Evaluation of three-dimensional CT reconstruction on the anatomic variation of inferior mesenteric artery and left colic artery / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To demonstrate the clinical applicability of three-dimensional CT angiography by evaluating the anatomic features and variation of inferior mesenteric artery(IMA) and left colic artery(LCA) in order to provide reference to vessel ligation strategy in laparoscopic rectal cancer surgery.</p><p><b>METHODS</b>Clinical and image data of 123 patients receiving abdominal multislice CT at The Sixth Affiliated Hospital from 2014 to 2015 were retrospectively analyzed. The images were 3D-reconstructed with computer 3D CT angiography and arterial enhancement phase images were chosen for analysis. Linear distances from IMA root to abdominal aortic bifurcation and from LCA at IMA root level to IMA root were measured. Branch types of IMA, coursing pattern of LCA, and association between LCA and inferior mesenteric vein (IMV) site were summarized.</p><p><b>RESULTS</b>Of 123 cases, 80 were males and 43 were females, mean age was (46.8±16.6) years, body weight was (57.7±10.4) kg, and BMI was (21.3±3.6) kg/m. The average distance from IMA root to abdominal aortic bifurcation was (42.5±7.9) mm, and this distance was closely associated with body weight (OR=4.771, 95%CI: 1.398 to 16.283, P=0.013). Longer distance tended to appear in the heavier patients. LCA and sigmoid artery (SA) originating from same single IMA was found in 61(49.6%) cases; LCA and SA forking at same point in 35(28.5%) cases; LCA and SA coursing together and forking afterwards in 24(19.5%) cases, and LCA disappearing in 3(2.4%) cases. In 71(57.7%) patients, LCA ascended medial to the lateral border of left kidney, while in 16(13.0%) patients, LCA arranged below the inferior border of left kidney. When the LCA site was higher and the distance from LCA to IMA root was closer [distance from LCA to IMA root level was (24.2±9.9) mm, (30.0±15.2) mm and (66.6±12.3) mm, F=83.2, P<0.001]. At the level of IMA root, LCA located medial to IMV in 21(17.1%) cases, located just lateral to IMV in 54(43.9%) cases, and located lateral and ascended far away from IMV in 48(39.0%) cases.</p><p><b>CONCLUSION</b>3D-CT angiography is non-invasive, efficient and accurate in evaluating coursing features and variation of IMA and its branches, which can provide important reference to the surgeons, promising laparoscopic surgery smooth and safe.</p>

Influence of atoxiban on pregnancy outcome in patients with repeated implantion failure in Blastcyst Thawed Embryo Transfer / 实用医学杂志

Objective To investigate the influence of atosiban on the pregnancy outcome in patients with repeated implantation failure(RIF)in blastcyst thawed embryo transfer(bTET) Methods From January 2014 to December 2015,a total of 262 RIF patients undergoing bTET were retrospectively studied. They were divided into study group with a single bolus dose (6.75 mg/0.9 mL,iv) of atosiban before bTET (n = 94),and control groupwithout atosiban(n = 168). Results The clinical pregnancy rate(57.41%),implantation rate(38.41%) and living-birth rate(46.81%) of study group were significantly higher than those of control group (41.12%, 28.32% and 33.93% respectively;P 0.05). Conclusion Atosiban treatment before embryo transfer may improve pregnancy outcomes of RIF patients in bTET.

Study of ocular surface macro genome in dry eye patients / 眼科新进展

Objective To investigate the difference in ocular surface microbiota between dry eye patients and healthy subjects,and discuss the role of microbiota in dry eye.Methods Twenty cases of dry eye patients and 90 cases of healthy subjects were collected in the PLA General Hospital and Zhongshan Ophthalmic Center.The samples of conjunctiva impression cytology were collected from all subjects,and then metagenomic shotgun sequencing was performed following the DNA extraction.The differences in alpha diversity and metabolic pathways of the ocular surface microbiota between dry eye patients and healthy subjects were evaluated.Results There was no significant difference in alpha diversity of the microbial community between dry eye patients and healthy subjects (P =0.13).However,an increase of 15 species and a decrease of 10 species were detected on the ocular surface of dry eye patients.The enriched antibiotic resistance genes in dry eye patients were more than healthy subjects.Conclusion Although the alpha diversity of the microbial community on ocular surface between dry eye patients and healthy subjects are not distinguishable,a significant difference could be found in relative abundance and metabolic pathways,suggest that these specific microbiome may be related to the pathogenesis and disease progression of dry eye.

