Double contrast-enhanced ultrasonography improves diagnostic accuracy of T staging compared with multi-detector computed tomography in gastric cancer patients

BACKGROUND Gastric cancer(GC)is the most common malignant tumor and ranks third for cancer-related deaths among the worldwide.The disease poses a serious public health problem in China,ranking fifth for incidence and third for mortality.Knowledge of the invasive depth of the tumor is vital to treatment decisions.AIM To evaluate the diagnostic performance of double contrast-enhanced ultrasonography(DCEUS)for preoperative T staging in patients with GC by comparing with multi-detector computed tomography(MDCT).METHODS This single prospective study enrolled patients with GC confirmed by preoperative gastroscopy from July 2021 to March 2023.Patients underwent DCEUS,including ultrasonography(US)and intravenous contrast-enhanced ultrasonography(CEUS),and MDCT examinations for the assessment of preoperative T staging.Features of GC were identified on DCEUS and criteria developed to evaluate T staging according to the 8th edition of AJCC cancer staging manual.The diagnostic performance of DCEUS was evaluated by comparing it with that of MDCT and surgical-pathological findings were considered as the gold standard.RESULTS A total of 229 patients with GC(80 T1,33 T2,59 T3 and 57 T4)were included.Overall accuracies were 86.9%for DCEUS and 61.1%for MDCT(P<0.001).DCEUS was superior to MDCT for T1(92.5%vs 70.0%,P<0.001),T2(72.7%vs 51.5%,P=0.041),T3(86.4%vs 45.8%,P<0.001)and T4(87.7%vs 70.2%,P=0.022)staging of GC.CONCLUSION DCEUS improved the diagnostic accuracy of preoperative T staging in patients with GC compared with MDCT,and constitutes a promising imaging modality for preoperative evaluation of GC to aid individualized treatment decision-making.

Effects of O_(2)adsorption on secondary electron emission properties

The surface adsorption of gas molecules is a key factor limiting the secondary electron yield(SEY)of a material in many areas of applied physics.The influence of O_(2)adsorption on the SEY of metallic Ag is investigated in this work.To account for the particle distribution,we propose a BET theory based on multilayer O_(2)physisorption model.Furthermore,based on the phenomenological model of secondary electron(SE)emission and by taking into account the different scattering processes between electrons and particles in the adsorbed layer,we develop a numerical model of SEY in the adsorbed state using Monte Carlo simulations.The relationships among O_(2)adsorption,adsorption layer thickness,and SEY variation characteristics are then examined through a series of experiments.After 12-h exposure to O_(2),the clean samples increases12%-19%of the maximum value of SEY and 2.3 nm in thickness of the adsorbed layer.Experimental results are also compared with the results from the MC model to determine whether the model is accurate.

人工晶状体度数计算公式的研究现状

随着屈光性白内障手术的发展,白内障术后屈光效果具有更高的准确性和可预测性。现在各种类型人工晶状体(IOL)应用于临床,对IOL度数计算公式精确度的要求越来越高。根据计算原理以及所需参数的不同,本文就IOL度数计算公式的研究现状作一综述。

Expression of interleukin-32 in bone marrow of patients with myeloma and its prognostic significance

BACKGROUND The guiding effect of prognostic stratification in multiple myeloma(MM) for treatment has been increasingly emphasized in recent years. The stratification of risk factors based on the International Staging System(ISS), Durie-Salmon(DS)staging and related indicators is affected by the renal function of patients,resulting in poor performance. This study assesses the relationship between interleukin-32(IL-32) and related risk factors in 67 patients with MM and their clinical outcomes.AIM To investigate the feasibility of IL-32 in evaluating prognosis in patients with MM and the factors influencing prognosis.METHODS This was a pragmatic, prospective observational study of patients with MM at a single center. According to IL-32 level, patients were divided into two groups.The variables under consideration included age, blood β2-microglobulin,albumin, C-reactive protein, serum calcium, serum creatinine, lactate dehydrogenase, M protein type, ISS stage, DS stage, and IL-32 levels and minimal residual disease(MRD) after induction treatment. The main outcomes were progression-free survival(PFS) and overall survival(OS).RESULTS IL-32 was an important factor affecting PFS and OS in patients with MM.Compared with patients with IL-32 levels ≥ 856.4 pg/m L, patients with IL-32 levels < 856.4 pg/m L had longer PFS(P = 0.0387) and OS(P = 0.0379);Univariate analysis showed that IL-32 level and MRD were significantly associated with OS and PFS(P < 0.05). Multivariate analysis showed that IL-32 levels ≥ 856.4 pg/m L and MRD positive were still independent risk factors for OS and PFS(P < 0.05).CONCLUSION IL-32 is valuable for assessing the prognosis of MM patients. IL-32 level combined with MRD may be a useful routine evaluation index for MM patients after treatment.

