Occurrence of hypopituitarism after severe craniocerebral trauma and its predictors / 中华内分泌外科杂志

Objective:To investigate the occurrence and predictors of hypopituitarism after traumatic brain injury (TBI) .Methods:A prospective study was conducted on 185 patients with severe TBI in the Emergency Department of the First Hospital of Shanxi Medical University from Jan. 2020 to May. 2022, of whom 108 were male and 77 were female; age ranged from 18 to 79 years, mean (51.32±9.34) years. Pituitary function was assessed within 3-7 d after the onset of TBI, and the occurrence of hypopituitarism after severe TBI was counted. 41 cases in the hypopituitarism group, 26 males and 15 females, aged (52.76±9.83) years, were divided into the hypopituitarism group (hypopituitarism occurred) and the non-hypopituitarism group (hypopituitarism did not occur) according to whether hypopituitarism occurred. In the non-decompensated group, there were 144 cases, 82 males and 62 females, aged (50.91±9.27) years. The clinical data of the decompensated and non-decompensated groups were compared, and the factors influencing the occurrence of hypopituitarism were analysed, and a logistic prediction model was constructed based on the relevant influencing factors. The value of this model in predicting the occurrence of hypopituitarism after severe TBI was evaluated by using the receiver operating characteristic (ROC) curve.Results:The prevalence of hypopituitarism in the 185 patients with severe TBI in this study was 22.16%; the Glasgow coma scale (GCS) score on admission was lower in the decompensated group than in the non-decompensated group [ (6.36±1.04) vs (7.48±0.59) ], the percentage of hyperbaric oxygen therapy was lower than in the non-decompensated group (21.95% vs 49.31%) , the percentage of intracranial pressure (82.93% vs 49.31%) , midline displacement ≥5 mm (78.05% vs 29.86%) , skull base fracture (34.15% vs. 17.36%) , diffuse cerebral edema (19.51% vs 4.17%) , and serum brain derived neurophic factor (BDNF) . Brain derived neurophic factor (BDNF) was higher than that in the non-reduced group [ (6.35±1.29) ng/ml vs (4.51±1.06) ng/ml], and neuronal-specific enolase (NSE) was higher than that in the non-reduced group [ (33.06±5.42) μg/L vs (23.15±4.97) μg/L]. (4.97) μg/L]. Vascular epithelial growth factor (VEGF) was higher than that in the non-reduced group [ (312.07±24.35) pg/ml vs (226.80±20.96) pg/ml], tumor necrosis factor-α (TNF-α) was higher than that in the non-reduced group [ (281.24±38.91) ng/L vs (186.91) pg/ml], and tumor necrosis factor-α (TNF-α) was higher than that in the non-reduced group (186.55±35.72) ng/L (all P<0.05) . Increased intracranial pressure, midline displacement ≥5 mm, diffuse cerebral edema, serum BDNF, NSE, VEGF, and TNF-α levels were all independent risk factors for the development of hypopituitarism after severe TBI, with admission GCS score and hyperbaric oxygen therapy as protective factors ( P<0.05) ; a logistic prediction model was constructed based on the influencing factors as: Logit ( P) = 5.264-0.880×admission GCS score + 1.618×increased intracranial pressure + 1.941×midline displacement ≥5 mm + 1.289×diffuse cerebral edema+1.306×BDNF+1.426×NSE+1.781×VEGF+1.615×TNF-α-0.758×hyperbaric oxygen therapy; the model predicted the occurrence of severe TBI after the area under the curve (AUC) of hypopituitarism was 0.930 (95% CI 0.883-0.962) , with a predictive sensitivity and specificity of 90.24% and 89.19%, respectively. Conclusions:The incidence of hypopituitarism is higher after severe TBI. Increased intracranial pressure, midline displacement ≥5 mm, diffuse cerebral edema, serum BDNF, NSE, VEGF and TNF-α levels are all used as predictors of hypopituitarism.

