Clinical risk factors analysis of large volume central lymph node metastasis in papillary thyroid carcinoma / 中华内分泌外科杂志

Objective:To investigate the clinical risk factors of large volume lymph node metastasis (LV-LNM) in the central region of papillary thyroid cancer (PTC) .Methods:The clinical data of 1367 PTC patients admitted to the Department of Oncological Surgery, Hangzhou First People’s Hospital, Affiliated to Zhejiang University School of Medicine from Jan. 2016 to Jan. 2019 were retrospectively analyzed. There were 310 males and 1057 females. A total of 1644 cases of central region were included in the study.According to the number of lymph node metastasis in the central area, they were classified into small-volume lymph node metastasis (SV-LNM) group and LV-LNM group.71 cases of LV-LNM, 1573 cases of SV-LNM.The correlation between CLNM and LV-LNM and various clinicopathological features such as the sex, age, tumor size and so on of PTC patients was analyzed by chi-square test and Logistic regression analysis.Results:The proportion of CLNM in the affected side was 35.28% (580/1 644) , and the incidence of LV-LNM in the central area of the affected side was 4.32% (71/1644) . Univariate analysis showed that the LV-LNM in the central region of the affected side was closely correlated with gender, age, bilateral lesions, multiple lesions, size of lesions, membranous invasion and lateral cervical lymph node metastasis on the affected side were closely related ( P<0.05) . Multivariate regression analysis showed that male (OR=2.115, P=0.006) , age < 38 years old (OR=0.586, P=0.004) , multiple lesions on the affected side (OR=2.837, P=0.004) , lesions >7mm on the affected side (OR=1.762, P=0.002) and cervical lymph node metastasis on the affected side (OR=7.023, P<0.001) were independent predictors of LV-LNM in the central region of the affected side ( P<0.001) . The receiver operating characteristic curve (ROC) , sensitivity and specificity of LV-LNM predicted by the model were 0.839, 81.69% and 78.39%. The incidence of ipsilateral cervical lymph node metastasis in the affected central region of LV-LNM was 11.57 times higher than that of SV-LNM. Conclusion:PTC with male, age < 38 years old, multiple lesions on the affected side, lesion >7 mm and lateral cervical lymph node metastasis are prone to LV-LNM in the affected central region.

Daidzein affects proliferation and apoptosis in non-small cell lung cancer cells:role of p53 signaling pathway / 中国药理学通报

Aim To investigate the effects of daidzeinDD on the proliferation and apoptosis of non-small cell lung cancer cells,with a focus on the possible role of the p53 signaling pathway in this regard. Methods CCK-8 method and flow cytometry were used to detect the effects of soy isoflavone crude extract and DD on the viability and apoptosis of HELF and H1299 cells. Gene microarray was used to detect the changes in gene expression after treatment of H1299 cells with DD. GSEA and differential analysis were used to screen the major pathways and key genes. RT-qPCR and Western blot were performed to verify the differences in mRNA and protein expression of key genesp53 and CASP9 in the major pathways. After p53 inhibitor Pifithrin-α inhibited the expression of p53,the effect of DD on p53 mRNA and protein expression levels was examined,and the proliferative effect on H1299 cells was observed. Results Soy isoflavone crude extract and DD promoted proliferation and inhibited apoptosis of normal lung cells and inhibited proliferation and promoted apoptosis of lung cancer cells. p53 signaling pathway was significantly enriched in the DD-treated groupNES=1.78,P=0.000,and the expressions of p53 and CASP9 genes were found to be significantly up-regulated in the treated group. Compared with the control group,mRNA expression of CASP9 and p53 significantly increased in both HELF and H1299 cells treated with DDP<0.05,and p53 protein expression also increased in HELF cellsP<0.05. After inhibition of p53 expression,DD significantly increased the mRNA expression of p53 in H1299 and HELF cellsP<0.05 and also markedly increased the expression of p53 protein in H1299 cellsP<0.05,and it was observed that DD inhibited the proliferation of lung cancer cells. Conclusions DD inhibits the proliferation and promotes the apoptosis of lung cancer H1299 cells,and the mechanism mainly involves the p53 signaling pathway.

