Therapeutic effects of combined oxaliplatin and S-1 in older patients with advanced gastric cardiac adenocarcinoma

AIM:To evaluate the effects and safety of combination chemotherapy with oxaliplatin (L-OHP) and S-1 (SOX regimen) in older patients with advanced gastric cardiac adenocarcinoma (GCA). METHODS: Seventy patients with advanced GCA were classified according to age into an older group (≥ 75 years) and a control group (< 75 years). The SOX regimen was administered to the two groups as follows: S-1 (40 mg/m2 po bid) on days 1 to 14 followed by a 7-d off period, plus L-OHP (65 mg/m2 iv) for 2 h on days 1 and 8 of a 21-d cycle. This regimen was repeat-ed for four to six cycles. Response and swallow statuses were evaluated after two cycles (6 wk). Effects and toxicity were evaluated four weeks after chemotherapy was completed. RESULTS: The response rate was 65.6% (21/32) in the older group and 68.4% (26/38) in the control group (χ2 = 0.062 and P = 0.804). Improvement in swallowing was 78.1% (25/32) in the older group and 76.3% (29/38) in the control group (χ2 = 0.032 and P = 0.857). Effi cacy was 68.8% (22/32) in the older group and 65.8% (25/38) in the control group (χ2 = 0.069 and P = 0.793). Toxicities were reversible and similar in both groups (P > 0.05). CONCLUSION: The SOX regimen is an effective, safe and well-tolerated regimen for older patients with advanced GCA.

Comparative genomic hybridization analysis of genetic aberrations associated with development of esophageal squamous cell carcinoma in Henan, China

AIM: To characterize cytogenetic alterations in esophageal squamous cell carcinoma (ESCC) and its metastasis. METHODS: A total of 37 cases of primary ESCC and 15 pairs of primary ESCC tumors and their matched metastatic lymph nodes cases were enrolled from Linzhou, the high incidence area for ESCC in Henan, northern China. The comparative genomic hybridization (CGH) was applied to determine the chromosomal aberrations on the DNA extracted from the frozen ESCC and metastatic lymph node samples from these patients. RESULTS: CGH showed chromosomal aberrations in all the cases. In 37 cases of primary ESCC, chromosomal profile of DNA copy number was characterized by frequently detected gains at 8q (29/37, 78%), 3q (24/37, 65%), 5p (19/37, 51%); and frequently detected losses at 3p (21/37, 57%), 8p and 9q (14/37, 38%). In 15 pairs of primary ESCC tumors and their matched metastatic lymph node cases, the majority of the chromosomal aberrations in both primary tumor and metastatic lymph node lesions were consistent with the primary ESCC cases, but new candidate regions of interest were also detected. The most significant finding is the gains of chromosome 6p with a minimum high-level amplification region at 6p12-6q12 in 7 metastatic lymph nodes butonly in 2 corresponding primary tumors (P = 0.05) and 20p with a minimum high-level amplification region at 20p12 in 11 metastatic lymph nodes but only in 5 corresponding primary tumors (P < 0.05). Another interesting finding is the loss of chromosome 10p and 10q in 8 and 7 metastatic lymph nodes but only in 2 corresponding primary tumors (P < 0.05). CONCLUSION: Using the CGH technique to detect chromosomal aberrations in both the primary tumor and its metastatic lymph nodes of ESCC, gains of 8q, 3q and 5p and loss of 3p, 8p, 9q and 13q were specifically implicated in ESCC in Linzhou population. Gains of 6p and 20p and loss of 10pq may contribute to the lymph node metastasis of ESCC. These findings suggest that the gains and losses of chromosomal regions may contain ESCC-related oncogenes and tumor suppressor genes and provide important theoretic information for identifying and cloning novel ESCC-related oncogenes and tumor suppressor genes.

