Bidirectional associations between maladaptive cognitions and emotional symptoms, and their mediating role on the quality of life in adults with ADHD: a mediation model.

Background/objectives: Adults with attention-deficit/hyperactivity disorder (ADHD) have more maladaptive cognitions, emotional problems and a poorer quality of life (QoL). A verification of the psychological model in clinical samples is needed for a better understanding of the mechanisms of ADHD diagnosis on QoL via maladaptive cognitions, emotional symptoms, and their interactions. Methods: 299 ADHD participants and 122 healthy controls were recruited. ADHD core symptoms, maladaptive cognitions, emotional symptoms and psychological QoL were rated. Pearson's correlation and structural equation modeling were analyzed to explore the relationship and influence of ADHD diagnosis on QoL. Results: More maladaptive cognitions, emotional symptoms, and poorer QoL were found in the ADHD group, and the dysfunctional attitudes were on par between ADHD with or without medication (p = 0.368). Moderate to strong correlations were found between emotional symptoms, maladaptive cognitions and QoL, and ADHD core symptoms presented correlations among the above scores (r = 0.157 ~ 0.416, p < 0.01) in ADHD participants. The influence of ADHD diagnosis on QoL was mediated through maladaptive cognitions, emotional symptoms, and their bidirectional interactions (p < 0.05), especially those with stable medication. Conclusion: Our study is the first to verify the psychological model in adults with ADHD in China. The findings determined the direct influence of ADHD diagnosis on QoL and the indirect influence through maladaptive cognitions, emotional symptoms, and their interactions, emphasizing the importance of interventions for emotional symptoms and maladaptive cognitions for ADHD patients both with or without medication for a better QoL outcome.

Small molecules targeting protein-protein interactions for cancer therapy

Protein-protein interactions (PPIs) are fundamental to many biological processes that play an important role in the occurrence and development of a variety of diseases. Targeting the interaction between tumour-related proteins with emerging small molecule drugs has become an attractive approach for treatment of human diseases, especially tumours. Encouragingly, selective PPI-based therapeutic agents have been rapidly advancing over the past decade, providing promising perspectives for novel therapies for patients with cancer. In this review we comprehensively clarify the discovery and development of small molecule modulators of PPIs from multiple aspects, focusing on PPIs in disease, drug design and discovery strategies, structure-activity relationships, inherent dilemmas, and future directions.

Correlation between traditional Chinese medicine and reduced risk of readmission in rheumatoid arthritis patients with hypoproteinemia:a retrospective cohort study / 中国中药杂志

This study aimed to explore the correlation between traditional Chinese medicine(TCM) and reduced risk of readmission in patients having rheumatoid arthritis with hypoproteinemia(RA-H). A retrospective cohort study was conducted on 2 437 rheumatoid arthritis patients in the information system database of the First Affiliated Hospital of Anhui University of Chinese Medicine from 2014 to 2021, and 476 of them were found to have hypoproteinemia. The patients were divided into TCM users and non-TCM users by propensity score matching. Exposure was defined as the use of oral Chinese patent medicine or herbal decoction for ≥1 month. Cox regression analysis was performed to explore the risk factors of clinical indicators of rheumatoid arthritis. Additionally, the use of TCM during hospitalization was analyzed, and analysis of association rules was conducted to investigate the correlation between TCM, improvement of indicators and readmission of patients. Kaplan-Meier survival curve was plotted to compare the readmission rate of TCM users and non-TCM users. It was found the readmission rate of RA-H patients was significantly higher than that of RA patients. By propensity score matching, 232 RA-H patients were divided into TCM group(116 cases) and non-TCM group(116 cases). Compared with the conditions in the non-TCM group, the readmission rate of the TCM group was lowered(P<0.01), and the readmission rate of middle-aged and elderly patients was higher than that of young patients(P<0.01). Old age was a risk factor for readmission of RA-H patients, while TCM, albumin(ALB) and total protein(TP) were the protective factors. During hospitalization, the TCMs used for RA-H patients were mainly divided into types of activating blood and resolving stasis, relaxing sinew and dredging collaterals, clearing heat and detoxifying, and invigorating spleen and resolving dampness. The improvement of rheumatoid factor(RF), immunoglobulin G(IgG), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP) and ALB was closely related to TCM. On the basis of western medicine treatment, the application of TCM could reduce the readmission rate of RA-H patients, and longer use of TCM indicated lower readmission rate.