Survey on the application of external cardiopulmonary resuscitation in Chinese children with sudden cardiac arrest / 中华儿科杂志

Objectives: To investigate the current application status and implementation difficulties of extracorporeal cardiopulmonary resuscitation (ECPR) in children with sudden cardiac arrest. Methods: This cross-sectional survey was conducted in 35 hospitals. A Children's ECPR Information Questionnaire on the implementation status of ECPR technology (abbreviated as the questionnaire) was designed, to collect the data of 385 children treated with ECPR in the 35 hospitals. The survey extracted the information about development of ECPR, the maintenance of extracorporeal membrane oxygenation (ECMO) machine, the indication of ECPR, and the difficulties of implementation in China. These ECPR patients were grouped based on their age, the hospital location and level, to compare the survival rates after weaning and discharge. The statistical analysis used Chi-square test and one-way analysis of variance for the comparison between the groups, LSD method for post hoc testing, and Bonferroni method for pairwise comparison. Results: Of the 385 ECPR cases, 224 were males and 161 females. There were 185 (48.1%) survival cases after weaning and 157 (40.8%) after discharge. There were 324 children (84.2%) receiving ECPR for cardiac disease and 27 children (7.0%) for respiratory failure. The primary cause of death in ECPR patients was circulatory failure (82 cases, 35.9%), followed by brain failure (80 cases, 35.0%). The most common place of ECPR was intensive care unit (ICU) (278 cases, 72.2%); ECPR catheters were mostly inserted through incision (327 cases, 84.9%). There were 32 hospitals (91.4%) had established ECMO emergency teams, holding 125 ECMO machines in total. ECMO machines mainly located in ICU (89 pieces, 71.2%), and the majority of hospitals (32 units, 91.4%) did not have pre-charged loops. There were no statistically significant differences in the post-withdrawal and post-discharge survival rates of ECPR patients among different age groups, regions, and hospitals (all P>0.05). The top 5 difficulties in implementing ECPR in non-ICU environments were lack of ECMO machines (16 times), difficulty in placing CPR pipes (15 times), long time intervals between CPR and ECMO transfer (13 times), lack of conventional backup ECMO loops (10 times), and inability of ECMO emergency teams to quickly arrive at the site (5 times). Conclusion: ECPR has been gradually developed in the field of pediatric critical care in China, and needs to be further standardized. ECPR in non-ICU environment remains a challenge.

Analysis of risk factors of mortality in infants and toddlers with moderate to severe pediatric acute respiratory distress syndrome / 中华儿科杂志