Histochemical studies on intestinal metaplasia adjacent to gastric cardia adenocarcinoma in subjects at high-incidence area in Henan, north China

AIM： To characterize the histochemical type and pattern of intestinal metaplasia （IM） adjacent to gastric cardia adenocarcinoma （GCA） and distal gastric cancer （GC） in Unzhou, Henan Province, China. METHODS： Alcian-blue-periodic acid Schiff and high iron diamine-Alcian blue histochemical methods were performed on 142 cases of IM, including 49 cases of GCA and 93 cases of GC. All the patients were from Linzhou, Henan Province, China, the highest incidence area for both GCA and squamous cell carcinoma. Radio- or chemotherapy was not applied to these patients before surgery. RESULTS： The detection rate of IM in tissues adjacent to GCA tissues was 44.9%, which was significantly lower than that in GC tissues （80.64%, P〈0.01）. The rates of both incomplete small intestinal and colonic IM types identified by histochemistry in GCA tissues （31.82% and 63.64%, respectively） were significantly higher than those in GC （5.33% and 21.33%, respectively, P〈0.01）. CONCLUSION： IM in GCA and GC should be considered as a separate entity. Further research is needed to evaluate whether neoplastic progression of IM is related to its mucin profile in GCA.

Proteomic profiling of fetal esophageal epithelium, esophageal cancer, and tumor-adjacent esophageal epithelium and immunohistochemical characterization of a representative differential protein, PRX6

AIM To understand the molecular mechanism of esophageal cancer development and provide molecular markers for screening high-risk populations and early diagnosis. METHODS Two-dimensional electrophoresis combined with mass spectrometry were adopted to screen differentially expressed proteins in nine cases of fetal esophageal epithelium, eight cases of esophageal cancer, and eight cases of tumor-adjacent normal esophageal epithelium collected from fetuses of different gestational age, or esophageal cancer patients from a high-risk area of esophageal cancer in China. Immunohistochemistry(avidin-biotin-horseradish peroxidase complex method) was used to detect the expression of peroxiredoxin(PRX)6 in 91 cases of esophageal cancer, tumoradjacent normal esophageal tissue, basal cell hyperplasia, dysplasia, and carcinoma in situ, as well as 65 cases of esophageal epithelium from fetuses at a gestational age of 3-9 mo.RESULTS After peptide mass fingerprint analysis and search of protein databases, 21 differential proteins were identified; some of which represent a protein isoform. Varying degrees of expression of PRX6 protein, which was localized mainly in the cytoplasm, were detected in adult and fetal normal esophageal tissues, precancerous lesions, and esophageal cancer. With the progression of esophageal lesions, PRX6 protein expression showed a declining trend(P < 0.05). In fetal epithelium from fetuses at gestational age 3-6 mo, PRX6 protein expression showed a declining trend with age(P < 0.05). PRX6 protein expression was significantly higher in well-differentiated esophageal cancer tissues than in poorly differentiated esophageal cancer tissues(P < 0.05).CONCLUSION Development and progression of esophageal cancer result from interactions of genetic changes(accumulation or superposition). PRX6 protein is associated with fetal esophageal development and cancer differentiation.

Characterization of E-cadherin expression in normal mucosa,dysplasia and adenocarcinoma of gastric cardia and its influence on prognosis