Acupuncture for delayed sleep-wake phase disorder: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical effect of acupuncture for delayed sleep-wake phase disorder (DSWPD).@*METHODS@#A total of 84 patients with DSWPD were randomized into an observation group (42 cases, 2 cases dropped off) and a control group (42 cases, 3 cases dropped off). On the basis of sleep hygiene education, acupuncture was applied at Shenmai (BL 62), Zhaohai (KI 6), Hegu (LI 4), Taichong (LR 3), Zusanli (ST 36) and Sanyinjiao (SP 6) in the observation group, while placebo acupuncture was applied at the same acupoints in the control group. The treatment lasted for 8 weeks, once every other day, 3 times a week in the 1st to 4th weeks; once every 3 days, 2 times a week in the 5th to 8th weeks. Before and after treatment, the actigraphy (ACT) indexes of objective sleep (total time of stay in bed, total sleep time, sleep efficiency, the number of awakenings and the wake time after falling asleep) and plasma cortisol (CORT) level were observed; before and after treatment and in follow-up of 1, 3 months after treatment, the scores of morningness-eveningness questionnaire (MEQ), insomnia severity index (ISI), fatigue severity scale (FSS) and Epworth sleepiness scale (ESS) were observed in the two groups.@*RESULTS@#Compared before treatment, the total sleep time was prolonged, the sleep efficiency was improved, the number of awakenings was reduced, and the wake time after falling asleep was shortened after treatment in the observation group (P<0.01, P<0.05), and those in the observation group after treatment were superior to the control group (P<0.01, P<0.05). Compared before treatment, the MEQ scores after treatment in both groups and in the follow-up of 1, 3 months after treatment in the observation group were increased (P<0.01), and the MEQ score of each time point after treatment in the observation group was higher than the control group (P<0.01). The scores of ISI, FSS and ESS after treatment, and the scores of ISI、ESS in follow-up of 1, 3 months after treatment in the observation group were decreased compared with those before treatment (P<0.01, P<0.05), and in the observation group, the scores of ISI, FSS and ESS of each time point after treatment were lower than those in the control group (P<0.01, P<0.05). After treatment, the plasma CORT level in the observation group was decreased compared with that before treatment and that in the control group (P<0.01, P<0.05).@*CONCLUSION@#Acupuncture can improve the sleep and wake phase of patients with DSWPD, improve sleep quality and daytime function, and its mechanism may be related to the down-regulation of plasma CORT level.

Efficacy of cognitive behavioural therapy in medicated adults with attention-deficit/hyperactivity disorder in multiple dimensions: a randomised controlled trial.

The study aimed to evaluate the efficacy of group cognitive behavioural therapy (CBT) in medicated adults with attention-deficit/hyperactivity disorder (ADHD) with a multidimensional evaluation and follow-up to week 36. Ninety-eight adult ADHD were randomly allocated to the CBT combined with medication (CBT + M) group or the medication (M) only group. The primary endpoint was the ADHD-Rating Scale (ADHD-RS). Secondary endpoints included emotional symptoms, self-esteem, automatic thoughts, quality of life (QoL), and executive function (EF). The outcome measures were obtained at baseline (T1), after the 12-week CBT treatment (T2), and at two follow-up time points (week 24, T3, and week 36, T4). Compared to the M-only group, the patients in the CBT + M group showed an overall significantly greater reduction from baseline in ADHD core symptoms (ADHD-RS total score at T3, and inattention subscale at T2 and T3), depression and anxiety symptoms (T2-T4), state anxiety (T2 and T3) and trait anxiety (T2), automatic thoughts questionnaire at T3, and QoL (physical domain, psychological domain, and social domain, most significant at T3 and weakened at T4). These findings further confirmed the efficacy of CBT on multiple dimensions and verified improvements in automatic thinking in adult ADHD. The superiority of the combination treatment mainly manifested in reduced inattention, emotional symptoms, and maladaptive thoughts and improved QoL. Trial registration number ChiCTR1900021705 (March-05-2019).