Analysis of contaminated microorganisms in commercial honey / 上海预防医学

Objective To investigate the microbial contamination in 54 batches of commercial honey. Methods Aerobic plate colony counts for bacteria and colonies of mould and osmophilic yeasts in honey were determined according to the National Food Safety Standard. The bacteria and fungi in unqualified samples were further identified and analyzed by morphology， MALDI-TOF-MS and large subunit （LSU） rRNA gene sequence. Results Three unqualified batches were found. One batch had aerobic plate colony counts exceeding the standard， with a variety of bacteria including Bacillus sp.， Paenibacillus sp. and Brevibacillus sp. Two batches had mould counts exceeding the standard. Aspergillus sp was detected in both samples （from the same manufacturer）， and the DNA sequence homology was very high， suggesting the mould might come from the same pollution source. Conclusion There are many kinds of microbial contamination in honey. Manufacturers should strengthen the microbe control in monitoring process to avoid the repeated microbial contamination.

Progress in the diagnosis and treatment of mitochondrial neurogastrointestinal encephalopathy / 中华实用儿科临床杂志

Mitochondrial neurogastrointestinal encephalopathy (MNGIE) is a rare autosomal recessive disease with a wide age range of onset from neonates to 50 years old, characterized by multisystem involvement.In this article, the research progress of the genetic characteristics, clinical phenotype, diagnosis and treatment of MNGIE was reviewed to further improve its clinical understanding.

Comparative analysis of molecular characteristics of dengue virus E gene in Shantou city between 2018 and 2019 / 中华微生物学和免疫学杂志

Objective:To analyze the molecular characteristics of dengue virus (DENV) strains circulating in Shantou city in 2018 and 2019 for elucidating the reasons causing strikingly different dengue fever epidemics during the two years and understanding the transmission characteristics and routes of DENV, and to provide reference for the prevention and control of dengue fever.Methods:Detection of viral nucleic acid contents and amplification and sequencing of E gene were carried out on 872 samples positive for DENV acid in 2018 and 2019. Phylogenetic trees were constructed based on the E gene sequences to analyze the homology of DENV strains. The sources and transmission routes of the strains were also analyzed. Results:A total of 99 sequences of DENV E gene were acquired, including 68 DENV-1 sequences and 31 DENV-2 sequences. The cases of dengue fever were sporadic in 2018. Phylogenetic tree showed the strains isolated in 2018 were from multi-sources and closely related to those found in Guangzhou city and Southeast Asia area. Dengue fever outbreaks occurred in 2019 and most of the prevalent strains were from a single source, which was speculated to be Cambodia. Conclusions:Dengue fever in Shantou city was mainly caused by imported strains of the same year rather than by local strains in previous years. DENV strains in Shantou might be traced back to Southeast Asia area and transmitted to Shantou through many routes.

Neurexin-3α IgG mediated autoimmune encephalitis: a case report / 中华神经科杂志

The clinical characteristics, laboratory tests, treatment and prognostic characteristics of a case of neurexin-3α antibody-mediated autoimmune encephalitis,who was admitted in Xi′an International Medical Center Hospital on January 4, 2020 were summaried. The patient was a 56-year-old male with pre-symptoms of infection before his illness. The main manifestations were rapid progress of cognitive dysfunction, mental and behavioral abnormalities, refractory epilepsy, and status epilepticus, dystonia, accompanied by autonomic nerve involvement such as increased heart rate, breathing, and sweating, suspected of central hypoventilation, clinical manifestations were similar to N-methyl-D-aspartate-receptor (NMDAR) encephalitis and magnetic resonance imaging suggested bilateral hippocampal, temporal, and insular high signals, cerebrospinal fluid examination and other laboratory tests were normal. After treatment with methylprednisolone and intravenous immunogloblin, he died a few days after being discharged. The clinical manifestations of neurexin-3α antibody-mediated autoimmune encephalitis were similar to NMDAR encephalitis and severe, and neurexin-3α antibodies need to be further tested to confirm the diagnosis when NMDAR antibody was negative.