Significance of P53 and high mobility group box 1 protein in different levels of liver fibrosis in chronic hepatitis B / 中南大学学报(医学版)

OBJECTIVE@#To investigate the role of P53 and high mobility group protein 1 (HMGB1) protein expression in liver fibrosis stages in chronic hepatitis B patients.
@*METHODS@#According to the pathological grades, 103 patients were divided into 3 groups: no fibrosis group (n=18), low fibrosis group (n=49) or high fibrosis group (n=36). Serum HMGB1 levels were determined and receiver operating characteristic (ROC) curve was made based on the HMGB1 level and liver fibrosis score. Liver fibrosis model was developed by CCl4 in 60 male SD rats, which were sacrificed 6 or 12 weeks later. The degree of fibrosis was examined by Masson staining; HMGB1 and P53 protein expression were analyzed by Western blot; histone deacetylase (HDAC) activity, TNF-α, IL-1β and IL-6 levels in serum were measured.
@*RESULTS@#The serum levels of HMGB1 level in low and high fibrosis groups were significantly higher than that in no fibrosis group (P<0.01, respectively). ROC curve showed that serum HMGB1 in the diagnosis of hepatic fibrosis with cut off at 74 pg/mL, specificity at 65% and sensitivity at 87%. Compared with the control group, HMGB1 expression in both low and high fibrosis group was decreased in nucleus but was increased in cytoplasm, accompanied by the elevated P53 expression, increased HDAC activity and inflammatory cytokine levels (all P<0.01, respectively).
@*CONCLUSION@#P53 and HMGB1 expression was significantly increased in chronic hepatitis B patients with liver fibrosis; serum HMGB1 level was positively correlated with the degree of liver cirrhosis and HMGB1 could be used as a sensitive and specific index for liver fibrosis prognosis.

Association between Helicobacter pylori infection and stages of liver pathology in patients with chronic hepatitis B / 临床肝胆病杂志

ObjectiveTo investigate the association between Helicobacter pylori (Hp) infection and stages of liver pathology in patients with chronic hepatitis B (CHB). MethodsSeventy-nine patients who were hospitalized in the People’s Hospital of Liuzhou from February 2008 to December 2014 were selected, and liver biopsy was performed for all patients to determine the liver inflammation grade (G) and fibrosis stage (S). Meanwhile, 14C urea breath test (14C-UBT) was performed to detect Hp infection. The patients were divided into Hp-positive group and Hp-negative group based on the results of 14C-UBT, and liver inflammation grade and fibrosis stage were compared between the two groups. The t-test was applied for comparison of continuous data between the two groups, and χ2 test was applied for comparison of categorical data between the two groups. ResultsThere were no differences in liver inflammation grade or fibrosis stage between Hp-positive group and Hp-negative group (t=-1.622 and -1.263, respectively; both P＞0.05); there was no difference in the proportion of patients ≥G2 between the two groups (χ2=1.58; P＞0.05); there was no difference in the proportion of patients ≥S2 between the two groups (χ2=0.02; P＞0.05). ConclusionHp infection may not be associated with liver inflammation grade or fibrosis stage in patients with CHB.

Risk factors for perioperative pulmonary infection in patients with senile hip fracture / 中国组织工程研究