BACKGROUND Gastric cardia adenocarcinoma(GCA),which has been classified as type II adenocarcinoma of the esophagogastric junction in western countries,is of similar geographic distribution with esophageal squamous cell carcinoma in China,and even referred as"sister cancer"by Chinese oncologists.The molecular mechanism for GCA is largely unknown.Recent studies have shown that decreased expression of E-cadherin is associated with the invasion and metastasis of multiple cancers.However,the E-cadherin expression has not been well characterized in gastric cardia carcinogenesis and its effect on GCA prognosis.AIM To characterize E-cadherin expression in normal gastric cardia mucosa,dysplasia and GCA tissues,and its influence on prognosis for GCA.METHODS A total of 4561 patients with GCA were enrolled from our previously established GCA and esophageal cancer databases.The enrollment criteria included radical surgery for GCA,but without any radio-or chemo-therapy before operation.The GCA tissue from 4561 patients and matched adjacent normal epithelial tissue(n=208)and dysplasia lesions(n=156)were collected,and processed as tissue microarray for immunohistochemistry.The clinicopathological characteristics were retrieved from the medical records in hospital and follow-up was carried out through letter,telephone or home interview.E-cadherin protein expression was determined by two step immunohistochemistry.Kaplan–Meier and Cox regression analyses were used to correlate E-cadherin protein expression with survival of GCA patients.RESULTS Of the 4561 GCA patients,there were 3607 males with a mean age of 61.6±8.8 and 954 females with a mean age of 61.9±8.6 years,respectively.With the lesions progressed from normal gastric cardia mucosa to dysplasia and GCA,the positive immunostaining rates for E-cadherin decreased significantly from 100%to 93.0%and 84.1%,respectively(R2=0.9948).Furthermore,E-cadherin positive immunostaining rate was significantly higher in patients at early stage(0 and I)than in those at late stage(II and III)(92.7%vs 83.7%,P=0.001).E-cadherin positive expression rate was significantly associated with degree of differentiation(P=0.001)and invasion depth(P<0.001).Multivariate analysis showed that the GCA patients with positive E-cadherin immunostaining had better survival than those with negative(P=0.026).It was noteworthy that E-cadherin positive expression rate was similar in patients with positive and negative lymph node metastasis.However,in patients with negative lymph node metastasis,those with positive expression of E-cadherin had better survival than those with negative expression(P=0.036).Similarly,in patients with late stage GCA,those with positive expression of E-cadherin had better survival than those with negative expression(P=0.011).CONCLUSION E-cadherin expression may be involved in gastric cardia carcinogenesis and low expression of E-cadherin may be a promising early biomarker and overall survival predictor for GCA.

Association of genotypes of rs671 within ALDH2 with risk for gastric cardia adenocarcinoma in the Chinese Han population in high-and low-incidence areas

Objective: This study aimed to determine if gastric cardia adenocarcinoma(GCA) risk was associated with the lys(A or *2) allele at the rs671(glu504lys) polymorphism within the aldehyde dehydrogenase 2(ALDH2) gene in a Chinese Han population. We also aimed to investigate ALDH2 genotypic distributions between subjects from high- and low-incidence areas for both GCA and esophageal squamous cell carcinoma(ESCC).Methods: We designed a case-control study including 2,686 patients with GCA and 3,675 control subjects from high- and lowincidence areas for both GCA and ESCC in China. Taq Man allele discrimination assay was used to genotype the rs671 polymorphism. χ~2 test and binary logistic regression analysis were used to estimate the odds ratios for the development of GCA,and multivariate ordinal logistic regression was used to analyze ALDH2 genotypic distributions among different groups.Results: Compared with ALDH2*1/*1 homozygotes, ALDH2*1/*2 and ALDH2*2/*2 carriers did not increase the risk for GCA in the Chinese Han population(P>0.05). Interestingly, the ratio of homozygous or heterozygous ALDH2 *2 carriers in highincidence areas for both GCA and ESCC was lower than that in low-incidence areas(P<0.001).Conclusions: Genotypes of rs671 at ALDH2 may not increase GCA susceptibility in Chinese Han populations. In addition, the ALDH2 genotypic distribution differs between Chinese Han populations from high- and low-incidence areas for both GCA and ESCC. Our findings may shed light on the possible genetic mechanism for the dramatic geographic differences of GCA occurrence in China.