Adult ADHD, executive function, depressive/anxiety symptoms, and quality of life: A serial two-mediator model.

BACKGROUND: Adult attention-deficit/hyperactivity disorder (ADHD) is associated with impaired executive function (EF), depressive/anxiety symptoms, and poor quality of life (QoL). In this study, we aimed to investigate correlations among these variables and to build a simple or serial mediation model for exploring the mechanisms between adult ADHD and QoL. METHODS: This was a cross-sectional study. The sample included 223 participants with ADHD and 54 healthy volunteers. Participants were required to complete the following scales: ADHD Rating Scale (ADHD-RS), Brief Version of the World Health Organization Quality of Life Scale (WHOQOL-BREF), Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A), Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS). Correlations among EF, depressive/anxiety symptoms and QoL were analyzed using Pearson correlation. The simple and serial mediation models were analyzed using PROCESS (version 3.3). RESULTS: The correlations between EF and QoL, depressive/anxiety symptoms and QoL, and depressive/anxiety symptoms and EF were statistically significant. In ADHD adults with comorbidities, the correlation coefficients were between -0.19 and -0.47, -0.20 and -0.62, 0.28 and 0.50, respectively. In simple mediation models, EF and depressive/anxiety symptoms were significant mediators respectively between ADHD and QoL, respectively. In a serial two-mediator model, ADHD could affect QoL indirectly via EF and then via depressive/anxiety symptoms significantly. LIMITATIONS: The average age was young, the degree of education was high, and only self-reported scales were relied on. CONCLUSIONS: There is a mutual effect between EF and emotional symptoms. This was the first study to build a serial two-mediator model between ADHD and QoL, suggesting the importance of EF and depressive/anxiety symptoms.

Comparative study of three cell morphological analysis methods on in vitro micronucleus assay / 上海预防医学

Objective To investigate the feasibility of genotoxicity assessment for chemicals via flow cytometry (FCM) and high-content screening (HCS) based on high-throughput screening in vitro micronucleus assays. Methods In reference to the methodology of OECD TG487, the typical positive controls, cyclophosphamide (CP) and mitomycin C (MMC), were selected.And no serum MEM medium was treated as negative control.Dose range of CP was 5-20 mg/L and MMC was 0.25-1.0 mg/L.CHL cells were treated with three concentrations of each chemical for 4 h.High-throughput screening in vitro micronucleus assays based on FCM and HCS were established.The results of the frequency of micronuclei were compared to traditional cytokinesis blocking micronucleus assay in each group with or without metabolic activation. Results The frequencies of micronuclei induced by CP and MMC (ascending rank) were separately 1.9%, 7.6%, 10.4% and 5.9%, 11.4%, 16.7%, which were obtained by conventional microscopic scoring.The frequencies of micronuclei induced by CP and MMC (ascending rank) were separately 2.8%, 2.6%, 7.8% and 3.2%, 3.7%, 5.1%, which were obtained by flow cytometry screening.The frequencies of micronuclei induced by CP and MMC (ascending rank) were separately2.8%, 6.2%, 9.1% and 7.9%, 10.1%, 10.2%, which were obtained by high-content screening.Compared with negative controls, the differences of the results were statistically significant(P < 0.05), and there was a dose-response relationship. Conclusion In this study, the results of high-throughput screening assays of FCM and HCS are in accordance to the results of traditional cytokinesis blocking micronucleus assay, indicating that high-throughput screening in vitro micronucleus assays could detect micronucleus formation automatically and improve the efficiency.Therefore, the method could provide data support for using high-throughput screening in vitro micronucleus assays into genotoxicity assessment of chemicals.