BACKGROUND:At present, few studies concerned pulmonary infection after treatment of senile fracture. For special parts of senile patients, there are no studies on complications of pulmonary infection in perioperative period after hip fracture. OBJECTIVE:To study risk factors for pulmonary infection in patients with senile hip fractures in perioperative period. METHODS:The data of 46 senile hip fracture patients with perioperative pulmonary infection were retrospectively analyzed. A matched case-control study was conducted in 46 senile hip fracture patients without pulmonary infection in the same hospital and the same period. The difference in perioperative various clinical indexes was compared between the two groups. Risk factors of pulmonary infection received Logistic regression analysis. RESULTS AND CONCLUSION:Multivariate analysis screened out 14 possible perioperative pulmonary infection factors:chronic obstructive pulmonary disease, smoking, diabetes mel itus, heart disease, mechanical ventilation, intraoperative bleeding amount, erythrocyte infusion, operation time, preoperative low body mass index (body mass index<18.5 kg/m2 ), serum albumin<35 g/L, electrolyte disturbance, time of entering intensive care unit and length of stay. Logistic regression analysis displayed that chronic obstructive pulmonary disease (OR=23.317;95%CI:2.702-60.312;P=0.000), entering intensive care unit (OR=7.890;95%CI:2.624-76.012;P=0.008), mechanical ventilation (OR=35.210;95%CI:8.464-131.203;P=0.017) and operation time (OR=12.122;95%CI:5.154-99.098;P=0.012) were independent risk factors for perioperative pulmonary infection in patients with senile hip fracture. These data indicated that one should be alert to the possible occurrence of pulmonary infection in senile hip fracture patients with the presence of chronic obstructive pulmonary disease, entering intensive care unit and mechanical ventilation.

Clinical value of multiple organ dysfunction syndrome score in evaluating prognosis for patients with liver failure / 中华全科医师杂志

Objective To study clinical value of multiple organ dysfunction syndrome (MODS) score to evaluate prognosis for patients with liver failure. Methods A total of 189 patients with liver failure were recruited into the study, 125 deaths and 64 survivals. Their vital sign, platelets count (PLT), prothrombin time (PT) and international normalized ratio of PT (INRPT), fraction of inhaled oxygen (FiO2), arterial oxygen partial pressure (PaO2), serum levels of total bilirubin (TB), albumin (ALB), creatinine (Cr), pressure-adjusted heart rate (PAHR), glasgow coma score (GCS), degree of aacitic fluid (DAF) and stage of hepatic encephalopathy (SHE) were evaluated within 24 hours after admission. Each of the patients scored according to the criteria of MODS score, Child-Turcotte-Pugh (CTP) score and model for end-stage liver disease (MELD) score. Difference in MODS score between death and survival groups was compared and accuracy of prognosis of MODS score, CTP score and MELD score were evaluated by the area under receiver operating characteristic (ROC) curve. Survival time of patients in the two groups classified by their MODS scores was compared with Kaplan-Meier (K-M) survival curve. Results There was significant difference in PT, INRPT, PaO2, Cr, GCS, SHE between death and survival groups, but there was no difference in TB, ALB, PLT, FiO2, PHAR and DAF between them. Mean score of MODS in death group (9±2) was significantly higher than that in survival group (7±1) (t=9.076, P<0.01). The area under ROC curve (AUC) of MODS score (0.814) was close to that of MELD score (0.827), but higher than that of CTP score (0.714). There was significant difference in survival time between the varied groups classified by MODS score (χ2=72.451, P<0.01). Conclusions Clinical value of MODS score is equivalent to that of MELD score in evaluating prognosis for patients with liver failure, even better than that of CTP score, which can be used to evaluate short-term prognosis for patients with liver failure.

Expression of cytokeratin 19,galectin-3,HBME-1,p27 and CyclinD1 in thyroid papillary carcinoma and their clinicopathological significance / 中国癌症杂志