Objective: To identify the risk factors in mortality of pediatric acute respiratory distress syndrome (PARDS) in pediatric intensive care unit (PICU). Methods: Second analysis of the data collected in the "efficacy of pulmonary surfactant (PS) in the treatment of children with moderate to severe PARDS" program. Retrospective case summary of the risk factors of mortality of children with moderate to severe PARDS who admitted in 14 participating tertiary PICU between December 2016 to December 2021. Differences in general condition, underlying diseases, oxygenation index, and mechanical ventilation were compared after the group was divided by survival at PICU discharge. When comparing between groups, the Mann-Whitney U test was used for measurement data, and the chi-square test was used for counting data. Receiver Operating Characteristic (ROC) curves were used to assess the accuracy of oxygen index (OI) in predicting mortality. Multivariate Logistic regression analysis was used to identify the risk factors for mortality. Results: Among 101 children with moderate to severe PARDS, 63 (62.4%) were males, 38 (37.6%) were females, aged (12±8) months. There were 23 cases in the non-survival group and 78 cases in the survival group. The combined rates of underlying diseases (52.2% (12/23) vs. 29.5% (23/78), χ2=4.04, P=0.045) and immune deficiency (30.4% (7/23) vs. 11.5% (9/78), χ2=4.76, P=0.029) in non-survival patients were significantly higher than those in survival patients, while the use of pulmonary surfactant (PS) was significantly lower (8.7% (2/23) vs. 41.0% (32/78), χ2=8.31, P=0.004). No significant differences existed in age, sex, pediatric critical illness score, etiology of PARDS, mechanical ventilation mode and fluid balance within 72 h (all P>0.05). OI on the first day (11.9(8.3, 17.1) vs.15.5(11.7, 23.0)), the second day (10.1(7.6, 16.6) vs.14.8(9.3, 26.2)) and the third day (9.2(6.6, 16.6) vs. 16.7(11.2, 31.4)) after PARDS identified were all higher in non-survival group compared to survival group (Z=-2.70, -2.52, -3.79 respectively, all P<0.05), and the improvement of OI in non-survival group was worse (0.03(-0.32, 0.31) vs. 0.32(-0.02, 0.56), Z=-2.49, P=0.013). ROC curve analysis showed that the OI on the thind day was more appropriate in predicting in-hospital mortality (area under the curve= 0.76, standard error 0.05,95%CI 0.65-0.87,P<0.001). When OI was set at 11.1, the sensitivity was 78.3% (95%CI 58.1%-90.3%), and the specificity was 60.3% (95%CI 49.2%-70.4%). Multivariate Logistic regression analysis showed that after adjusting for age, sex, pediatric critical illness score and fluid load within 72 h, no use of PS (OR=11.26, 95%CI 2.19-57.95, P=0.004), OI value on the third day (OR=7.93, 95%CI 1.51-41.69, P=0.014), and companied with immunodeficiency (OR=4.72, 95%CI 1.17-19.02, P=0.029) were independent risk factors for mortality in children with PARDS. Conclusions: The mortality of patients with moderate to severe PARDS is high, and immunodeficiency, no use of PS and OI on the third day after PARDS identified are the independent risk factors related to mortality. The OI on the third day after PARDS identified could be used to predict mortality.

Application of membrane anatomy in hepatopancreatobiliary and splenic surgery / 中华外科杂志

Understanding of a variety of membranous structures throughout the body,such as the fascia,the serous membrane,is of great importance to surgeons. This is especially valuable in abdominal surgery. With the rise of membrane theory in recent years,membrane anatomy has been widely recognized in the treatment of abdominal tumors,especially of gastrointestinal tumors. In clinical practice. The appropriate choice of intramembranous or extramembranous anatomy is appropriate to achieve precision surgery. Based on the current research results,this article described the application of membrane anatomy in the field of hepatobiliary surgery,pancreatic surgery,and splenic surgery,with the aim of blazed the path from modest beginnings.

Clinical application of bipolar tweezers-clamp for hepatic parenchymal transection / 中华外科杂志

Objective: To investigate the clinical value of the bipolar tweezers-clamp for the hepatic parenchymal transection in the resection of hepatocellular carcinoma. Methods: From January 2020 to January 2021,63 patients with the hepatocellular carcinoma for hepatectomy at Department of Hepatopancreatobiliary Surgery,Yuebei People's Hospital Affiliated to Shantou University Medical College were analyzed retrospectively.According to the different instruments used in the hepatic parenchymal transection,the patients were divided into bipolar tweezers-clamp group and ultrasonic scalpel group.There were 32 patients in bipolar tweezers-clamp group,with age of (55.5±10.5)years(range:37 to 78 years),including 22 males and 10 females,tumor size was (6.0±3.4)cm(range:2.4 to 13.4 cm). There were 6 patients with portal vein tumor thrombus and 5 patients with portal hypertension. There were 31 patients in ultrasonic scalpel group,with aged(57.8±10.1)years(range:37 to 79 years),including 27males and 4 females,tumor size was(7.9±5.1)cm(range: 2.4 to 21.3 cm),3 patients with portal vein tumor thrombus and 2 patients with portal hypertension. The preoperative baseline data,operation time,blood loss,postoperative liver function and the complications were compared between two groups using t test,χ2 test and Fisher exact probabilityrespectively. Results: The operation was successfully completed in both groups.Compared with the ultrasonic scalpel group,the operation time was significantly shorter((219.3±76.4)minutes vs.(294.0±100.8)minutes,t=-3.322,P=0.002),the blood loss was less((250(475)ml vs. 500(1 050)ml,t=-2.307,P=0.026),the concentrate red blood cells transfusion volume was less(0.92(0.88)U vs. 2.32(4.00)U,Z=-1.987,P=0.047) in the bipolar tweezers-clamp group.The postoperative serum ALB level was higher in the bipolar tweezers-clamp group than that in the ultrasonic scalpel group((33.5±6.1)g/L vs. (29.5±4.2)g/L,t=3.226,P=0.020) on postoperative day 1;((35.7±4.5)g/L vs.(30.1±3.2)g/L,t=5.575,P<0.01) on postoperative day 3;((33.2±3.7)g/L vs. (31.0±4.4)g/L,t=3.020,P=0.004) on postoperative day 7. There was no significant difference in serum ALT,TBIL and PT level between the two groups(all P>0.05).No postoperative bile leakage occurred in both groups.The postoperative complications occurred in 8 cases(25.0%)in the bipolar tweezers-clamp group,including liver failure in one,and in 11 cases(35.5%)in the ultrasonic scalpel group,including liver failure in two(P>0.05). Conclusion: The bipolar tweezers-clamp is a safe and reliable method for the hepatic parenchymal transaction,which is quick and less bleeding during the hepatic resection.