Sporadic adult Burkitt lymphoma confirmed by ascites test: report of one case and review of literature / 白血病·淋巴瘤

Objective:To improve the understanding of sporadic adult Burkitt lymphoma.Methods:The clinical data of a patient with sporadic adult Burkitt lymphoma who was admitted to the Affiliated Hospital of Chengde Medical College in August 2019 were retrospectively analyzed, and the relevant literature was reviewed.Results:The patient visited the clinic mainly for abdominal pain and abdominal distension, and the disease progressed rapidly. The early pathological examination of an ileocecal mass showed B-cell lymphoma, which was treated with R-CHOP regimen chemotherapy, and the mass disappeared immediately. The patient's symptoms were slightly improved, but the ascites was not significantly improved. The diagnosis of Burkitt lymphoma was confirmed by ascites test, and the treatment was adjusted to R-EPOCH regimen. The patient's condition was stable before the submission of this paper.Conclusion:Burkitt lymphoma is a highly aggressive malignancy, and cytological detection of serosal effusion is of important reference value in the diagnosis of Burkitt lymphoma.

The clinical research of five-step 180W XPS greenlight photoselective vaporization of the prostate for large volume benign prostatic hyperplasia / 中华泌尿外科杂志

Objective:To explore the efficacy and safety of five-step 180W XPS greenlight photoselective vaporization of prostate (PVP)for large volume (≥80ml) benign prostatic hyperplasia.Methods:A total of 240 BPH patients (PV≥ 80 ml), treated with five-step 180W XPS PVP from June 2017 to May 2019 in our center, were reviewed retrospectively. The average age was (70.18±7.71) years old, and 129 cases were over 70 years old. The average body mass index was (24.91±2.98 )kg/m 2. The median international prostate symptom score (IPSS) was 23 (20, 26) and the quality of life (QOL) score was 5 (4, 5) points. Besides, the preoperative median prostate volume (PV) was 98.29 (86.49, 116.32) ml, the median maximum urinary flow rate (Q max)was 6 (4, 8) ml/s and postvoid residual urine volume (PVR) was 120 (30, 200) ml. All patients underwent 180W XPS five-step method PVP operation according to the following method. The first step is vaporization of 1-2 o′clock (left lobe) and 10-11 o′clock (right lobe) in order to establish operating channel. The second step is vaporization of the lateral lobe layer by layer from the ventral side to the dorsal side. The third step is channel establishment of 5/7 o′clock mid lobe parasulcus. The forth step is ablation of the middle lobe laterally. The fifth step is vaporization of the apex of the prostate and trimming. The IPSS score, QOL score, Q max and PVR were evaluated 12 months later after the PVP operation. Results:All the 240 cases were treated by five-step 180W XPS PVP operation successfully. The median operation time and laser time were 83 (73, 98.75) min and 66 (60, 76) min. Capsular perforation was found in 3 cases, which occurred in the trimming stage. There were 9 cases treated with TURP to stop bleeding, and no cases suffered blood transfusion. Twenty-two patients underwent bladder irrigation for 6 to 24 hours after the operation, and the median catheter indwelling time and post-operative hospital stay were 3 (3, 4) days and 4 (3, 5) days respectively. Twenty-six patients suffered urinary incontinence, including 22 cases of urinary incontinence and 4 cases of stress urinary incontinence. In addition, there was no severe hematuria, severe bladder irritation or urinary retention among the patients. The postoperative IPSS score was 5(4, 7), QOL score 1(1, 2), Q max 18(15, 20)ml/s and PVR 10(0, 30)ml, which were all significantly improved compared with those before surgery ( P<0.01). None second PVP surgery was performed. Conclusions:The five-step 180W XPS PVP operation has the advantages of improving lower urinary tract symptoms, less blood loss and low incidence of perioperative adverse events. It is easy to use, which is a reliable minimally surgery.