Comparative study of three cell morphological analysis methods on in vitro micronucleus assay / 上海预防医学

Objective To investigate the feasibility of genotoxicity assessment for chemicals via flow cytometry (FCM) and high-content screening (HCS) based on high-throughput screening in vitro micronucleus assays. Methods In reference to the methodology of OECD TG487, the typical positive controls, cyclophosphamide (CP) and mitomycin C (MMC), were selected.And no serum MEM medium was treated as negative control.Dose range of CP was 5-20 mg/L and MMC was 0.25-1.0 mg/L.CHL cells were treated with three concentrations of each chemical for 4 h.High-throughput screening in vitro micronucleus assays based on FCM and HCS were established.The results of the frequency of micronuclei were compared to traditional cytokinesis blocking micronucleus assay in each group with or without metabolic activation. Results The frequencies of micronuclei induced by CP and MMC (ascending rank) were separately 1.9%, 7.6%, 10.4% and 5.9%, 11.4%, 16.7%, which were obtained by conventional microscopic scoring.The frequencies of micronuclei induced by CP and MMC (ascending rank) were separately 2.8%, 2.6%, 7.8% and 3.2%, 3.7%, 5.1%, which were obtained by flow cytometry screening.The frequencies of micronuclei induced by CP and MMC (ascending rank) were separately2.8%, 6.2%, 9.1% and 7.9%, 10.1%, 10.2%, which were obtained by high-content screening.Compared with negative controls, the differences of the results were statistically significant(P < 0.05), and there was a dose-response relationship. Conclusion In this study, the results of high-throughput screening assays of FCM and HCS are in accordance to the results of traditional cytokinesis blocking micronucleus assay, indicating that high-throughput screening in vitro micronucleus assays could detect micronucleus formation automatically and improve the efficiency.Therefore, the method could provide data support for using high-throughput screening in vitro micronucleus assays into genotoxicity assessment of chemicals.

Comparison of International Pharmaceutical Ranking Index System / 中国药学杂志

OBJECTIVE: To make a detailed analysis of the four international discipline ranking index systems, namely QS, ARWU, THE and US News and provide suggestions for the construction of world-class pharmaceutical disciplines. METHODS: Literature survey, website survey, comparative analysis and content analysis was used. RESULTS: The four international disciplines ranking index systems all set the threshold of dissertation publication, inspected the teaching situation and academic output, but there are differences in disciplines classification, data sources, scientific research output index and internationalization index. CONCLUSION: The status quo of pharmacy discipline ranking in Chinese universities is analyzed by data comparison. Suggestions on building world-class pharmaceutical discipline are put forward from four aspects: scientific research output, international cooperation, personnel training and information construction.

Primary cystic echinococcosis in the left femur: a case report / 中国血吸虫病防治杂志

This article reported a case with primary cystic echinococcosis in the left femur.

Application value of Revolution CT combining three-dimensional visualization technique in precision resection of hepatic alveolar echinococcosis / 中国血吸虫病防治杂志

Objective To explore the application value of Revolution CT combining three -dimensional visualization technique in the precision resection of hepatic alveolar echinococcosis. Methods Totally 12 patients with surgical treatment and pathologically confirmed hepatic alveolar echinococcosis in Qinghai Provincial People’s Hospital were retrospectively analyzed. All the patients underwent the Revolution CT plain and enhancement scan before surgery, and the 0.625 millimeter scan data were obtained. The DICOM format data were imported into MI-3DVS for three-dimensional reconstruction, simulated cutting, volume measurement, and surgical planning. Results The data of 12 patients were reconstructed successfully, and the sizes and locations of the lesions as well as the hepatic vascular systems were clearly displayed. The liver volume, hydatid volume, simulated resection volume, and residual liver ratio were measured accurately. The average whole liver volume and the lesion volume of the 11 surgical treated patients were (2 429.8 ± 335.9) mL and (919.6 ± 262.8) mL respectively. The average actually removed volume was highly associated with the average simulated resection volume (r = 0.979, P < 0.01). Conclusion Revolution CT combining three-dimensional visualization technique can achieve accurate diagnosis as well as optimal surgical planning before operation, which is of great value for the precision resection of difficult hepatic alveolar echinococcosis.