XPD Lys751Gln polymorphism and esophageal cancer risk: A meta-analysis involving 2288 cases and 4096 controls

AIM: To evaluate the association between xeroderma pigmentosum group D (XPD), genetic polymorphism Lys751Gln and esophageal cancer risk. METHODS: We searched PubMed up to September 1, 2010 to identify eligible studies. A total of 10 casecontrol studies including 2288 cases and 4096 controls were included in the meta-analysis. Statistical analysis was performed with Review Manage version 4.2. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of the association.RESULTS: The results suggested that there is no significant association between XPD Lys751Gln polymorphism and esophageal cancer susceptibility in the overall population. However, in subgroup analysis by histology type, a significant association was found between XPD Lys751Gln polymorphism and esophageal adenocarcinoma (for CC vs AA: OR = 1.25, 95% CI = 1.01-1.55, P = 0.05 for heterogeneity). CONCLUSION: Our meta-analysis suggested that XPD Lys751Gln polymorphism may be associated with increased risk of esophageal adenocarcinoma.

Medical care delivery at the Beijing 2008 OlympicGames

BACKGROUND： Beijing successfully hosted the 2008 Olympic Games, and the servicesincluding medical services were widely appreciated by both participants and visitors. Weretrospectively analyzed the quality of the medical services provided to athletes, spectators, VIPs,and the workforce during the Beijing 2008 Olympic Games. The information thus gathered would beuseful for planning strategies for managing mass gatherings.METHODS： Medical encounter forms filled during the Beijing 2008 Olympic Games wereretrospectively reviewed. Descriptive statistics was used to characterize the data by accreditation anddiagnostic categories.RESULTS： A total of 22 892 medical encounters were documented during the Beijing 2008Olympic Games. Among them, 10 549 （46.08%） involved the workforce, 3 365 （14.70%） athletes,3 019 （13.19%） spectators, 585 （2.56%） members of the media, 1 065 （4.65%） VIPs, and 4 309（18.82%） others. Of the 22 892 cases, physical injury accounted for 27.90% （6 386）, respiratorydisease 18.21% （4 169）, and heat-related illnesses 2.68% （615）.CONCLUSIONS： Preparations of the medical service for the Beijing 2008 Olympic Gameswere made for 7 years, and the service provided has been praised worldwide. This study providesvaluable information that may be useful for planning medical services for upcoming Olympic Games,including the London 2012 Olympic Games and other mass gatherings.

Preoperative maximal voluntary ventilation,hemoglobin,albumin,lymphocytes and platelets predict postoperative survival in esophageal squamous cell carcinoma

BACKGROUND Preoperative pulmonary function plays an important role in selecting surgical candidates and assessing postoperative complications.Reduced pulmonary function is associated with poor survival in several cancers,but the prognostic value of preoperative pulmonary function in esophageal squamous cell carcinoma(ESCC)is unclear.Nutritional and systemic inflammation parameters are vital to cancer survival,and the combination of these parameters improves the prognostic value.The hemoglobin,albumin,lymphocytes and platelets(HALP)score is a novel prognostic indicator to reflect the nutritional and inflammation status,but the clinical effects of the HALP score combined with maximal voluntary ventilation(MVV),an important parameter of pulmonary function,have not been well studied in ESCC.AIM To investigate the prognostic value of MVV and HALP score for assessing postoperative survival of ESCC patients.METHODS Data form 834 ESCC patients who underwent radical esophagectomy with R0 resection were collected and retrospectively analyzed.Preoperative MVV and HALP data were retrieved from medical archives.The HALP score was calculated by the formula:Hemoglobin(g/L)×albumin(g/L)×lymphocytes(/L)/platelets(/L).The optimal cut-off values of MVV and HALP score were calculated by the receiver operating characteristic curve analysis.The Kaplan-Meier method with log-rank test was used to draw the survival curves for the variables tested.Multivariate Cox proportional hazard regression models were used to analyze the independent prognostic factors for overall survival.RESULTS MVV was significantly associated with gender(P<0.001),age at diagnosis(P<0.001),smoking history(P<0.001),drinking history(P<0.001),tumor length(P=0.013),tumor location(P=0.037)and treatment type(P=0.001).The HALP score was notably associated with gender(P<0.001),age at diagnosis(P=0.035),tumor length(P<0.001)and invasion depth(P=0.001).Univariate Cox regression analysis showed that low MVV and low HALP score were associated with worse overall survival(all P<0.001).Multivariate analysis showed that low MVV and the HALP score were both independent risk factors for overall survival(all P<0.001).The combination of MVV and HALP score improved the prediction performance for overall survival than tumor-node-metastasis.Also,low combination of MVV and HALP score was an independent risk factor for poor overall survival(P<0.001).CONCLUSION MVV,HALP score and their combination are simple and promising clinical markers to predict overall survival of ESCC patients.