Retrospective analysis of etiological characteristics of community acquired pneumonia-like syndrome in Zhangjiakou area / 公共卫生与预防医学

Objective To retrospectively study the etiology of patients with community-acquired pneumonia-like syndrome in Zhangjiakou area in the past 3 years, and to provide guidance for clinical rapid diagnosis and empirical treatment. Methods A total of 471 patients with community-acquired pneumonia-like syndrome were initially diagnosed in the outpatient or inpatient hospitals in Zhangjiakou area from August 2015 to August 2018. According to the age of the cases, they were divided into the youth group (age≤29 years old, n=89), the junior middle-aged group (30≤age≤39, n=124), the middle-aged group (40≤age≤49, n=177) , and the elderly group (age≥50, n=81). The clinical records of each group of patients were collected to explore the clinical features and etiology of community-acquired pneumonia-like syndrome in different age groups. Results (1)The comparison of the duration of disease in each group showed that the duration of disease in the youth group was significantly lower than the average, while the duration of the elderly group was significantly higher than the average. There was no significant difference in the duration of the disease between the junior middle-aged and middle-aged groups; (2)Seasonal statistics of community-acquired pneumonia-like syndrome found that the overall incidence rate in autumn (48.20%) was higher than that in spring (13.06%), summer (16.77%), and winter (21.97%). The incidence in the elderly group mainly occurred in autumn and winter, which was significantly different from the other three groups; (3)The comparison of the CURB-65 scores revealed that the youth and the junior middle-aged groups were mainly at low-risk (57.30%, 65.32%), the middle-aged group was at low-risk and intermediate-risk (40.68%, 50.28%), and the elderly group was mainly at intermediate-risk and high-risk (29.01%, 33.33%). All the differences were statistically significant (P<0.05). Conclusion The community-acquired pneumonia-like syndrome in Zhangjiakou area was predominantly high in autumn, and was common in the elderly population. The disease was more serious with a longer course in the elderly group than other populations, which should be paid attention to in clinical practice.

Correlation of CXCR4 expression with clinicopathological characteristics and prognosis of patients with non-small cell lung cancer: a Meta-analysis / 肿瘤研究与临床

Objective:To systematically evaluate the relationship between CXCR4 and the clinicopathological characteristics and prognosis of patients with non-small cell lung cancer (NSCLC).Methods:The PubMed, EMbase, Cochrane Library, CNKI, Wanfang and China Biology Medicine databases were searched by the computer to collect the publicly published cohort studies on the correlation between CXCR4 expression and prognosis of NSCLC. The retrieval time was from the establishment of the database to May 31, 2018. Literature screening, data extraction and risk of bias were performed independently by two reviewers, and Meta-analysis was performed by using Stata 12.0 software.Results:Finally, 20 studies were included, with a total of 2 124 NSCLC patients. The positive expression rate of CXCR4 in patients with adenocarcinoma was 51.8% (337/650) and it was 50.3% (224/445) in patients with squamous cell carcinoma, the difference was statistically significant ( RR=1.22, 95% CI 1.09-1.38, P=0.001). The positive expression rate of CXCR4 in patients with stageⅠ-Ⅱ was 41.1% (317/772), and the rate was 57.0% (348/610) in patients with stage Ⅲ-Ⅳ, the difference was statistically significant ( RR=0.62, 95% CI 0.55-0.69, P < 0.01). The positive expression rate of CXCR4 in patients with distant metastasis was 55.3% (268/485), and the positive rate of CXCR4 in those without distant metastasis was 39.2% (256/653), the difference was statistically significant ( RR=1.78, 95% CI 1.54-2.06, P < 0.01). The expression of CXCR4 was not related to the size and invasion of the primary tumor, the positive expression rates of CXCR4 in T 1-T 2 and T 3-T 4 patients were 41.0%(215/524) and 53.8%(84/156) ( RR=0.71, 95% CI 0.60-0.84, P=0.053). The overall survival rate of patients with CXCR4-positive was lower than that of patients with CXCR4-negative, and the difference was statistically significant (30.1% vs. 66.9%, RR=0.45, 95% CI 0.30-0.61, P < 0.01). The disease-free survival rate of patients with CXCR4-positive was lower than that of patients with CXCR4-negative (38.0% vs. 20.1%, RR=1.89, 95% CI 1.45-2.47, P=0.002). Conclusions:The pathological type, tumor staging and distant metastasis of NSCLC patients are correlated with CXCR4 expression level. The expression level of CXCR4 in tumor tissues has a predictive value for the prognosis of NSCLC patients; and the higher the expression level of CXCR4 is, the lower the overall survival and disease-free survival rates are.

