Neuroendocrine carcinoma of the common hepatic duct coexisting with distal cholangiocarcinoma:A case report and review of literature

BACKGROUND Neuroendocrine carcinoma(NEC)of the extrahepatic bile duct is very rare,and the treatment and prognosis are unclear.Herein,we report the case of a middleaged female with primary large cell NEC(LCNEC)of the common hepatic duct combined with distal cholangiocarcinoma(dCCA).Additionally,after a review of the relevant literature,we summarize and compare mixed neuroendocrine-nonneuroendocrine neoplasm(MiNEN)and pure NEC to provide a reference for selecting the appropriate treatment and predicting the prognosis of this rare disease.CASE SUMMARY A 62-year-old female presented to the hospital due to recurrent abdominal pain for 2 months.Physical examination showed mild tenderness in the upper abdomen and a positive Courvoisier sign.Blood tests showed elevated liver transaminase and carbohydrate antigen 199 levels.Imaging examination revealed node dissection was performed,and hepatic duct tumours were unexpectedly found during surgery.Pathology suggested poorly differentiated LCNEC(approximately 0.5 cm×0.5 cm×0.4 cm),Ki-67(50%),synaptophysin+,and chromogranin A+.dCCA pathology suggested moderately differentiated adenocarcinoma.The patient eventually developed lymph node metastasis in the liver,bone,peritoneum,and abdominal cavity and died 24 months after surgery.Gene sequencing methods were used to compare gene mutations in the two primary bile duct tumours.CONCLUSION The prognosis of MiNEN and pure NEC alone is different,and the selection of treatment options needs to be differentiated.

Primary intra-abdominal paraganglioma:A case report

BACKGROUND Paragangliomas are rare neuroendocrine tumors.We hereby report a case of a localized paraganglioma found in the abdominal cavity,and review the relevant literature to improve the understanding of this disease.CASE SUMMARY A 29-year-old Chinese female patient was referred to our hospital due to an abdominal mass found on physical examination.Imaging revealed a mass in the left upper abdomen,suggestive of either a benign stromal tumor or an ectopic accessory spleen.Laparoscopic radical resection was subsequently performed,and histopathological analysis confirmed the diagnosis of a paraganglioma.The patient was followed up 3 months post-operation,and reported good recovery with no metastasis.CONCLUSION Radical resection can effectively treat intra-abdominal paragangliomas,with few side effects and low recurrence risk.In addition,early and accurate diagnosis and timely intervention are essential for the prognosis of this disease.

Comparative effectiveness of several adjuvant therapies after hepatectomy for hepatocellular carcinoma patients with microvascular invasion