Hot Deformation Behavior of Mg_2B_2O_5 Whiskers Reinforced Al Composite

The hot deformation behavior of Mg2B2O5w/Al composite was investigated by compression test at different temperatures and different strain rates. The constitutive equation was established by taking peak stresses as the function of temperatures and strain rates. It was found that the hyperbolic sine law creep equation is in good agreement with the experimental results and can be applied to all flow stresses under various deformation conditions. The apparent activation energy of the composite is 138. 64 kJ /mol, which is approximately equal to that of lattice self-diffusion of pure Al.

Truth telling for patients with esophageal squamous cell carcinoma in Henan,China

Objective: This study aims to investigate the truth-telling status and the relevant factors of esophageal squamous cell carcinoma(ESCC) patients in Henan, China.Methods: A cross-sectional study from April to June 2015 using questionnaires was given to 301 family members of hospitalized ESCC patients based in three affiliated hospitals of Zhengzhou University(i.e., The First Hospital, The Second Hospital, and Tumor Hospital) and Anyang Tumor Hospital.Results: Among the 41.9%(126/301) hospitalized ESCC patients who knew of their true diagnoses, only 4.0% patients were informed by their corresponding responsible doctors, 39.7% by their family members, and 56.3% by themselves. Univariate analyses showed that disclosure of confirmed ESCC diagnosis to patients was correlated with gender, family history of cancer(FHC), education level, vocation, hospital administrative level, and attitudes of family members(P < 0.05). Furthermore,multivariate analysis indicated that attitude of family members was the most important and an independent factor for diagnosis disclosure. Those patients with a negative FHC, under-education, manual occupation, advanced stages, and hospitalized in municipal hospitals exhibited a low rate of truth telling.Conclusions: Truth telling for ESCC patients in Henan is not prevalent and may be improved through consultation with family members, particularly for patients with a negative FHC, poor education, manual occupation, and advanced stages.

Development and validation of a prognostic nomogram model for Chinese patients with primary small cell carcinoma of the esophagus

BACKGROUND Primary small cell carcinoma of the esophagus(PSCE)is a highly invasive malignant tumor with a poor prognosis compared with esophageal squamous cell carcinoma.Due to the limited samples size and the short follow-up time,there are few reports on elucidating the prognosis of PSCE,especially on the establishment and validation of a survival prediction nomogram model covering general information,pathological factors and specific biological proteins of PSCE patients.AIM To establish an effective nomogram to predict the overall survival(OS)probability for PSCE patients in China.METHODS The nomogram was based on a retrospective study of 256 PSCE patients.Univariate analysis and multivariate Cox proportional hazards regression analysis were used to examine the prognostic factors associated with PSCE,and establish the model for predicting 1-,3-,and 5-year OS based on the Akaike information criterion.Discrimination and validation were assessed by the concordance index(C-index)and calibration curve and decision curve analysis(DCA).Histology type,age,tumor invasion depth,lymph node invasion,detectable metastasis,chromogranin A,and neuronal cell adhesion molecule 56 were integrated into the model.RESULTS The C-index was prognostically superior to the 7th tumor node metastasis(TNM)staging in the primary cohort[0.659(95%CI:0.607-0.712)vs 0.591(95%CI:0.517-0.666),P=0.033]and in the validation cohort[0.700(95%CI:0.622-0.778)vs 0.605(95%CI:0.490-0.721),P=0.041].Good calibration curves were observed for the prediction probabilities of 1-,3-,and 5-year OS in both cohorts.DCA analysis showed that our nomogram model had a higher overall net benefit compared to the 7th TNM staging.CONCLUSION Our nomogram can be used to predict the survival probability of PSCE patients,which can help clinicians to make individualized survival predictions.