Prognosis and related risk factors of distal cholangiocarcinoma after surgical treatment / 国际外科学杂志

Objective:To evaluate the prognosis and related risk factors of distal cholangiocarcinoma after surgical treatment.Methods:The clinical data of 123 patients of distal cholangiocarcinoma in Beijing Chaoyang Hospital between January 2011 and December 2019 were retrospectively analyzed, which including 72 males and 51 females, the average age was (64.9±9.2) years (range from 29 to 84 years). All patients underwent pancreatoduodenectomy. The observation measures contains: (1) Perioperative outcomes; (2) Follow-up outcomes; (3) Risk factors for long-term survival of distal cholangiocarcinoma. Follow-up was carried out to understand the long-term survival of patients, and follow-up method contains the outpatient reexamination and telephone. The deadline of follow-up date was March 2020. The normal distribution data were expressed by ( Mean± SD), and the non-normal distribution data were expressed by M ( P25, P75). Count data were expressed by cases and percentage. Kaplan-Meier method was used to calculate and draw the survival curve. Log-rank test was used to compare the survival rate. Cox proportional risk model was used in multivariate factor analysis. Results:(1) Perioperative outcomes: In our research, all of 123 patients were successfully completed the operations, and 6 patients dead during the perioperative. (2) Follow-up outcomes: The incidence of postoperative complications was 27.6%(34/123). One hundred and twenty-one patients were followed up, the follow-up rate was 98.4%, and the median follow-up time was 41.0 months.The overall 1-year, 2-year, 3-year and 5-year survival rates were 71.8%, 50.5%, 35.5% and 30.2%. And the median survival time was 42.7 months. (3) Risk factors for long-term survival of distal cholangiocarcinoma: Multivariate analysis showed that preoperative CA19-9 ( RR=1.470, 95% CI: 1.028-2.101), portal venous system invasion ( RR=2.020, 95% CI: 1.012-4.035) and tumor differentiation ( RR=1.735, 95% CI: 1.195-2.520) were independent risk factors for the prognosis. Conclusions:Radical pancreatoduodenectomy is the best treatment for distal cholangiocarcinoma. Preoperative CA19-9 level, portal venous system invasion and tumor differentiation are independent risk factors for the prognosis.

Analysis of the results of examinations of an acute phase case infected with type-2 dengue virus / 中华实验和临床病毒学杂志

Objective@#To analyze the results of various methods to detect dengue virus(DENV) infection and to provide experience for the development of reasonable detection strategies on DENV infection.@*Methods@#An acute phase case infected with type 2 DENV was used as an example to analyze various methods of detection and the relation of their results.@*Results@#While NS1 antigen, IgM and IgG antibody were all negative, the nucleic acid test showed a positive result ; the NS1 coding gene of the DENV strain from the infected case did not mutate significantly; by additional use of NS1 reagents from other manufacturers, the antigen test result turned to weakly positive.@*Conclusions@#To conduct screening of dengue fever cases, the result of nucleic acid detection should also be applied. Moreover, additional use of NS1 reagents from other manufacturers could be helpful in reducing missed diagnosis, and could obtain more reliable result.

Impact and mechanism of HIV derived microRNA99 on macrophages pyroptosis / 中华实验和临床病毒学杂志

Objective@#To determine the impact and mechanism of HIV derived microRNA99 (miRNA99) on macrophages pyroptosis.@*Methods@#THP-1 cells were stimulated by phorbol ester (PMA) and then were cultured and differentiated into sidewall attached macrophages; the morphology and phenotype of CD11b were measured by microscopy and flow cytometry. TLR8 RNAi plasmid was transfected to macrophages and were detected by confocal fluorescence microscopy. The levels of IL-18 and IL-1β released by macrophages were measured by ELISA. Western blot(WB) was employed to examine TLR8 and cleaved caspase-1 protein expression in macrophages.@*Results@#THP-1 cells that were challenged with PMA (100 ng/ml) for 24 h became smooth and adherent. In addition, the expression of CD11b in macrophages was up to 99%. TLR8 protein expression in macrophages transfected with TLR8 plasmids was significantly lower than that in macrophages transfected with control plasmids. Levels of IL-18 and IL-1β secreted by macrophages were elevated in LPS+ ATP group, miRNA99 group and control plasmid group, but not in control group and TLR8 RNAi plasmid group. Cleaved caspase-1 protein from macrophages of miRNA99 experimental group/ LPS+ ATP group and control plasmid group was significantly higher than that of control group and TLR8 RNAi plasmid group.@*Conclusions@#The present study demonstrates that HIV-derived miRNA99 could induce pyroptosis of macrophages via TLR8-dependent pathway.