Ten-year retrospect of ALPPS in the treatment of hepatocellular carcinoma:an eternal concept with cautious technologic choice / 中华外科杂志

Clinical practice using associating liver partition and portal vein ligation for staged hepatectomy(ALPPS) or its modified procedures in treatment of primary hepatocellular carcinoma(HCC) with insufficient future liver remnant(FLR) in the past 10 years has failed to meet our expectations both in achieving decreased perioperative complications and mortality.The efficacy of ALPPS in improving long-term survival outcome of HCC still remains poor.Due to the trauma of two surgery within a short period,and patients with inadequate FLR are all diagnosed at advanced disease stages,ALPPS can only achieve surgical rather than biological tumor-curability.Previous studies have demonstrated comparable 5-year survival rates between early and advanced stages of HCC who underwent regional treatments.Therefore,tumor biological conversion is the key strategy prior to liver remnant volume conversion in improving treatment outcomes for HCC patients with insufficient FLR.Target therapy,immunotherapy together with locally treatment were expected to improve the conversion efficacy.Looking back at the development of ALPPS for the last decade,the rapid proliferation of FLR should be passed on,while the technology costs high risks and result in poor long-term outcome must be cautiously selected.

Discussion on the necessity of Delphian lymph node dissection for papillary thyroid carcinoma / 中华内分泌外科杂志

Objective:To investigate the clinical significance of Delphian lymph node (DLN) dissection in papillary thyroid cancer (PTC) .Methods:The correlation of DLN detection and metastasis in 208 PTC patients with various clinical and pathological features was analyzed retrospectively. The value of DLN metastasis in predicting PTC high-risk features was evaluated, and the tendency of surgical selection for PTC with DLN metastasis was also discussed.Results:① Of 208 PTC patients, DLN was detected in 144 patients (69.23%) . The detection rate of DLN was related to gender, number of central lymph nodes (excluding DLN) removed and metastasis (all P<0.05) . Male, greater number of nodes in the central compartment (excluding DLN) was more favorable for DLN detection. ② The rate of DLN metastasis was 18.27% (38/208) . In the univariate analysis, DLN metastasis was significantly associated with the following variables:gender, whether it is microcarcinoma, isthmus involvement, number of lesions, extrathyroidal extension, tumor size, number of central lymph nodes (excluding DLN) removed and metastasis (all P<0.05) . In the multivariate analysis, tumor size larger than 1 cm, isthmus involvement and greater number of central lymph nodes (excluding DLN) metastasis were independent risk factors of DLN metastasis ( P<0.05) . ③ The sensitivity of DLN metastasis to predict extranodal invasion, central and lateral lymph node metastasis was 54.54%, 37.36% and 62.86%, with specificity of 78.69%, 92.45% and 55.56%, respectively. ④ Patients with DLN metastasis were more likely to receive total thyroidectomy, bilateral central lymph node dissection, and lateral cervical lymph node dissection. Conclusions:Due to high rate of DLN detected and metastasis, DLN should be routinely dissected. Patients with DLN metastasis predict high risk characteristics of PTC and extensive lymph node metastasis, which is of clinical significance for lymph node dissection.