BACKGROUND For resectable hepatocellular carcinoma(HCC),radical hepatectomy is commonly used as a curative treatment.However,postoperative recurrence significantly diminishes the overall survival(OS)of HCC patients,especially with microva-scular invasion(MVI)as an independent high-risk factor for recurrence.While some studies suggest that postoperative adjuvant therapy may decrease the risk of recurrence following liver resection in HCC patients,the specific role of adju-vant therapies in those with MVI remains unclear.AIM To conduct a network meta-analysis(NMA)to evaluate the efficacy of various adjuvant therapies and determine the optimal adjuvant regimen.METHODS A systematic literature search was conducted on PubMed,EMBASE,and Web of Science until April 6,2023.Studies comparing different adjuvant therapies or comparing adjuvant therapy with hepatectomy alone were included.Hazard ratios(HRs)with 95%confidence intervals were used to combine data on recurrence free survival and OS in both pairwise meta-analyses and NMA.RESULTS Fourteen eligible trials(2268 patients)reporting five different therapies were included.In terms of reducing the risk of recurrence,radiotherapy(RT)[HR=0.34(0.23,0.5);surface under the cumulative ranking curve(SUCRA)=97.7%]was found to be the most effective adjuvant therapy,followed by hepatic artery infusion chemotherapy[HR=0.52(0.35,0.76);SUCRA=65.1%].Regarding OS improvement,RT[HR:0.35(0.2,0.61);SUCRA=93.1%]demonstrated the highest effectiveness,followed by sorafenib[HR=0.48(0.32,0.69);SUCRA=70.9%].INTRODUCTION Hepatocellular carcinoma(HCC)is the sixth most common malignant tumor in the world and ranks third in terms of worldwide malignant tumor mortality rates in 2020[1].Curative treatments for HCC include ablation,radical hepatectomy,and liver transplantation.However,ablation is suitable only for early-stage HCC patients,who represent a small percentage of the overall HCC population.Although liver transplantation serves as the optimal treatment for HCC patients,the scarcity of donor organs restricts the availability of this procedure.Therefore,hepatectomy is the most commonly employed curative treatment for resectable HCC.Unfortunately,the 5-year recurrence rate for patients who undergoing hepatectomy ranges from 50%to 70%[2,3].Recurrence of HCC is associated with several risk factors[4],including single nodule>5 cm,vascular invasion,and multiple nodules.Among these factors,microvascular invasion(MVI)is an independent risk factor for recurrence.MVI is defined as the presence of cancer cells in the lumen of endothelium-lined vessels,typically in the small branches of the portal and hepatic veins of the paracancerous liver tissue,visible only under the microscope[5].Previous studies have shown that among HCC patients who underwent hepatectomy,those with MVI had a higher risk of recurrence and shorter overall survival(OS)than those without MVI[6].Several studies have indicated that adjuvant therapy following curative hepatectomy can prevent recurrence and improve OS in HCC patients with MVI.These postoperative adjuvant therapies include transarterial chemoembolization(TACE)[7],sorafenib[8],hepatic artery infusion chemotherapy(HAIC)[9],and radiotherapy(RT)[10].However,the existing studies mostly compare individual adjuvant therapy with hepatectomy alone.Direct or indirect comparisons between the various adjuvant therapies are lacking.Therefore,we performed the network meta-analysis(NMA)to compare the relative efficacy of each adjuvant therapy to determine the optimal treatment.

Analysis of therapeutic effect of cell reduction combined with intraperitoneal thermoperfusion chemotherapy in treatment of peritoneal pseudomyxoma

BACKGROUND Pseudomyxoma peritonei is a rare tumor that can produce a biological behavior similar to that of a malignant tumor.Surgical resection combined with chemo-therapy is the traditional treatment method,but the effect is not good.Cell reduction(CRS)combined with intraperitoneal thermoperfusion chemotherapy(HIPEC)has become a new method for the treatment of peritoneal pseudomy-xoma(PMP).AIM To find out if CRS and HIPEC can be used safely and effectively to treat PMP.METHODS This is an observational study.Clinical data of PMP patients treated with CRS+HIPEC at our hospital from January 2013 to June 2023 was collated and analyzed.The main outcome measures were overall survival(OS),and the secondary outcome measures were the incidence of surgical complications and serious adverse events.Complications were graded according to common adverse event evaluation criteria.Peritoneal tumor staging was performed using the peritoneal tumor index(PCI)scoring system,and a cell reduction degree(CCR)score was performed after CRS.CCR-0 and CCR-1 were considered satisfactory CRS.RESULTS A total of 186 patients with PMP were included,with a median age of 56(48-64)years,65(34.9%)years in males,and 121(65.1%)years in females.The median PCI score was 28(20-34)points.The median operative time was 300(211-430)minutes,and no significant complications occurred.91.4%(170/186)were from the appendix,53.2%(99/186)were from the low grade,and 30.6%(57/186)were from the high grade.CCR scores showed that 55 patients(29.6%)achieved satisfactory CRS,and 113 patients(60.8%)did not achieve satisfactory CRS.The fatality rate at 30 days after surgery was 2.7%(5/186),1.6%(3/186)needed a second operation,and the fatality rate at 90 days was 4.3%(8/186).The total incidence of III-IV complications was 43.0%(80/186),among which the higher incidence was mainly anemia(27.4%,51/186),electrolyte disturbance(11.6%,21/181),and albumin decrease(7.5%,14/186).The main compli-cations associated with abdominal surgery were gastrointestinal anastomotic leakage(2.2%,4/186),abdominal hemorrhage(2.2%,4/186),and abdominal infection(4.3%,8/186).The median follow-up was 38.1(95%CI:31.2-45.1)months.The 5-year OS of PMP patients treated with CRS+HIPEC was 50.3%(95%CI:40.7%-59.9%),and the median survival time was 66.1(95%CI:43.1-89.1)months.The results of the survival analysis showed that patients with a low pathological grade,a low PCI,and a satisfactory CCR score had a higher survival rate(all P<0.05).5-year OS was 88.9%(95%CI:68.3%-100.0%)in CCR-0 patients,77.6%(95%CI:62.7%-92.5%)in CCR-1 patients,and 42.0%(95%CI:29.5%-54.5%)in CCR-2/3 patients.CONCLUSION The application of CRS+HIPEC in PMP is safe and feasible,and the survival benefit is high,especially in those who achieve satisfactory CRS,which can significantly extend the OS.