Significance of T-cell dot test and combined detection of adenosine deaminase in tuberculous pleurisy at different ages / 中国综合临床

Objective To analyze the clinical value of combined detection of tuberculous T cell enzyme-linked immuno spot assay (T-SPOT.TB) and adenosine deaminase (ADA) in tuberculous pleurisy patients of different ages.Methods From February 2014 to February 2018,three hundred and thirty-six patients with pleural effusion were admitted to Hebei Thoracic Hospital.Among them,two hundred and fifty five cases were diagnosed as tuberculous pleurisy and 81 cases were diagnosed as non-tuberculous pleurisy.The patients were divided into two groups according to their age.The younger group (214 cases) was 16-59 years old and the older group (122 cases) was over 60 years old.The sensitivity and specificity of T-SPOT.TB combined with ADA in the diagnosis of tuberculous pleurisy were compared between the two groups.Results The sensitivity and specificity of T-SPOT.TB were 85.5％ (153/179) and 71.4％ (25/35) in the young and middle-aged group,73.7％ (56/76) and 58.7％ (27/46) in the old group,respectively.The sensitivity of the young and middle-aged group was significantly higher than that of the old group (x2 =4.990,P =0.045).The sensitivity and specificity of T-SPOT.TB combined with ADA were 98.9％ (177/179) and 94.3％ (33/35) in the young and middle-aged group,96.1％ (73/76) and 89.1％ (41/46) in the elderly group,respectively.There was no significant difference in sensitivity and specificity between the two groups (x2 =0.256,P=0.393、x2=0.655,P=0.218).Conclusion The diagnostic efficacy of T-SPOT.TB combined with ADA in patients with tuberculous pleurisy at different ages has been improved,especially for those who can not tolerate pleural biopsy and elderly patients.

Unilateral congenital microphthalmia in newborn: a case report / 中华围产医学杂志

Here,we reported a case of term infant with unilateral congenital microphthalmia (CM).Physical examination conducted on 2 d after birth showed that the left eye was barely open and the eye socket was deeper than the right.Meanwhile,the cornea of the left eye was not completely exposed and the light reflex could not be elicited.Ophthalmology consultation,ultrasound and CT scan were conducted,and CM was finally diagnosed since the infant was found to have a small eyeball and shortened axial length,accompanying by pathological changes in the lens,vitreous body and retina.This case suggested that detailed physical examination should be carried out,especially for the eyes,including orbit and eyelid,presence or absence of secretion or concealed eyeball,together with medical imaging techniques technology,to ensure an early detection and diagnosis of CM in neonates.

Intraoperative frozen pathological diagnosis in radical resection of hilar cholangiocarcinoma / 中华普通外科杂志

Objective To evaluate rapid frozen pathology in the operation of hilar cholangiocarcinoma.Methods Clinical data of 49 patients of hilar cholangiocarcinoma undergoing surgical treatment were analyzed retrospectively from Jan 2011 to Dec 2017 at Department of Hepatobiliary Surgery,Beijing Chaoyang Hospital Affiliated to Capital Medical University to evaluate rapid frozen pathology on operative strategy of hilar cholangiocarcinoma and the prognosis of patients.Results All patients with hilar cholangiocarcinoma underwent intraoperative frozen pathological examination.5 patients adjusted the operation approach because of the discrepancy between frozen pathological examination and preoperative imaging results.47 intraoperative frozen pathological results were consistent with postoperative pathological diagnosis,and the accuracy rate was 95.9％,sensitivity 90％,specificity 97.4％,false positive rate 2.6％,false negative rate 10％.Frozen section margin negative patients had significantly longer survival time(P ＜ 0.05).Conclusions Intraoperative frozen pathological examination can guide the operation approach,greatly improve the resection rate of R0 and the prognosis of patients.