Lower tacrolimus trough levels in the late period after living donorliver transplantation contribute to improvements in long-term clinicaloutcomes

Background： Previous studies have emphasized the need to reduce tacrolimus （TAC） trough levels in theearly post-liver transplantation （LT） period. However, whether late-period TAC trough levels influence the long-term outcomes of liver recipients is not clear.

Increased prognostic value of clinical–reproductive model in Chinese female patients with esophageal squamous cell carcinoma

BACKGROUND In China,it has been well recognized that some female patients with esophageal squamous cell carcinoma(ESCC)have different overall survival(OS)time,even with the same tumor-node-metastasis(TNM)stage,challenging the prognostic value of the TNM system alone.An effective predictive model is needed to accurately evaluate the prognosis of female ESCC patients.AIM To construct a novel prognostic model with clinical and reproductive data for Chinese female patients with ESCC,and to assess the incremental prognostic value of the full model compared with the clinical model and TNM stage.METHODS A new prognostic nomogram incorporating clinical and reproductive features was constructed based on univariatie and Cox proportional hazards survival analysis from a training cohort(n=175).The results were recognized using the internal(n=111)and independent external(n=85)validation cohorts.The capability of the clinical–reproductive model was evaluated by Harrell’s concordance index(C-index),Kaplan–Meier curve,time-dependent receiver operating characteristic(ROC),calibration curve and decision curve analysis.The correlations between estrogen response and immune-related pathways and some gene markers of immune cells were analyzed using the TIMER 2.0 database.RESULTS A clinical–reproductive model including incidence area,age,tumor differentiation,lymph node metastasis(N)stage,estrogen receptor alpha(ESR1)and beta(ESR2)expression,menopausal age,and pregnancy number was constructed to predict OS in female ESCC patients.Compared to the clinical model and TNM stage,the time-dependent ROC and C-index of the clinical–reproductive model showed a good discriminative ability for predicting 1-,3-,and 5-years OS in the primary training,internal and external validation sets.Based on the optimal cut-off value of total prognostic scores,patients were classified into high-and low-risk groups with significantly different OS.The estrogen response was significantly associated with p53 and apoptosis pathways in esophageal cancer.CONCLUSION The clinical–reproductive prognostic nomogram has an incremental prognostic value compared with the clinical model and TNM stage in predicting OS in Chinese female ESCC patients.

High-quality chromosome-level genome assembly of Tibetan fox(Vulpes ferrilata)

DEAR EDITOR,Using Oxford Nanopore and Hi-C sequencing technology,we successfully assembled a chromosome-level genome of the Tibetan fox(Vulpes ferrilata),with a total size of 2.38 Gb and N50 length of 133960477 bp.The 157 contigs were further assembled into 18 chromosomes with a sequence length of2378.42 Mb,accounting for 99.95%of the total length.

Clinicopathological characterization of ten patients with primary malignant melanoma of the esophagus and literature review