NT4(Si)-p53(N15)-antennapedia induces cell death in a human hepatocellular carcinoma cell line

AIM： To construct the recombinant lentivirus expression plasmid, pLenti6/V5-NT4 p53（N 15）-antennapedia （Ant）, and study its effect on HepG2 cells. METHODS： Plasmid pLenti6/V5-NT4 p53（N15）-Ant was constructed incorporating the following functional regions, including signal peptide sequence and proregion of neurotrophin 4, N-terminal residues 12-26 of p53 and 17 amino acid drosophila carrier protein, Ant. Hepatocellular carcinoma （HepG2） cells were used for transfection. 3-[4,5-climethyl-thiazol-2yl]-2,5 diphenyl tetrazolium bromide （MI-I） assay, lactate dehydrogenase （LDH） release assay, transmission electron microscopy （TEM） and flow cytometric analysis （FCM） were employed to investigate the effects of LV-NT4（Si）- p53（N15）-Ant in vitro on HepG2 cells. In vivo experiment was also performed to investigate the inhibitory effect of LV-NT4（Si）-p53（N15）-Ant on tumor growth in nude mice.RESULTS： LV-NT4（Si）-p53（N15）-Ant significantly suppressed the growth of HepG2 cells. MTT assay showed that the growth of HepG2 cells was mucj more significantly inhibited by LV-NT4（Si）-p53（N15）-Ant than by LV-EGFP. The inhibition rate for HepG2 cell growth in the two groups was 46.9% and 94.5%, respectively, 48 h after infection with LV-NT4（Si）-p53（N15）-Ant, and was 33.9% and 95.8%, respectively, 72 h after infection with LV-NT4（Si）-p53（N15）-Ant （P 〈 0.01）. Light microscopy and TEM showed morphological changes in HepG2 cells infected with LV-NT4（Si）-p53（N15）-Ant, but no significant changes in HepG2 cells infected with LV-EGFR Changes were observed in ultra-structure of HepG2 cells infected with LV-NT4（Si）-p53（N15）-Ant, with degraded membranes, resulting in necrosis. LDH release from HepG2 cells was analyzed at 24, 48, 72 and 96 h after infection with LV-NT4（Si）-p53（N15）-Ant and LV-EGFP, which showed that LDH release was significantly higher in LV-NT4（Si）-p53（N15）-Ant treatment group （682 IU/L） than in control group （45 IU/L, P 〈 0.01）. The longer the time was after infection, the bigger the difference was in LDH release. FCM analysis showed that LV-NT4（Si）- p53（N15）-Ant could induce two different kinds of cell death： necrosis and apoptosis, with apoptosis being the minor type and necrosis being the main type, suggesting that LV-NT4（Si）-p53（N15）-Ant exerts its anticancer effect on HepG2 cells by inducing necrosis. The in vivo study showed that LV-NT4（Si）-p53（N15）-Ant significantly inhibited tumor growth with an inhibition rate of 66.14% in terms of tumor size and weight. CONCLUSION： LV-NT4（Si）-p53（N15）-Ant is a novel recombinant lentivirus expression plasmid and can be used in gene therapy for cancer.