The diagnostic value of high-sensitivity troponin Ⅰ, homocysteine, and inflammatory markers in acute exacerbation of chronic obstructive pulmonary disease / 国际检验医学杂志

Objective To investigate the diagnostic value of hypersensitive troponin I (hs-cTnI) , homocysteine (Hcy) , hypersensitive C-reactive protein (hs-CRP) and calcitonin (PCT) detection in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) .Methods Ninety-six patients with AECOPD were enrolled in this study.50healthy subjects were included in the healthy control group.Hs-cTnI was measured by electrochemiluminescence, Hcy level was measured by circulating enzyme method, hs-CRP level was determined by immunoturbidimetry, and colloidal gold blotting was performed.PCT levels, correlation analysis using Pearson correlation analysis, analysis of the correlation between the indicators and AECOPD, using ROC curve analysis of hs-cTnI, Hcy, hs-CRP, PCT diagnosis COPE acute exacerbation curve area (AUC) .Results The levels of hs-cTnI, hs-CRP and PCT in the AECOPD group were higher than those in the healthy control group (P<0.05) .The Hcy in the AECOPD group was lower than that in the healthy control group.The difference was not statistically significant (P>0.05) .Pearson correlation analysis shows that hs-cTnI, hsCRP and PCT were positively correlated with AECOPD (r=0.346, 0.401, 0.509) , and Hcy had a poor correlation with AECOPD (r=0.078) .In the ROC curve analysis, the area under the curve (AUC) for hs-cTnI, hsCRP, and PCT were 0.825, 0.834, and 0.922, respectively, The best diagnostic cut-off values were:0.082, 18.25, 3.075, and the sensitivities were 0.823, 0.802, and 0.781, respectively.The specificities were:0.92, 0.62, and 0.94.Youden′s index was 0.743, 0.422, and 0.721, respectively.The kappa values are:0.699, 0.423, 0.664.Conclusion The detection value of Hcy in the diagnosis of AECOPD is low.The detection of hs-cTnI, hsCRP and PCT has a certain diagnostic value in AECOPD.It can be used as an auxiliary diagnosis index of AECOPD.

Expression of long noncoding RNA in papillary thyroid carcinoma with Hashimoto's thyroiditis / 中华内分泌外科杂志

Objective To analyze long noncoding RNAs (lncRNAs) expression profiles in papillary thyroid carcinoma (PTC) with Hashimoto's thyroiditis (PTC-HT,group A) and PTC only (PTC,group B).Methods 55 cases of thyroid species were collected.High-throughput microarray lncRNh was used to detect the expression difference of lncRNAs between group A and group B.Real-time quantitative PCR (QRT-PCR) was used to verify.Results 1031 lncRNAs and 1338 mRNAs were detected abnormally expressed in tissue samples of group A compared to B.GO and Pathway analysis of mRNAs suggested some biological processes changed obviously,such as immune system and immune reaction.QRT-PCR showed that the expression of uc002stn.1,ENST00000452578 and uc002sti.1 in group A and group B was significantly different.Conclusion IncRNAs expression was significantly different in PTC with or without HT,which may play important roles in the pathogenesis of PTC with HT.

Clinical research of the lymph node dissection posterior to the right recurrent laryngeal nerve in papillary thyroid carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the clinical value of the lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN, right VI-2) dissection in papillary thyroid carcinoma (PTC). METHODS We studied the relationships between LN-prRLN metastasis and the clinicopathological characteristics in 408 patients with right or bilateral PTC who underwent LN-prRLN dissection. RESULTS Right VI-2 lymph node metastasis was 16.67％. Single factor analysis showed that there were statistically significant correlations between right VI-2 metastasis and gender, age, size and number of right thyroid lobe tumor, capsular invasion, right VI-1 lymph node metastasis and their size, and also metastatic lymph node in the right cervical lateral compartment. Multivariate Logistic regression analysis showed that Right VI-2 lymph node metastasis was related to right tumor size, capsular invasion, the right VI-1 metastasis and right lateral lymph node metastasis(P＜0.05). The receiver-operator characteristic (ROC) analysis showed that the risk factors of LN-prRLN: age ＜35.5 years, right tumor size ＞0.85 cm, lymph node (right VI-1) number ＞1.5, metastatic lymph node (right VI-1) size ＞0.45 cm, lymph node number in the right cervical lateral compartment ＞0.5 and the areas under the ROC curves were 0.585, 0.787, 0.788, 0.725, 0.719. CONCLUSION The dissection of LN-prRLN should be considered when patient with the risk factors such as male, age ＜35.5 years, right tumor size ＞0.85 cm, capsular invasion, lymph node (right VI-1) number ＞1.5, metastatic lymph node (right VI-1) size ＞0.45 cm, lymph node number in the right cervical lateral compartment ＞0.5.