Surgical treatment and prognosis analysis of hilar cholangiocarcinoma / 国际外科学杂志

Objective To analyse the experience and prognosis of surgical treatment of hilar cholangiocarcinoma.Methods Clinical data of 49 patients of hilar cholangiocarcinoma underwent surgical treatment were analyzed retrospectively from January 2011 to December 2017 in Department of Hepatobiliary Surgery,Beijing Chaoyang Hospital affiliated to Capital Medical University.Of the 49 patients,29 patients underwent R0 resection and 10 patients underwent R1 resection according to the patient's condition.The overwall prognosis and R0 resection rate were analyzed.All patients were followed up by outpatient or telephone.The follow-up deadline was December 2017.The long-term prognosis of R0 and R1 resection were compared.Normal distribution data were expressed as (Mean ± SD),while non-normal distribution data were expressed as M(P25,P75).Survival curve was depicted by Kaplan-Meier method,and survival rate was compared by Log-Rank test.Results All patients underwent surgical treatment.There were 5 complications (10.2％) during the perioperative period,and no deaths occurred.Radical resection was performed in 39 patients,with a radical resection rate of 79.6％.The overall median survival time was (27.0± 1.2) months.The survival rates in 6 months,1,3 and 5 years were 95.9％,85.6％,34.5％,6.6％ respectively.The total median survival time of R0 resection and R1 resection was (28.0 ± 6.5) months and (16.0 ± 0.7) months respectively.The 6 months,1,2,and 3 years survival rates were 94.9％,89.7％,43.5％,8.3 ％ and 80.0％,68.6％,0,0 respectively.Conclusion Surgical treatment is safe and effective,and it can improve the prognosis of patients.

Application of vascular replacement technique with allogenic blood vessel in radical resection for pancreatic carcinoma: a report of 33 cases / 中华外科杂志

Objective@#To analyze the application of vascular replacement technique with allogenic blood vessel in radical resection for pancreatic carcinoma.@*Methods@#The clinical data of 33 patients with vascular invasion of pancreatic carcinoma who underwent radical resection from April 2013 to April 2017 in Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital were retrospectively analyzed. There were 14 males and 19 females with age of (62.5±10.6)years(ranging from 35 to 78 years). Vascular replacement technique with allogenic blood vessel was used on all patients who underwent radical resection for pancreatic carcinoma. The operation procedure was made according to the specific location of the carcinoma, and the allogenic blood vessel was selected according to the type of vascular invasion. The matching vessel was selected for replacement to the patient who was invaded only one vessel. And the "Y" type of iliac vein was selected for replacement to the patient who was invaded the confluence of portal vein, splenic vein and superior mesenteric vein. After the operation, the patients were followed up by telephone and outpatient review.@*Results@#All of 33 patients were successfully completed the operations. There were 28 patients underwent pancreaticoduodenectomy with vascular replacement, and 5 patients underwent total pancreatectomy with vascular replacement. All the patients were confirmed pancreatic carcinoma and R0 resection according to the postoperative pathology. There were 16 patients with the carcinoma invasion the confluence of portal vein, splenic vein and superior mesenteric vein, 12 patients with the carcinoma invasion the superior mesenteric vein, and 5 patients with the carcinoma invasion the portal vein. There was no perioperative death in this group and no complications related to allogenic blood vessel. The incidence of postoperative complications was 18.2% (6/33), and the incidence of pancreatic fistula was 6.1% (2/33), all of which were biochemical fistula. There were 32 patients were followed up, and the follow-up rate was 96.9%. The median survival time was 14.6 months. The half-year, 1-year and 2-year survival rates were 75.6%, 37.6% and 27.4%.@*Conclusion@#The application of vascular replacement technique with allogenic blood vessel for pancreatic carcinoma has a great significance for improving the R0 resection rate and the prognosis of patients.