Effect of refining processes on inclusions and mechanical properties of cast Al-2Li-2Cu-0.2Zr alloy

The effect of different refining processes on inclusions and mechanical properties of cast Al-2Li-2Cu-0.2Zr alloy was investigated, including two-stage hexachloroethane (C2Cl6) refining process, two-stage rotating gas bubbling refining process and two-stage composite refining process. It was found that the two-stage composite refining process, which combined C2Cl6 and rotating gas bubbling, can significantly improve the melt purity and mechanical properties of cast Al-2Li-2Cu-0.2Zr alloy. Compared to the unrefined alloy, the volume fraction of gas porosity defects and slag inclusions decreased from 1.47% to 0.12%, and the yield strength, ultimate tensile strength and elongation of as-quenched alloy increased from 113 MPa,179 MPa and 3.9% to 142 MPa, 293 MPa and 18.1%, respectively. C2Cl6 was first utilized to degas and remove large size slag inclusions before lithium addition, and then the rotating gas bubbling was utilized to do the further degassing and remove the suspended fine inclusions after lithium addition. The two-stage composite refining process can take advantage of two methods and get the remarkable refining effect.

Commissioning the photocathode radio frequency gun:a candidate electron source for Hefei Advanced Light Facility

The Hefei Advanced Light Facility(HALF)proposed by the National Synchrotron Radiation Laboratory(NSRL)is a diffraction-limited storage ring(DLSR),which plans to use a full energy linac as the injector.To ensure injection efficiency,the injection beam needs to have low emittance.Therefore,a photocathode radio frequency(RF)gun was developed in the HALF R&D project.The gun is designed to deliver high-quality electron bunches with a typically 0.5 nC charge and~4.5 MeV energy with low emittance.The initial system commission with an electron beam was completed at the end of 2020,and a stable 1.2–1.4 mm.mrad emittance with a bunch charge of 500 pC was demonstrated.In this paper,we report the experimental results and experience obtained during the commission,including the RF gun,drive laser system,and beam diagnostics.

Determination of Residual Acrylamide in Medical Polyacrylamide Hydrogel by High Performance Liquid Chromatography tandem Mass Spectroscopy

Objective To determine residual acrylamide in medical polyacrylamide hydrogel by high performance liquid chromatography tandem mass spectroscopy （HPLC-MS）. Methods After 13C3 labeled acrylamide was added, the sample was extracted with water and then cleaned up with ExtrelutTM 20. The polyacrylamide hydrogel sample and 20 clinical cases were analyzed by HPLC-MS/MS and isotope dilution quantifying technique in selected reaction monitoring （SRM） mode. Results Acrylamide was separated from polyacrylamide hydrogel. The concentration of acrylamide in polyacrylamide hydrogel ranged from 3.9×10^-9 to 3.1×10^- 8g/L in the 20 clinical cases. The peak area was favorable linear and the range was up to 3 000 μg/L. The recovery rate was 103.1% with a relative standard deviation （RSD） of 6.20%, when the mark level was 50 lag/L. Conelusion HPLC-MS is a rapid, accurate, and sensitive method for the determination of residual acrylamide in medical polyacrylamide hydrogel.

LncRNA cancer susceptibility 20 regulates the metastasis of human gastric cancer cells via the miR-143-5p/MEMO1 molecular axis

BACKGROUND Gastric cancer(GC)is considered as one of the most widespread malignancies.Emerging evidence has shown that lncRNAs can function as important oncogenes or tumor suppressors during GC progression.AIM To investigate the effect and mechanism of lncRNA cancer susceptibility 20(CASC20)in the proliferation and metastasis of GC cells.METHODS Data mining and clinical samples were used to evaluate the expression of CASC20 in GC and adjacent tissues.CASC20 was down-regulated in GC cells by shortinterfering RNA.Cell proliferation was evaluated by CCK-8 assay,and cell migration and invasion were detected by wound healing and Transwell assays.The expressions of proteins related to epithelial-mesenchymal transition were detected by western blot assay.RESULTS The expression of CASC20 was increased in GC tumor tissues and various GC cell lines.High CASC20 expression was correlated with a high risk of lymphatic metastasis and poor prognosis in GC patients.In vitro assays showed that silencing CASC20 reduced cell proliferation,migration,and invasion in GC cells.Mechanistic studies revealed that CASC20 exhibits oncogenic functions by regulating MEMO1 expression through competitive endogenous binding to miR-143-5p,leading to induction of epithelial-mesenchymal transition.CONCLUSION Our findings indicate that CASC20 serves as a tumor promoter by regulating metastasis in GC via the miR-143-5p/MEMO1 axis.CASC20 may be a potential therapeutic target for GC.