Study on the molecular phylogeny of Echinococcus multilocularis in Qinghai Province / 中国血吸虫病防治杂志

Objective To amplify and sequence Coxl and Nadl genes in Echinococcus multilocularis isolates from Qinghai Province, and to create phylogenetic trees and molecular clocks, so as to provide evidence for estimating the evolutionary relationships and origins of E. multilocularis in Qinghai Province. Methods Twenty-two post-surgical specimens of patients with hepatic alveolar echinococcosis were sampled from Qinghai Provincial People’s Hospital in 2017. The Coxl and Nadl genes were amplified from E. multilocularis samples and sequenced. Then, the gene sequences were aligned to the Coxl and Nadl genes of Echinococcus species in GenBank database. The intra-species variation was observed, and the phylogenetic tree and molecular clock were created. Results All E. multilocularis samples shared more than 99% genetic homology with the sequences of Coxl and Nadl genes from the E. multilocularis Asian strain in the GenBank database. A total of 6 genotypes were identified, including 2 isolates that had no 100% homology with the sequences of known genes in the GenBank database. Phylogenetic tree analysis revealed remarkable clustering of the E. multilocularis samples with the E. multilocularis Asian strain, and the E. multilocularis isolates from Qinghai Province were estimated to date back to 94 000 years ago by the molecular clock. Conclusions The present study characterizes 6 E. multilocularis genotypes in Qinghai Province, including 2 novel genotypes. Asian strain is the predominant strain of E. multilocularis in Qinghai Province, and the E. multilocularis isolates from Qinghai Province date back to 94 000 years ago.

Value of three-dimensional visualization technology in preoperative evaluation of liver autotransplantation for end-stage hepatic alveolar echinococcosis / 中国血吸虫病防治杂志

Objective To evaluate the value of the three-dimensional visualization technology for the preoperative assessment of liver autotransplantation for end-stage hepatic alveolar echinococcosis. Methods A total of 8 patients with end-stage hepatic alveolar echinococcosis undergoing liver autotransplantation in Qinghai Provincial People’s Hospital from May 2013 to July 2017 were collected. All cases received preoperative abdominal CT scanning and dynamic three-phase enhanced CT scanning, and the original CT data were transferred to the human 3D visualization virtual surgical planning system. The volumes of Echinococcus multilocularis and pre-resected liver were measured using the 3D visualization reconstruction, and the relationship between the lesion and the neighboring tissues was observed. The value of the 3D visualization technology for the preoperative assessment of liver autotransplantation for end-stage hepatic alveolar echinococcosis was assessed by comparing with the intraoperative findings. Results The 3D visualization reconstruction model clearly displayed the adjacent relationship between the lesions of end-stage hepatic alveolar echinococcosis and the neighboring tissues, and no significant difference was seen between the pre-resected liver volume in 3D visualization reconstruction model and the actually resected liver volume (t = 1.083, P > 0.05). Conclusions 3D visualization technology is feasible to develop a reasonable scheme for liver resection and vascular anastomosis for end-stage hepatic alveolar echinococcosis prior to liver autotransplantation, which may increase the success of surgery and improve the prognosis.

Analysis of related factors for hepatic alveolar echinococcosis and gallbladder complications of children in Qinghai Province / 中国血吸虫病防治杂志