Chinese Medicine Formula "Shenqi San" Extract Inhibits Proliferation of Human Lung Adenocarcinoma A549 Cells via Inducing Apoptosis / 华中科技大学学报（医学）（英德文版）

The main purpose of this study was to investigate the active components of the Chinese medicine formula Shenqi San (SS) by high performance liquid chromatography with diode array detector and electrospray ionization-hybrid quadrupole time-of-flight mass spectrum (HPLC-DAD-ESI-QTOF-MS),and demonstrate the anticancer mechanism of SS on human lung adenocarcinoma A549 cells by evaluating the cell proliferation and apoptosis induction.The chloroform extraction of SS (CE-SS) was extracted from SS,while HPLC-DAD-ESI-QTOF-MS assay was performed to identify components of CE-SS.MTT assay was used to quantify the proliferation of A549 cells with the treatment of CE-SS.Apoptosis analysis was carried out by detecting phosphatidylserine (PS) externalization using the Annexin V-FITC Apoptosis Detection Kit and the stained cells were analyzed with a flow cytometer.DAPI staining assay was carried out to observe morphological characteristics of apoptotic cells.Western blotting was used to detect the expression of important signaling proteins including caspase-3,-8,-9,p53,Bax and Bcl-2.Eight compounds were identified through HPLC-DAD-ESI-QTOF-MS analysis and 3-pyridine carboxylic acid,barbatin C,scutebarbatine F and barbatine D might be the main compounds responsible for the antitumor effect of CE-SS.CE-SS suppressed the proliferation of lung cancer A549 cells in a time-and dose-dependent manner.By Annexin V-FITC/PI double staining,we found that treatment with CE-SS induced apoptosis in A549 cells.After 24-h exposure to CE-SS,the expression of cleaved-caspase-9,cleaved-caspase-8 and cleaved-caspase-3 protein was activated,the expression of p53 protein increased while the ratio of Bax/Bcl-2 also increased.This study identified the eight compounds of CE-SS,and demonstrated their anticancer effect on human lung adenocarcinoma A549 cells via induction of apoptosis.

Clinical research about level Ⅵ-1 lymph nodes and the lymph nodes posterior to the right recurrent laryngeal nerve of the papillary thyroid carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE The objective of this study is to discuss when to dissect the lymph nodes behind the right recurrent laryngeal nerve (LN-prRLN) from the standpoint of the right cervical level Ⅵ-1 (superficial layer to the recurrent laryngeal nerve) lymph nodes in papillary thyroid carcinoma (PTC) patients.METHODS The clinical data of 306 bilateral or right PTC patients from the Hangzhou First People's Hospital who underwent dissection of level Ⅵ-1 lymph nodes and LN-prRLN between March 2014 and September 2015 were analyzed. We measured the number of level Ⅵ-1 metastatic lymph nodes and size of level Ⅵ-1 lymph nodes metastasis loci to predict the metastasis of LN-prRLN.RESULTS The number of level Ⅵ-1 metastatic lymph nodes and size of level Ⅵ-1 lymph nodes metastasis loci were risk factors of LN-prRLN metastasis(P<0.05). When the number of the level Ⅵ-1 metastatic lymph nodes was greater than 1.5, the AUC was 0.813 (the sensitivity was 78.43%, the specificity was 76.65%). The ROC showed that when the size of level Ⅵ-1 lymph nodes metastasis loci were more than 0.45 cm, the AUC was 0.726 (sensitivity was 90.20%, specificity was 48.90%).CONCLUSION In bilateral or right PTC patients with metastasis of level Ⅵ-1 lymph nodes, especially when the number of level Ⅵ-1 metastatic lymph nodes was greater than 2cm and the metastasis loci were more than 0.45 cm, we should dissect the LN-prRLN.