Clinical study on tri-tongue acupuncture combined with lowfrequency electrical stimulation for treating post-stroke dysarthria

BACKGROUND Few studies have investigated low-frequency electrical stimulation combined with tri-tongue acupuncture for the treatment of post-stroke dysarthria.This randomized clinical study assessed the correlation between the clinical efficacy of low-frequency electrical stimulation combined with tri-tongue acupuncture in patients with post-stroke dysarthria.AIM To investigate the clinical effects of tri-tongue acupuncture combined with lowfrequency electrical stimulation for treating post-stroke dysarthria.METHODS Ninety patients with post-stroke dysarthria,who were admitted to our hospital from December 2019 to June 2021,were selected and equally divided into two groups(n=45/group)according to the random number table method.Tri-tongue acupuncture was administered in the control group.The treatment group received both tri-tongue acupuncture and low-frequency electrical stimulation.The clinical efficacy,Western Aphasia Battery(WAB)score,general quality of life inventory(GQOLI-74)score,Frenchay Dysarthria Assessment score,and speech function grades were compared and analyzed between both groups.RESULTS The overall efficacy in the treatment group was better than that in the control group(P<0.05).Before treatment,the WAB,Frenchay Dysarthria Assessment,or GQOLI-74 scores(P>0.05)did not differ between the groups.After therapy,the WAB,Frenchay Dysarthria Assessment,and GQOLI-74 scores in both groups increased significantly(P<0.05),and the treatment group exhibited a significantly greater increase than that of the controls(P<0.05).Moreover,the classification of speech function did not differ between the two groups before treatment(P>0.05),whereas significant improvements were observed in both groups after treatment(P<0.05).The degree of improvement in the treatment group was greater than that in the control group(P<0.05).CONCLUSION Low-frequency electrical stimulation,in conjunction with tri-tongue acupuncture,exhibits a good clinical effect on post-stroke dysarthria.

E3 ubiquitin ligase TRIM55 promotes metastasis of gastric cancer cells by mediating epithelial-mesenchymal transition

BACKGROUND Gastric cancer(GC)is considered a major global health problem.The role of TRIM55,a member of the three-domain protein family,in GC is unknown.AIM To determine the expression of TRIM55 in GC tissues and its relationship with clinicopathological characteristics,and to investigate the effects of TRIM55 on the malignant biological behavior of GC cells.METHODS Differential expression of TRIM55 in GC and para-cancer tissues was detected by immunohistochemistry,and the relationship between TRIM55 level and clinicopathological characteristics and prognosis was analyzed.Gain-of-function,lossof-function,cell counting kit-8 assay,colony formation,transwell assay,wound healing assay,and western blot analysis were used to assess the potential role of TRIM55 in the development of GC.RESULTS TRIM55 expression was significantly increased in GC tissues compared with adjacent normal tissues.High expression of TRIM55 was associated with advanced pathological stage and poor prognosis.Overexpression of TRIM55 promoted invasion and metastasis of GC cells in vitro by regulating epithelial-mesenchymal transition(EMT),whereas knockdown of TRIM55 had the opposite effect.Our data showed that TRIM55 is highly expressed in GC tissues,and is associated with poor prognosis.TRIM55 plays the role of an oncogene in GC,and it promotes metastasis of GC through the regulation of EMT.CONCLUSION TRIM55 may be a possible target for the diagnosis and prognosis of GC patients.