Objective To investigate the distribution characteristics of gallbladder diseases in children with hepatic alveolar echinococcosis, and to analyze the related factors for hepatic alveolar echinococcosis and gallbladder diseases. Methods The clinical data of hepatic alveolar echinococcosis patients under 18 years were collected in Qinghai Provincial People’s Hospital-from January 2012 to December 2017, and the gallbladder-related complications in the surgically treated patients with hepatic al-veolar echinococcosis were analyzed. Results The clinical data of 51 child patients with hepatic alveolar echinococcosis were collected and analyzed. According to the PNM classification criteria of WHO, P1, P2 and P3 in the 51 patients accounted for 37.25% (19/51), 41.18% (21/51) and 19.60% (10/51), respectively. According to the diagnostic criteria (WS 257–2006) of China for echinococcosis, the patients of infiltration type, calcification type and liquefaction cavitary type accounted for 66.67% (34/51), 21.57% (11/51) and 11.76% (6/51), respectively. Among the 51 patients, 78.43% (40/51) of the patients had clinical symptoms of biliary tract disease, and 58.82% (30/51) had gallbladder-related complications. The operations were performed on 40 patients, and 77.50% (31/40) of them had the postoperative complications. The results of binary multivariate logistic regression analysis showed that the clinical image classification, the liver segment distribution, size, location and number of lesions of hepatic alveolar echinococcosis were important correlative factors for the occurrence of gallbladder complications in hepatic alveolar echinococcosispatients. Conclusions The incidence of complications related to gallbladder diseases is higher in the children with hepatic alveolar echinococcosis in Qinghai Province, and it has great influence on the operation mode and the occurrence and prognosis of postoperative complications. The early diagnosis and treatment of alveolar echinococcosis in children is particularly important.

Expression of follicular helper T cells in peripheral blood of patients with hepatic echinococcosis / 中国血吸虫病防治杂志

Objective To detect the expression of follicuLar helper T cells (Tfh) and interleukin-21 (IL-21) in the peripheral blood of patients with hepatic echinococcosis and healthy controls, so as to explore the associations of Tfh and IL-21 expression with the progression of hepatic echinococcosis. Methods Fifty cases of hepatic echinococcosis and healthy controls were collected from Qinghai Provincial People's Hospital, respectively. Flow cytometry was used to detect the expression of Tfh cells in the peripheral blood of hepatic echinococcosis patients and healthy controls, and enzyme-linked immunosorbent assay (ELISA) was used to detect serum IL-21 expression in hepatic echinococcosis patients and healthy controls. The correlation between Tfh cell expression and serum IL-21 level was examined in the patients with hepatic echinococcosis. Results Flow cytometry detected a higher percentage of CD4+CXCR5+ T cells (18.49% ± 5.67% vs. 16.18% ± 4.04%, P < 0.05), CD4+CXCR5+PD-1+ T cells (4.94% ± 1.91% vs. 2.29% ± 0.79%, P < 0.05) and CD4+CXCR5+ICOS+PD-1+ T cells (30.93% ± 24.10% vs. 21.07% ± 14.25%, P < 0.05) in hepatic echinococcosis patients than in healthy controls, and no significant difference was seen in the percentage of CD4+CRCR5+ICOS+ T cells between the patients and controls (0.29% ± 0.32% vs. 0.25% ± 0.31%, P > 0.05) . The serum IL-21 level was significantly higher in the patients with hepatic echinococcosis than in healthy controls ([ 293.35 ± 2 03.65) pg/mL vs. (192.72 ± 70.09) pg/mL, P < 0.05]; however, there was no correlation between the Tfh cell expression and serum IL-21 level in patients with hepatic echinococcosis (P > 0.05). Conclusion The expression of peripheral blood Tfh cells and serum IL-21 is elevated in patients with hepatic echinococcosis, and Tfh cells and IL-21 may contribute to the progression of hepatic echinococcosis.