Background and purpose: The diagnosis of thyroid papillary carcinoma sometimes is difficult, metastasis of lymph node is the major reason of local relapse and influence prognosis.This study explores the immunohistochemical expression and their diagnostic value of CK19,HBME-1,galectin3,p27 and cyclinD1 in thyroid papillary carcinoma and the relations between p27,cyclinD1 and lymph node metastasis of papillary carcinoma.Methods: Immunohistochemical staining was used on 50 specimens of benign lesions (40 speciments of nodular goiters and 10 cases of follicular adenomas) and 50 specimens of papillary carcinomas (40 specimens of classic variants and 10 specimens of follicular variants) operated in our hospital from January of 2005 to December of 2008. Results: CK19,HBME-1 and galectin3 were expressed in cytoplasm or on the membrane, but p27 and cyclinD1 were expressed on the nucleus. The expressions of CK19,HBME-1 and galectin3 in thyroid papillary carcinoma were middle to strong positive, the positive ratios were 100%,96% and 100%, respectively;their expressions in benign lesions were negative or low positive, the positive ratios were 10%,10% and 6%, respectively;there were statistical differences between them (P<0.01). The expression of p27 in thyroid papillary carcinoma was low positive or negative, the positive ratio was 14%, but the expression of p27 in benign lesions was middle to strong positive, the ratio was 84%, there was also significant difference between them(P<0.01). The expression of CyclinD1 were similar in benign and malignant lesions of thyroid, the positive ratios were 68% and 78%, respectively, there was no statistical difference between them(P>0.05). There were significant differences(P<0.01) between the benign lesions and the papillary carcinomas in terms of the combination of CK19,HBME-1 and galectin3 expression and there were no significant differences(P>0.05) in the group of the former with underexpression of p27 between the two groups. The differences were not statistically significant (P>0.05) between the underexpression of p27 with the expression of cyclinD1 (the positive ratios in metastasis group and no metastasis group are 72.7% and 71.4%) in the lymph node metastasis. Conclusion: The combined immunohistochemical stainings of CK19,HBME-1 and galectin3 are useful on the diagnosis and differential diagnosis of thyroid papillary carcinoma, there is no predicted value of the underexpression of p27 with the expression of cyclinD1 for lymph node matastasis of thyroid papillary carcinoma.

Clinical research of B-mode ultrasonography detecting middle hepatic vein in chronic liver disease / 中国基层医药

Objective To investigate the diagnostic value of B-mode ultrasonography in detecting middle hepatic vein(MHV)in chronic liver disease patients.Methods 80 chronic liver disease patients were divided into 2 groups(chronic hepatitis and liver cirrhosis).Liver biopsies and the inner diameter(ID)of MHV was detected with B-mode ultrasonography.The ID of MHV was compared in the chronic hepatitis and liver cirrhosis groups,different liver fibrosis stages and compensation/non-compensation liver cirrhosis.The ability of ID of MHV in auxiliary diagnosis liver cirrhosis was analyzed with the receiver operating characteristic curve(ROC).Results The size of ID of MHV in liver cirrhosis(3.82±1.84)mm was smaller than that of chronic hepatitis(6.15±1.67)mm(P＜0.01).The size of ID of MHV in non-compensation liver cirrhosis(2.98±1.15)mm was smaller than that of compensation liver cirrhosis(4.42±2 20)mm(P＜0.05).There was midrange negative correlation with liver fibrosis stages and the ID of MHV(rs=-0.465,P＜0.01).The cutoff point of ID of MHV diagnosis liver cirrhosis was 4.7mm.The area under ROC(AUC)achieved 0.813(P＜0.01).The sensitivity(Se),specificity,(Sp),positive predictive value (PPV),negative predictive value(NPV)and Youden index were 67.5%,90.0%,88.0%,73.5% and 57.5%,respectively.Conclusion There is well clinical value with B-mode ultrasonography detecting ID of MHV for the auxiliary diagnosis of chronic liver disease.

Observation on the therapeutic effect of Lamivudin on chronic hepatitis B / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To observe the therapeutic effect of Lamivudine on controlling hepatitis B virus DNA replication.</p><p><b>METHODS</b>The liver disease patients were divided into two groups, the treated group (n=64) was given Lamivudine 100 mg once a day for one year and was additionally given liver protection drugs according to their liver function, while the control group (n=30) was given common liver protection drugs. The blood routine test, liver function and the viral markers were detected at defined times.</p><p><b>RESULTS</b>The results showed that after one year treatment of chronic hepatitis B with Lamivudine, the recovery rate of ALT was 90.7%, the negative conversion rate of HBV DNA was 73.1% showing a significant difference as compared with the control group (P<0.05). The negative seroconversion rate of HBeAg was 50%, HBeAg/anti HBe changing rate was 38.2%, that had no significant different as compared with the control group (P<0.05). The percentage for disease relapse and second elevation of ALT was 3.1% in therapeutic group that was significantly different from that of the control group (P<0.05). Two cases with severe hepatitis in the treated group were all alive.</p><p><b>CONCLUSIONS</b>Lamivudine could effectively control HBV DNA replication, making ALT normal, it also could decrease the relapse rate of chronic hepatitis B and raise the survival rate of the patients with liver disease.</p>