The clinical observation of disease outcome of early nasogastric nutrition on patients with acute decompensated chronic heart failure / 中国医师杂志

Objective To investigate early nasogastric nutrition on patients with acute decompensated chronic heart failure,and observe its influence on patient's disease outcome.Methods From January 2012 to December 2013,100 cases with acute decompensated chronic heart failure were used as the research subjects,were randomly divided into experimental and control groups with 50 cases each group.Patients of two groups adopt expansion of blood vessels,strong heart,diuresis,and routine anti-infection treatment;Based on this scheme,experimental group adopt early nasogastric nutrition.The cardiac function index,the change of nutritional status and clinical curative effect and the result of follow-up within 1 year after discharge of two groups were compared.Results Left ventricular end-diastolic dimension (LVEDD) and left ventricular end-systolic dimension (LVESD) in two groups after treatment were decreased,and the descender of experimental group was superior to that of the control group with statistically significant difference (P ＜ 0.05).After treatment,left ventricular ejection fractions (LVEF) of two groups were improved,and the rise of experimental group was superior to that of control group with statistically significant difference (P ＜0.05).In the two groups after treatment,the serum brain natriuretic peptide (BNP) levels were significantly decreased,and the descender of the experimental group was more than that of control group with statistically significant difference (P ＜ 0.05).After treatment,body mass index (BMI),the level of serum prealbumin (PA),transferrin (TRF),and the total number of lymphocytes of two groups were increased significantly (P ＜ 0.05);and BMI,the level of serum PA and TRF,and the total number of lymphocytes of the experimental group were significantly better than those of the control group (P ＜ 0.05).The total effective rate of the experimental group was significantly higher than that of the control group (P ＜ 0.05).The exacerbation rates,readmission and mortality rate of experimental group follow-up within 1 year after discharge were significantly lower than that of the control group (P ＜ 0.05).Conclusions The early nasogastric nutrition on the patients with acute decompensated chronic heart failure was better able to improve patients' nutrition state,more conducive to patients with cardiac function recovery,improve the clinical curative effect,and reduce the exacerbation rates,and readmission and mortality rate.

Expression of Ki67 and clinical significance in breast cancer / 国际检验医学杂志

Objective To explore the expression level of Ki67 and its correlation with clinicopathological types and prognosis of patients with breast cancer.Methods Clinical data of 93 patients with breast cancer and 20 patients with benign breast diseases were collected from Jan.2013 to Dec.2015,and the correlation between Ki67 and pathological parameters and laboratory parameters were analyzed.Results Among the 93 patients with breast cancer,the Ki67 index was 1% to 90%,with median of 21.65%.Ki67 index was correlated with tumor grade,tumor size and human epidermalgrowth factor receptor-2(HER2,P0.05).Ki67 index of patients with triple negative breast cancer,patients with non-triple negative breast cancer and patients with benign breast diseases were 30.15%,20.26% and 4.67%,which were with significant difference(P<0.04).Ki67 index was also related to the breast cancer subtypes(P<0.05),and serum potassium and hematocrit levels of patients with breast cancer(P<0.05).Conclusion Ki67 index could be used for the diagnosis,treatment and prognosis of patients with breast cancer.