Application value of Revolution CT combining three-dimensional visualization technique in precision resection of hepatic alveolar echinococcosis / 中国血吸虫病防治杂志

Objective To explore the application value of Revolution CT combining three -dimensional visualization technique in the precision resection of hepatic alveolar echinococcosis. Methods Totally 12 patients with surgical treatment and pathologically confirmed hepatic alveolar echinococcosis in Qinghai Provincial People’s Hospital were retrospectively analyzed. All the patients underwent the Revolution CT plain and enhancement scan before surgery, and the 0.625 millimeter scan data were obtained. The DICOM format data were imported into MI-3DVS for three-dimensional reconstruction, simulated cutting, volume measurement, and surgical planning. Results The data of 12 patients were reconstructed successfully, and the sizes and locations of the lesions as well as the hepatic vascular systems were clearly displayed. The liver volume, hydatid volume, simulated resection volume, and residual liver ratio were measured accurately. The average whole liver volume and the lesion volume of the 11 surgical treated patients were (2 429.8 ± 335.9) mL and (919.6 ± 262.8) mL respectively. The average actually removed volume was highly associated with the average simulated resection volume (r = 0.979, P < 0.01). Conclusion Revolution CT combining three-dimensional visualization technique can achieve accurate diagnosis as well as optimal surgical planning before operation, which is of great value for the precision resection of difficult hepatic alveolar echinococcosis.

Study on the molecular phylogeny of Echinococcus multilocularis in Qinghai Province / 中国血吸虫病防治杂志

Objective To amplify and sequence Coxl and Nadl genes in Echinococcus multilocularis isolates from Qinghai Province, and to create phylogenetic trees and molecular clocks, so as to provide evidence for estimating the evolutionary relationships and origins of E. multilocularis in Qinghai Province. Methods Twenty-two post-surgical specimens of patients with hepatic alveolar echinococcosis were sampled from Qinghai Provincial People’s Hospital in 2017. The Coxl and Nadl genes were amplified from E. multilocularis samples and sequenced. Then, the gene sequences were aligned to the Coxl and Nadl genes of Echinococcus species in GenBank database. The intra-species variation was observed, and the phylogenetic tree and molecular clock were created. Results All E. multilocularis samples shared more than 99% genetic homology with the sequences of Coxl and Nadl genes from the E. multilocularis Asian strain in the GenBank database. A total of 6 genotypes were identified, including 2 isolates that had no 100% homology with the sequences of known genes in the GenBank database. Phylogenetic tree analysis revealed remarkable clustering of the E. multilocularis samples with the E. multilocularis Asian strain, and the E. multilocularis isolates from Qinghai Province were estimated to date back to 94 000 years ago by the molecular clock. Conclusions The present study characterizes 6 E. multilocularis genotypes in Qinghai Province, including 2 novel genotypes. Asian strain is the predominant strain of E. multilocularis in Qinghai Province, and the E. multilocularis isolates from Qinghai Province date back to 94 000 years ago.

[Expression of follicular helper T cells in peripheral blood of patients with hepatic echinococcosis].

OBJECTIVE: To detect the expression of follicuLar helper T cells (Tfh) and interleukin-21 (IL-21) in the peripheral blood of patients with hepatic echinococcosis and healthy controls, so as to explore the associations of Tfh and IL-21 expression with the progression of hepatic echinococcosis. METHODS: Fifty cases of hepatic echinococcosis and healthy controls were collected from Qinghai Provincial People's Hospital, respectively. Flow cytometry was used to detect the expression of Tfh cells in the peripheral blood of hepatic echinococcosis patients and healthy controls, and enzyme-linked immunosorbent assay (ELISA) was used to detect serum IL-21 expression in hepatic echinococcosis patients and healthy controls. The correlation between Tfh cell expression and serum IL-21 level was examined in the patients with hepatic echinococcosis. RESULTS: Flow cytometry detected a higher percentage of CD4+CXCR5+ T cells (18.49% ± 5.67% vs. 16.18% ± 4.04%, P < 0.05), CD4+CXCR5+PD-1+ T cells (4.94% ± 1.91% vs. 2.29% ± 0.79%, P < 0.05) and CD4+CXCR5+ICOS+PD-1+ T cells (30.93% ± 24.10% vs. 21.07% ± 14.25%, P < 0.05) in hepatic echinococcosis patients than in healthy controls, and no significant difference was seen in the percentage of CD4+CRCR5+ICOS+ T cells between the patients and controls (0.29% ± 0.32% vs. 0.25% ± 0.31%, P > 0.05) . The serum IL-21 level was significantly higher in the patients with hepatic echinococcosis than in healthy controls ([ 293.35 ± 2 03.65) pg/mL vs. (192.72 ± 70.09) pg/mL, P < 0.05]; however, there was no correlation between the Tfh cell expression and serum IL-21 level in patients with hepatic echinococcosis (P > 0.05). CONCLUSIONS: The expression of peripheral blood Tfh cells and serum IL-21 is elevated in patients with hepatic echinococcosis, and Tfh cells and IL-21 may contribute to the progression of hepatic echinococcosis.