BACKGROUND Primary malignant melanoma of the esophagus(PMME) is a rare malignant disease and has not been well characterized in terms of clinicopathology and survival.AIM To investigate the clinical features and survival factors in Chinese patients with PMME.METHODS The clinicopathological findings of ten cases with PMME treated at Henan Provincial People’s Hospital were summarized. Moreover, the English-and Chinese-language literature that focused on Chinese patients with PMME from 1980 to September 2021 was reviewed and analyzed. Univariate and multivariate analyses were employed to investigate the clinicopathologic factors that might be associated with survival.RESULTS A total of 290 Chinese patients with PMME, including ten from our hospital and 280 from the literature were enrolled in the present study. Only about half of the patients(55.8%) were accurately diagnosed before surgery. Additionally, 91.1% of the patients received esophagectomy, and 88 patients(36.5%) received adjuvant therapy after surgery. The frequency of lymph node metastasis(LNM) was 51.2%(107/209), and LNM had a positive rate of 45.3% even when the tumor was confined to the submucosal layer. The risk of LNM increased significantly with the p T stage [P < 0.001, odds ratio(OR): 2.47, 95% confidence interval(CI): 1.72-3.56] and larger tumor size(P = 0.006, OR: 1.21, 95%CI: 1.05-1.38). The median overall survival(OS) was 11.0 mo(range: 1-204 mo). The multivariate Cox analysis showed both the p T stage [P = 0.005, hazard ratio(HR): 1.70, 95%CI: 1.17-2.47] and LNM(P = 0.009, HR: 1.78, 95%CI: 1.15-2.74) were independent prognostic factors for OS. The median disease-free survival(DFS) was 5.3 mo(range: 0.8-114.1 mo). The multivariate analysis indicated that only the advanced p T stage(P = 0.02, HR: 1.93, 95%CI: 1.09-3.42) was a significant independent indicator of poor RFS in patients with PMME.CONCLUSION The correct diagnosis of PMME before surgery is low, and physicians should pay more attention to avoid a misdiagnosis or missed diagnosis. Extended lymph node dissection should be emphasized in surgery for PMME even though the tumor is confined to the submucosal layer. Both the LNM and p T stage are independent prognosis factors for OS, and the p T stage is the prognosis factor for DFS in patients with PMME.

VTIQ和SPECT首次通过法测定肝血流指数对乙肝纤维化的临床诊断价值

背景通过单光子发射计算机断层显像(single-photon emission computed tomography,SPECT)首次通过法测定肝血流指数,定量声触诊组织成像(virtual touch tissue imaging quantification,VTIQ)检测剪切波横向速度(shear wave velocity,SWV),将两种方法结合评估慢性肝病患者的肝纤维化程度.目的探究VTIQ和SPECT首次通过法诊断慢性乙型肝炎(chronic hepatitis B,CHB)患者肝纤维化的临床诊断价值.方法选取2020-08/2021-08我院42例CHB肝纤维化患者作为研究组,另选42例CHB无肝纤维化患者作为对照组,开展前瞻性研究.均行VTIQ获取SWV,行SPECT检查获取肝血流指数,比较两组一般资料、血常规指标[白细胞计数(white blood cell count,WBC)、单核细胞计数(absolute monocyte count,AMC)、中性粒细胞计数(neutrophil count,NEUT)、血小板计数(platelet count,PLT)]、凝血功能[血酶原时间(prothombin time,PT)、凝血酶原活动度(prothrombin activity,PTA)]、肝功能指标[总胆红素(total bilirubin,TBIL)、谷丙转氨酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、白蛋白(albumin,ALB)]、AST与PLT比值(aspartate aminotransferase to platelet ratio index,APRI)、纤维蛋白原(fibrinogen,Fib)-4及SWV、肝血流指数,通过肝组织病理确定研究组肝纤维化程度,比较不同肝纤维化程度患者SWV、肝血流指数,采用Spearman相关系数模型分析SWV、肝血流指数与CHB肝纤维化程度的相关性,并通过受试者工作特征(receiver operating characteristic,ROC)曲线分析SWV、肝血流指数诊断CHB肝纤维化的价值.结果研究组APRI、Fib-4、SWV、肝血流指数均高于对照组(P<0.05);研究组肝纤维化S3-S4级患者SWV、肝血流指数均高于S2级、S1级患者,S2级患者高于S1级患者(P<0.05);SWV、肝血流指数与CHB肝纤维化程度呈正相关(P<0.05);SWV、肝血流指数诊断CHB肝纤维化的曲线下面积(area under the curve,AUC)均>0.7,联合诊断的AUC最大,为0.930.结论VTIQ中SWV值和SPECT首次通过法测定肝血流指数CHB肝纤维化诊断方面具有良好价值,且能评估肝纤维化程度,具有一定应用价值.