Yb:CaF_(2)-YF_(3)transparent ceramics ultrafast laser at dual gain lines

Yb^(3+):CaF_(2)–YF_(3)transparent ceramics with excellent optical quality was successfully fabricated by hot-pressed method.Pulsed laser properties of this ceramics were investigated for the first time.Laser diode(LD)was applied as the pump source to generate a dual-wavelength mode-locked(ML)laser.The maximum average output power was 310 mW,which represents the highest output power of ultrafast calcium fluoride ceramic laser.The spectrum separated at 1048.9 nm and 1049.7 nm with a total pulse duration of 8.9 ps.The interval period between the beating signals was about 4.3 ps,corresponding to a 0.23 THz beat pulse repetition rate.These results demonstrate its potential in producing dual-wavelength ultrashort pulses.These Yb^(3+):CaF_(2)–YF_(3)ceramics with low-cost and short-preparation period are ideal candidate materials for ultrafast lasers.

Shape Anisotropy and Resonance Mode Guided Reliable Interconnect Design for In-plane Magnetic Logic

Dipole coupled nanomagnets controlled by the static Zeeman field can form various magnetic logic interconnects.However, the corner wire interconnect is often unreliable and error-prone at room temperature. In this study, we address this problem by making it into a reliable type with trapezoid-shaped nanomagnets, the shape anisotropy of which helps to offer the robustness. The building method of the proposed corner wire interconnect is discussed,and both its static and dynamic magnetization properties are investigated. Static micromagnetic simulation demonstrates that it can work correctly and reliably. Dynamic response results are reached by imposing an ac microwave field on the proposed corner wire. It is found that strong ferromagnetic resonance absorption appears at a low frequency. With the help of a very small ac field with the peak resonance frequency, the required static Zeeman field to switch the corner wire is significantly decreased by ~21 m T. This novel interconnect would pave the way for the realization of reliable and low power nanomagnetic logic circuits.

Design and comparison of hybrid multi-bend achromat lattices for HALF storage ring

The Hefei Advanced Light Facility(HALF)proposed by the National Synchrotron Radiation Laboratory is a green-field vacuum ultraviolet and soft X-ray diffraction-limited storage ring light source with a beam energy of 2.2 GeV and emittance goal of less than 100 pm rad.Inspired by the ESRF-EBS hybrid multi-bend achromat(HMBA),SLS-2,and Diamond-II lattices,we have proposed and designed a modified H6BA lattice as the baseline lattice of the HALF storage ring with 20 identical cells and a natural emittance of approximately 86 pm rad.In this paper,three other types of HMBA lattices including two H7BA lattices and a H6BA lattice are designed for HALF with the same number of cells.The main storage ring proper-ties of these four HMBA lattices are compared.Because the intra-beam scattering(IBS)effect is significant in the HALF storage ring,we calculate and compare the equilibrium emittances of the four lattices with IBS included.These comparisons show that the present modified H6BA lattice,which has a relatively low equilibrium emittance and more straight sections,is preferred for the HALF storage ring after a comprehensive consideration.

Quantitative evaluation of colorectal tumour vasculature using contrast-enhanced ultrasound:Correlation with angiogenesis and prognostic significance

BACKGROUND Ultrasound is a vital tool for the diagnosis and management of colorectal cancer(CRC).Contrast-enhanced ultrasound(CEUS)is a non-invasive,safe,and cost-effective method for evaluating tumour blood vessels,that play a crucial role in tumour growth and progression.AIM To explore CEUS’s role in the quantitative evaluation of CRC blood vessels and their correlation with angiogenesis markers and prognosis.METHODS This study prospectively enrolled 100 patients with CRC confirmed by histo-pathology.All patients received preoperative CEUS examinations.Quantitative parameters,such as peak intensity(PI),time to peak(TTP),and area under the curve(AUC),were derived from time-intensity curve(TIC)analysis.Tumour tissue samples were obtained during surgery and examined immunohistochem-ically to assess the expression of angiogenesis markers,including vascular endo-thelial growth factor(VEGF)and microvessel density(MVD).The correlation between CEUS parameters,angiogenesis markers,and clinicopathological features was evaluated using appropriate statistical tests.RESULTS Quantitative CEUS parameters(PI,TTP,and AUC)showed significant correlations with VEGF expression(P<0.001)and MVD(P<0.001),indicating a strong link between tumour blood vessels and angiogenesis.Increased PI,reduced TTP,and expanded AUC values were significantly related to higher tumour stage(P<0.001),lymph node metastasis(P<0.001),and distant metastasis(P<0.001).Furthermore,these parameters were recognized as independent predictors of overall survival and disease-free survival in multivariate analysis(P<0.001).CONCLUSION CEUS has a high potential in guiding treatment planning and predicting patient outcomes.However,more com-prehensive,multicentre studies are required to validate the clinical utility of CEUS in CRC management.