Anxiety and depression status of coal miners and related influencing factors / 中华劳动卫生职业病杂志

Objective@#To analyze the anxiety and depression status of coal miners and related influencing factors, and to provide justifications for occupational health protection.@*Methods@#From April 2017 to June 2017, a total of 650 coal miners in a mining area in Shanxi, China were enrolled; The coal miners were evaluated for their anxiety and depression status using the Hamilton Anxiety Rating Scale (14 items) and the Hamilton Depression Rating Scale (17 items) , respectively. The related influencing factors for anxiety and depression of the coal miners were analyzed with nonparametric test, chi-square test, and logistic regression.@*Results@#The incidence rates of anxiety and depression were 51.1% and 60.5%, respectively. As suggested by the scores and detection rates of anxiety and depression, males had significantly higher anxiety and depression scores than females (P<0.05) ; subjects in older-age groups and those working in shifts had significantly higher anxiety scores (P<0.05) ; subjects with higher education degrees and smokers had significantly higher depression scores (P<0.05) ; while subjects with longer length of service, those with poor sleep quality, and those working in the underground mines had both significantly higher anxiety and depression scores (P<0.05) . The detection rate of anxiety was significantly higher in subjects with a drinking habit than in those who did not drink (P<0.05) . The detection rate of depression was significantly higher in subjects with hypertension than in those with normal blood pressure (P<0.05) . A multivariate logistic regression analysis showed that work type and length of service were related to anxiety; gender and length of service were related to depression; length of service was positively correlated with both anxiety and depression.@*Conclusion@#The anxiety and depression in coal miners and related influencing factors should be taken seriously. Gender, age, length of service, working in shifts, education degree, smoking, sleep quality, underground working environment, and hypertension may be risk factors for anxiety and depression in coal miners.

Analysis on the application of vascular closure system in portal vein reconstruction of liver transplantation: report of 137 cases / 器官移植

Objective To analyze the application effect of non-penetrating vascular closure system in portal vein reconstruction of allogenic liver transplantation in adults. Methods Clinical data of 222 patients undergoing allogeneic liver transplantation were retrospectively analyzed. According to whether vascular closure system was used in portal vein reconstruction during operation, all patients were divided into vascular clip group (n=137) and traditional suture group (n=85). Perioperative conditions, clinical prognosis and complications were statistically compared between two groups. Results All patients successfully completed the surgery. The success rate of one-time portal vein anastomosis was 93.4% (128/137) in the vascular clip group. A total of 14 patients died during perioperative period in this study with a mortality rate of 6.3% (14/222). No portal vein-related complications occurred during perioperative period in both groups. The time of portal vein anastomosis in the vascular clip group was (5.6±1.7) min, which was significantly shorter than (10.7±3.6) min in the traditional suture group (P<0.05). The incidence and grade of perioperative complications did not significantly differ between two groups (all P>0.05). Conclusions It is safe and feasible to utilize vascular closure system to reconstruct the portal vein during liver transplantation. Compared with traditional suture, it can effectively shorten the time of portal vein anastomosis.

Gene identification in a family of hereditary hemorrhagic telangiectasia / 中华血液学杂志

Objective@#To study the mutation of ENG, ACVRL1, and SMAD4 genes in one of a family of hereditary hemorrhagic telangiectasia (HHT) and explore its molecular pathogenesis. @*Methods@#A family spectrum of a patient with a clinical diagnosis of HHT was surveyed. Peripheral blood samples from proband and their eldest were collected, and ENG, ACVRL1 and SMAD4 gene analysis was performed by chip capture high-throughput sequencing. The mutation detected was verified by Sanger. @*Results@#9 of the 71 family members were diagnosed with HHT with the main manifestation of recurrent nasal bleeding. Genetic analysis showed that the proband and the eldest son of ENG gene exon 9 frameshift mutation: c.1502-1503insGG (p.Gly501GlyfsX18) , and mutations in ACVRL1 and SMAD4 genes were not detected. @*Conclusion@#The frameshift mutation c.1502-1503insGG (p.Gly501GlyfsX18) of the ENG gene is the genetic basis for the pathogenesis of this HHT family.