium with either 5.5 mmol/L D-glucose (NG), 25 mmol/L D-glucose (HG) or 5.5 mmol/L D-glucose + 19.5 mmol/L mannitol (HM) in the absence or presence of 30 mmol/L N-acetylcysteine [NAC, a reactive oxygen species inhibitor (ROS)] for 48 hours. FACS was used to investigate the MDCs immunophenotypic expression. Immune function was evaluated by allogeneic mixed T lymphocyte reaction and measurement of cytokine levels from culture supernatants. Intracellular ROS production in MDCs was also measured by 2', 7'-dichlorodihydrofluorescein (DCF, 10 micromol/L) fluorescence using confocal laser-scanning microscopy techniques.</p><p><b>RESULTS</b>Compared with NG and HM treated MDCs, the expression of maturation markers such as CD1a, HLA-DR, CD83, CD86 were significantly upregulated, allogeneic T cells proliferation as well as the cytokines secretions (IL-2, IL-12, IL-10 and IFN-gamma) significantly increased in HG treated MDCs. Intracellular ROS production in MDCs was also significantly increased and all these stimulatory effects of HG could be partially attenuated by NAC.</p><p><b>CONCLUSION</b>High glucose promote the maturation of MDCs and augment their capacity to stimulate T-cell proliferation and cytokine secretions at least in part through enhancing intracellular ROS generation. These stimulating effects of high glucose on MDCs maturation may be one of the mechanisms of accelerated atherosclerosis found in patients with diabetes.</p>
Subject(s)
Humans , Cell Differentiation , Cell Proliferation , Cells, Cultured , Culture Media , Cytokines , Dendritic Cells , Allergy and Immunology , Metabolism , Glucose , Pharmacology , Immunophenotyping , Monocytes , Cell Biology , Reactive Oxygen Species , Metabolism , T-Lymphocytes , Cell BiologyABSTRACT
<p><b>OBJECTIVE</b>To study the changes of lectin-like oxidized low density lipoprotein receptor-1 (LOX-1) expression in the autologous vein grafts and vein graft atherosclerotic lesions.</p><p><b>METHODS</b>Thirty New Zealand white rabbits were randomly assigned to normal control group (rabbits fed with normal diet, n = 10), vein graft group (autologous external jugular vein grafting to common carotid artery and fed with normal diet, n = 10) or vein graft plus high-lipid diet group (autologous vein graft and fed with high-lipid diet, n = 10) for 12 weeks. LOX-1 expressions in the grafts were examined by immunohistochemistry and semi-quantitative reverse transcription-PCR. The relationships between serum total cholesterol level, intimal thickness and LOX-1 expression were also investigated.</p><p><b>RESULTS</b>LOX-1 expression was low in the endothelium of external jugular veins in the normal control group and significantly increased in the endothelium and neointima of vein grafts in the vein graft group (0.31 +/- 0.14 vs. 0.09 +/- 0.04, P < 0.01) and which was further increased in the endothelium and atherosclerotic lesions in the vein graft plus high-lipid diet group (0.93 +/- 0.34 vs. 0.31 +/- 0.14, P < 0.01). LOX-1 expression in the atherosclerotic lesions was located both in endothelial cells and foam cells and the expression was most prominent in endothelial cells. LOX-1 expression and intimal thickness were positively related to serum total cholesterol level (P = 0.00 and 0.02) and the partial correlation coefficient was 0.78 and 0.42, respectively.</p><p><b>CONCLUSIONS</b>LOX-1 expression is increased in endothelium and neointima of autologous vein grafts of rabbits. Hypercholesterolemia upregulates LOX-1 expression in vein graft atherosclerosis. Thus, LOX-1 might play an important role in the pathogenesis of vein graft atherosclerosis.</p>
Subject(s)
Animals , Male , Rabbits , Atherosclerosis , Metabolism , Pathology , Disease Models, Animal , Graft Occlusion, Vascular , Metabolism , Pathology , Lipoproteins, LDL , Blood , Scavenger Receptors, Class E , Metabolism , Transplantation, Autologous , Veins , TransplantationABSTRACT
<p><b>OBJECTIVE</b>To study the mechanism of injury of cortical nerve cell in the newborn with hypoxia/ischemia brain damage (HIBD), and the neuroprotective effect of Radix Astragali (RA).</p><p><b>METHODS</b>Neonatal HIBD model rats were established and divided into the sham group, the model group and the RA group. Brain of rats obtained at different time points after HIBD to conduct histopathological examination, neuron death rate count, as well as determination of caspase-3 (cysteinyl aspartate-specific proteinase-3) protein mRNA expression in cerebral cortex by immunohistochemistry, semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) respectively.</p><p><b>RESULTS</b>In the model group, caspase-3 mRNA and protein showed an increase at 6 hrs, reached the peak at 24 hrs, and decreased at 48 hrs after HIBD, on the 5th and 7th day restored to baseline level. After being treated by RA, the neuron death rate of ligated side was obviously reduced, caspase-3 mRNA and protein expression peak value decreased by 45% (mRNA) and 40% - 43% (protein).</p><p><b>CONCLUSION</b>RA shows markedly neuron protection in immature brain cortex after HIBD, which is related with the inhibition on caspase-3 expression.</p>