运用中医急救的体会和注意事项

中医急救手段现代在临床急救上很少应用,我们在急诊科及日常临床工作时常使用中医急救手段,取得了较好疗效。那么,运用中医急救需要注意哪些问题,以及如何与现代急救医学相辅相成?我们认为在医院及院外运用中医急救手段应遵循“先开枪再瞄准”的急救原则,同时明确诊断是进一步救治的基础。危重疾病需要西医治疗为后盾,才能保障医疗安全,同时积极发挥中医优势。中西医结合可为医院进一步急救和协同治疗争取更多的急救反应时间。

腹膜透析患者心脏瓣膜钙化与颈动脉粥样硬化的关系及影响因素

目的调查腹膜透析患者心脏瓣膜钙化及颈动脉粥样硬化(CAS)的发生率,探讨两者的相关性及影响因素。方法选取南京医科大学附属无锡人民医院腹膜透析中心行规律腹膜透析≥3个月的患者166例,收集患者一般临床资料、实验室检查资料,并行心脏超声和颈动脉超声检查。结果心脏瓣膜钙化组46例(27.7%),无心脏瓣膜钙化组120例(72.3%),心脏瓣膜钙化组患者25-羟维生素D水平为(18.32±10.64)ng/ml,无心脏瓣膜钙化组患者25-羟维生素D水平为(19.17±10.81)ng/ml,两组比较差异无统计学意义(P>0.05)。两组比较,年龄、透析时间、收缩压、血清白蛋白、hs-CRP、IL-6差异有统计学意义(P <0.05)。心脏瓣膜钙化组合并CAS的患者38例(82.6%),无心脏瓣膜钙化组的CAS患者50例(41.7%),两者比较差异有统计学意义(P <0.05)。既有心脏瓣膜钙化又有CAS的患者38例(A组),既无心脏瓣膜钙化又无CAS的患者70例(B组),两组间年龄、透析龄、收缩压、舒张压、血清白蛋白、LDL-C、hs-CRP、IL-6、iPTH比较,差异有统计学意义(P <0.05)。二分类Logistic回归分析显示,年龄、收缩压与hs-CRP、IL-6为心脏瓣膜钙化的危险因素(P <0.05)。年龄、透析龄、收缩压、hs-CRP、IL-6、吸烟为同时患心脏瓣膜钙化合并CAS的危险因素(P<0.05)。结论腹膜透析患者心脏瓣膜钙化和CAS常常伴发,心脏瓣膜钙化和/或CAS与患者年龄、血压、炎症相关。

精神心理因素与老年功能性消化不良的相关性及对患者ADL评分的影响

目的分析精神心理因素与老年功能性消化不良(functional dyspepsia,FD)的相关性及对患者日常生活活动能力评定(activity of daily living, ADL)评分的影响.方法选取2016-08/2017-09本院收治的FD的精神病老年患者60例作为研究组,精神状况良好的FD患者60例作为对照组,对两组患者均进行心理精神状况、胃功能指标等多方面测试.调查统计两组患者焦虑自测量表、抑郁自测量表、24 h心率变异性、水负荷试验的试验结果.结果研究组老年患者的焦虑自评量表、抑郁自评量表评分均显著高于对照组患者(P<0.05),研究组患者中出现焦虑、抑郁的人数显著多于对照组(P<0.05).研究组患者进行水负荷实验的初始感觉量、最大耐受量均显著低于对照组患者(P<0.05),研究组患者胃固体物的半排空时间显著长于对照组患者(P<0.05);研究组患者出现不良反应的发生率显著低于对照组患者(P <0.05);研究组老年患者的ADL评分在治疗前后均显著高于对照组患者(P<0.05).结论患者精神心理状况对FD的发生与发展有紧密的联系,对患者胃的感觉功能、运动功能造成损害,逐步加深对老年功能性精神心理因素研究,对治疗有着重要的意义.