Consistency of tumor sizes measured by sonographic and pathological examination in papillary thyroid carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE The aim of the study was to evaluated the difference and consistency in tumor size measured by sonographic and pathological examination in papillary thyroid carcinoma(PTC).METHODS A total of 114 patients with PTC, including 122 malignant nodules, was collected from Hangzhou First People's Hospital between Jun 2012 and Jun 2014. The tumor sizes were measured by preoperative sonographic and postoperative pathologic evaluation. Pearson correlation analysis, paired t-test, and Bland-Altman plot were used to evaluate the correlation and consistency in tumor size measured by the two methods.RESULTS Pearson correlation analysis showed that the largest tumor size measured by sonography were positively correlated with pathologic size (r=0.957, P=0.000). Paired t-test showed that there were statistically difference between sonographic size and pathological size (8.24±5.06) mmvs (7.79±4.75) mm,P=0.001. The absolute difference value of the largest tumor size measured by the two methods was from zero to 6.5 mm, with the average of (1.03±1.14) mm. Bland-Altman analysis showed that the limits of agreement (LoA) of difference was from -2.41 mm to 3.33 mm, with the 95% confidence interval from -2.87 mm to 3.78 mm.Within the limit of the consistency, the maximum moduli was 2.9 mm.CONCLUSION There is a significant discrepancy between the preoperative sonographic and the pathologic size of the papillary thyroid carcinoma, which should be taken into account in clinical practice.

Clinical significance of serum microRNA-222-3p expression in papillary thyroid carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the expression of serum miR-222-3p in papillary thyroid carcinoma and its clinical significance.METHODS Total RNA in serum was extracted from 121 patients of papillary thyroid carcinoma and benign thyroid diseases.The reverse transcription quantitative real-time polymerase chain reaction(qRT-PCR) method was used to detect the expression of miR-222-3p,and then the potential correlation between serum miR-222-3p and clinical pathological characteristics of papillary thyroid carcinoma was analyzed.The receiver operating characteristic area under the curve(ROCAUC) and their index for diagnosis evaluation were also calculated.RESULTS The median expression level of serum miR-222-3p in papillary thyroid carcinoma patients was significantly higher than that of control group (2.2188 vs 0.7022,P=0.002).Although the expressions of serum miR-222-3p was not associated with the gender,age,capsule invasion,TNM stage,but it was positively correlated with tumor size,bilateral involvement,lesion quantity and lymph node status.ROC curve analysis showed that the specificity and sensitivity of the miR-222-3p diagnosis of papillary thyroid cancer were 79.75％ and 61.90％,respectively,while the ROC-AUC was 0.717.CONCLUSION The serum miR-222-3p is over expressed in papillary thyroid carcinoma and its expression is significantly correlated with tumor progression.It will be helpful for PTC diagnosis.

Combined therapy with daclatasvir plus asunaprevir for chronic hepatitis C genotype 1b: a case report / 南方医科大学学报

The combination therapy with daclatasvir and asunaprevir can achieve a high sustained viral response rate against hepatitis C virus (HCV) genotype 1, but so far this regimen has not been reported in the treatment of Chinese patients with chronic hepatitis C (CHC) genotype 1b. Here we report a case of CHC genotype 1b in a 44-year-old female chinese patient who was treated with this regimen for 24 weeks. The patient showed sustained viral response after the treatment and was clinically cured. During the treatment, the patient experienced a transient elevation of serum total bilirubin accompanied by lowered hemoglobin fluctuating between 100 and 110 g/L.

Advances of long non-coding RNA in thyroid tumor / 中华内分泌外科杂志

Long non-coding RNA(lncRNA) is non-protein coding transcripts longer than 200 nucleotides,which plays an important role in the development of the metabolic process.Thyroid cancer is the most common cancer of the endocrine system,and as reported,lncRNA is related to the occurrence and development of thyroid tumors.Therefore,this paper reports the latest domestic and foreign research progress about lncRNA in thyroid tumor,in order to provide new ideas for molecular diagnosis and treatment of thyroid cancer.

HBsAg seroconversion after entecavir therapy for 7 years following a poor response to interferon-α 2b monotherapy in a HBeAg-negative patient with chronic hepatitis B / 南方医科大学学报

We report a rare case of HBsAg seroconversion after 7 years of entecavir therapy in a 48-year-old HBeAg-negative CHB male patient with chronic hepatitis B (CHB). After a poor response to a 48-week interferon-α 2b therapy, the patient received long-term entecavir therapy. Serum ALT levels became normal and HBV DNA viral load was undetectable at the 10th week after commencement of entecavir treatment, and seroconversion of HBsAg was detected after 7 years of entecavir therapy.