[Analysis of related factors for hepatic alveolar echinococcosis and gallbladder complications of children in Qinghai Province].

OBJECTIVE: To investigate the distribution characteristics of gallbladder diseases in children with hepatic alveolar echinococcosis, and to analyze the related factors for hepatic alveolar echinococcosis and gallbladder diseases. METHODS: The clinical data of hepatic alveolar echinococcosis patients under 18 years were collected in Qinghai Provincial People's Hospital-from January 2012 to December 2017, and the gallbladder-related complications in the surgically treated patients with hepatic al-veolar echinococcosis were analyzed. RESULTS: The clinical data of 51 child patients with hepatic alveolar echinococcosis were collected and analyzed. According to the PNM classification criteria of WHO, P1, P2 and P3 in the 51 patients accounted for 37.25% (19/51), 41.18% (21/51) and 19.60% (10/51), respectively. According to the diagnostic criteria (WS 257-2006) of China for echinococcosis, the patients of infiltration type, calcification type and liquefaction cavitary type accounted for 66.67% (34/51), 21.57% (11/51) and 11.76% (6/51), respectively. Among the 51 patients, 78.43% (40/51) of the patients had clinical symptoms of biliary tract disease, and 58.82% (30/51) had gallbladder-related complications. The operations were performed on 40 patients, and 77.50% (31/40) of them had the postoperative complications. The results of binary multivariate logistic regression analysis showed that the clinical image classification, the liver segment distribution, size, location and number of lesions of hepatic alveolar echinococcosis were important correlative factors for the occurrence of gallbladder complications in hepatic alveolar echinococcosispatients. CONCLUSIONS: The incidence of complications related to gallbladder diseases is higher in the children with hepatic alveolar echinococcosis in Qinghai Province, and it has great influence on the operation mode and the occurrence and prognosis of postoperative complications. The early diagnosis and treatment of alveolar echinococcosis in children is particularly important.

[Value of three-dimensional visualization technology in preoperative evaluation of liver autotransplantation for end-stage hepatic alveolar echinococcosis].

OBJECTIVE: To evaluate the value of the three-dimensional visualization technology for the preoperative assessment of liver autotransplantation for end-stage hepatic alveolar echinococcosis. METHODS: A total of 8 patients with end-stage hepatic alveolar echinococcosis undergoing liver autotransplantation in Qinghai Provincial People's Hospital from May 2013 to July 2017 were collected. All cases received preoperative abdominal CT scanning and dynamic three-phase enhanced CT scanning, and the original CT data were transferred to the human 3D visualization virtual surgical planning system. The volumes of Echinococcus multilocularis and pre-resected liver were measured using the 3D visualization reconstruction, and the relationship between the lesion and the neighboring tissues was observed. The value of the 3D visualization technology for the preoperative assessment of liver autotransplantation for end-stage hepatic alveolar echinococcosis was assessed by comparing with the intraoperative findings. RESULTS: The 3D visualization reconstruction model clearly displayed the adjacent relationship between the lesions of end-stage hepatic alveolar echinococcosis and the neighboring tissues, and no significant difference was seen between the pre-resected liver volume in 3D visualization reconstruction model and the actually resected liver volume (t = 1.083, P > 0.05). CONCLUSIONS: 3D visualization technology is feasible to develop a reasonable scheme for liver resection and vascular anastomosis for end-stage hepatic alveolar echinococcosis prior to liver autotransplantation, which may increase the success of surgery and improve the prognosis.