575-fs passively mode-locked Yb:CaF2 ceramic laser

A Yb-doped CaF2 transparent ceramics was successfully fabricated by the hot-pressed method and its laser characteristics were studied.A broad tuning performance and mode-locked laser operation were demonstrated in this ceramics for the first time,to our best knowledge.A 60-nm continuous-wavelength tunable laser from 1019 nm to 1079 nm was obtained with a birefringent filter.By employing a semiconductor saturable absorber mirror without additional dispersion compensation elements,a continuous-wave mode-locked laser with pulse duration as short as 575 fs was delivered,at a central wavelength of 1048.5 nm.The oscillator is operated under a repetition rate of 55 MHz.These results indicate that the Yb:CaF2 transparent ceramics is an ideal candidate for the development of ultrafast lasers in the near-infrared regime.

Exploring the mechanisms of Jiangtang decoction in the treatment of diabetic nephropathy based on network pharmacology

Background:The purpose of this research is to predict the mechanisms of the experienced prescription Jiangtang decoction for treating diabetic nephropathy based on network pharmacology,the predicted targets and pathways were validated by celluar experiments.Methods:The active ingredients of the experienced prescription Jiangtang decoction and their putative targets were collected from TCMSP Database and SwissTargetPrediction platform.Diabetic nephropathy-related targets were excavated from GeneCards and DisGeNET database.Then,the interactions of potential targets of the experienced prescription Jiangtang decoction with well-known diabetic nephropathy targets were used to construct the protein-protein interaction network by STRING database and Cytoscape,and screened the core targets via topological analysis.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis were performed by Metascape platform.Finally,we conducted in vitro experiments to verify this prediction of the network pharmacology.A diabetic nephropathy model was established by treating mesangial cells with D-ribose,in which the therapeutic effects of the experienced prescription Jiangtang decoction were evaluated.CCK-8 and LDH assay were used to test cell viability and cell toxicity,cell apoptosis was evaluated by Hoechst 33258 staining,AO/EB staining,levels of ROS were detected by fluorescent probe,the expression levels of MAPK signaling pathway-associated proteins and apoptosis-related proteins Bax were measured by western blotting assay.Results:A total of 74 active ingredients contained and 871 potential identified targets were retrieved from databases.Simultaneously,803 diabetic nephropathy-associated targets were also obtained,180 overlapped targets were considered as potential therapeutic targets of the experienced prescription Jiangtang decoction against diabetic nephropathy.By constructing a protein-protein interaction network and topological analysis,57 core targets were screened.Gene Ontology analysis highlighted 1655 Gene Ontology terms main including apoptotic signaling pathway,regulation of reactive oxygen species metabolic process and positive regulation of cell migration.KEGG enrichment analysis revealed that core targets were enriched mainly in MAPK,AGE-RAGE,TNF,PI3K-Akt signaling pathways.Cellular experiments further demonstrated D-ribose decreased mesangial cells viability,increased LDH release and the ROS level,induced apoptosis and activated the p38/JNK MAPK signal pathways,while the experienced prescription Jiangtang decoction could be useful in attenuation of D-ribose-induced damage.Conclusion:Network pharmacology intuitively shows the multi-component,multi-target and multi-pathway therapeutic effects of the experienced prescription Jiangtang decoction on diabetic nephropathy.By in vitro experiment,it revealed that the experienced prescription Jiangtang decoction has potential therapeutic effects on diabetic nephropathy via alleviating oxidative stress and apoptosis.the experienced prescription Jiangtang decoction treatment significantly inhibited the D-ribose-stimulated JNK and p38 MAPK activation.