Influence of Chromium on Mechanical Properties and CO_2/H_2S Corrosion Behavior of P110 Grade Tube Steel

Four kinds of P110 grade tube steels containing different chromium contents were designed to probe the in- fluence of Cr on the properties of tube steel. The microstrueture, mechanical properties and corrosion behavior of the four kinds of P110 grade tube steels were studied deeply and thoroughly. The analysis of the mechanical properties indicated that tensile strength and yield strength of the steel plates were improved, while transverse and longitudinal impact energy and elongation first increased and then decreased when Cr content rose. The impact energy and elonga tion reached the peak when Cr content was 1 ~. Cr precipitates were found only in 3 ~ Cr steel, with （Nb, Ti）（C, N） or Nb（C,N） as the core of precipitation and then grew up. The corrosion experiments demonstrated that the scales on the four steels had a two layer structure under the corrosion of CO2 and H2 S. The outer layer was mainly com- posed of FeS or FeS1 x and the inner layer consisted of FeCOa and Cr compounds. Cr was rich in the inner layer and the Cr content of the inner layer increased with the Cr content in matrix. The enriched Cr enhanced the compactness of the scales, further hindering the diffusion of ions from liquid to the surface of steel, thus reducing corrosion rate.

Combining proteomics, serum biomarkers and bioinformatics to discriminate between esophageal squamous cell carcinoma and pre-cancerous lesion

Objective: Biomarker assay is a noninvasive method for the early detection of esophageal squamous cellcarcinoma (ESCC). Searching for new biomarkers with high specificity and sensitivity is very important for the earlydetection of ESCC. Serum surface-enhanced laser desorption/ionization-time of flight mass spectrometry(SELDI-TOF-MS) is a high throughput technology for identifying cancer biomarkers using drops of sera. Methods: Inthis study, 185 serum samples were taken from ESCC patients in a high incidence area and screened by SELDI. Asupport vector machine (SVM) algorithm was adopted to analyze the samples. Results: The SVM patterns success-fully distinguished ESCC from pre-cancerous lesions (PCLs). Also, types of PCL, including dysplasia (DYS) and basalcell hyperplasia (BCH), and healthy controls (HC) were distinguished with an accuracy of 95.2% (DYS), 96.6% (BCH),and 93.8% (HC), respectively. A marker of 25.1 kDa was identified in the ESCC patterns whose peak intensity wasobserved to increase significantly during the development of esophageal carcinogenesis, and to decrease obviously after surgery. Conclusions: We selected five ESCC biomarkers to form a diagnostic pattern which can discriminateamong the different stages of esophageal carcinogenesis. This pattern can significantly improve the detection ofESCC.

Energy management for multi-microgrid system based on model predictive control

To reduce the computation complexity of the optimization algorithm used in energy management of a multi-microgrid system, an energy optimization management method based on model predictive control is presented. The idea of decomposition and coordination is adopted to achieve the balance between power supply and user demand, and the power supply cost is minimized by coordinating surplus energy in the multi-microgrid system. The energy management model and energy optimization problem are established according to the power flow characteristics of microgrids. A dual decomposition approach is imposed to decompose the optimization problem into two parts, and a distributed predictive control algorithm based on global optimization is introduced to achieve the optimal solution by iteration and coordination. The proposed method has been verified by simulation, and simulation results show that the proposed method provides the demanded energy to consumers in real time, and improves renewable energy efficiency. In addition, the proposed algorithm has been compared with the particle swarm optimization(PSO) algorithm. The results show that compared with PSO, the proposed method has better performance, faster convergence, and significantly higher efficiency.