Successful treatment of infantile hepatitis B with lamivudine: A case report

BACKGROUND How to treat infantile hepatitis B virus(HBV)infection remains a controversial issue.The nucleoside analogue lamivudine(LAM)has been approved to treat children(2 to 17 years old)with chronic hepatitis B.Here,we aimed to investigate the benefit of LAM treatment in infantile hepatitis B.CASE SUMMARY A 4-mo-old infant born to a hepatitis B surface antigen(HBsAg)-positive woman was found to be infected by HBV during a health checkup.Liver chemistry and HBV seromarker tests showed alanine aminotransferase of 106 U/L,HBsAg of 685.2 cut-off index,hepatitis B“e”antigen of 1454.0 cut-off index,and HBV DNA of>1.0×10^(9) IU/mL.LAM treatment(20 mg/d)was initiated,and after 19 mo,serum HBsAg was entirely cleared and hepatitis B surface antibody was present.The patient received LAM treatment for 2 years in total and has been followed for 3 years.During this period,serum hepatitis B surface antibody has been persistently positive,and serum HBV DNA was undetectable.CONCLUSION Early treatment of infantile hepatitis B with LAM could be safe and effective。

Effect of Occupational Extremely Low-Frequency Electromagnetic Field Exposure on the Thyroid Gland of Workers:A Prospective Study

Objective:The aim of this study was to investigate the biological effects of occupational extremely low-frequency electromagnetic field(ELF-EMF)exposure on the thyroid gland.Methods:We conducted a prospective analysis of 85 workers(exposure group)exposed to an ELF-EMF(100μT,10-100 Hz)produced by the electromagnetic aircraft launch system and followed up on thyroid function indices,immunological indices,and color Doppler images for 3 years.Additionally,116 healthy volunteers were randomly selected as controls(control group),the thyroid function of whom was compared to the exposure group.Results:No significant difference was observed in thyroid function between the exposure and control groups.During the follow-up of the exposure group,the serum free triiodothyronine(FT3)level was found to slowly decrease and free thyroxine(FT4)level slowly increase with increasing exposure time.However,no significant difference was found in thyroid-stimulating hormone(TSH)over the three years,and no significant difference was observed in the FT3,FT4 and TSH levels between different exposure subgroups.Furthermore,no significant changes were observed in thyroid autoantibody levels and ultrasound images between subgroups or over time.Conclusion:Long-term exposure to ELF-EMF may promote thyroid secretion of T4 and inhibit deiodination of T4 to T3.ELF-EMF has no significant effect on thyroid immune function and morphology.

Indole alkaloids of Alstonia scholaris(L.)R.Br.alleviated nonalcoholic fatty liver disease in mice fed with high-fat diet

Alstonia scholaris(L.)R.Br(Apocynaceae)is a well-documented medicinal plant for treating respiratory diseases,liver diseases and diabetes traditionally.The current study aimed to investigate the effects of TA on non-alcoholic fatty liver disease(NAFLD).A NAFLD model was established using mice fed a high-fat diet(HFD)and administered with TA(7.5,15 and 30 mg/kg)orally for 6 weeks.The biochemical parameters,expressions of lipid metabolism-related genes or proteins were analyzed.Furthermore,histopathological examinations were evaluated with Hematoxylin-Eosin and MASSON staining.TA treatment significantly decreased the bodyweight of HFD mice.The concentrations of low-density lipoprotein(LDL),triglyceride(TG),aspartate aminotransferase(AST)and alanine aminotransferase(ALT)were also decreased significantly in TA-treated mice group,accompanied by an increase in high-density lipoprotein(HDL).Furthermore,TA alleviated hepatic steatosis injury and lipid droplet accumulation of liver tissues.The liver mRNA levels involved in hepatic lipid synthesis such as sterol regulatory element-binding protein 1C(SREBP-1C),regulators of liver X receptorα(LXRα),peroxisome proliferator activated receptor(PPAR)γ,acetyl-CoA carboxylase(ACC1)and stearyl coenzyme A dehydrogenase-1(SCD1),were markedly decreased,while the expressions involved in the regulation of fatty acid oxidation,PPARα,carnitine palmitoyl transterase 1(CPT1A),and acyl coenzyme A oxidase 1(ACOX1)were increased in TA-treated mice.TA might attenuate NAFLD by regulating hepatic lipogenesis and fatty acid oxidation.

A meta-analysis of randomized controlled trials of Yiyiren Decoction in the treatment of rheumatoid arthritis

目的：系统评价薏苡仁汤联合西药与西药治疗类风湿关节炎的有效性和安全性.方法：计算机检索中国期刊全文数据库、维普期刊资源整合平台、万方数据库、Pub Med、Medline、Cochrane library、Embase数据库;并手工检索纳入文献的参考文献,相关学位论文和会议论文集.检索时间为建库至2017年7月.由2名研究人员分别独立的进行文献的检索和筛选工作,各自独立依据Jadad评分量表对纳入的研究进行质量评价和数据的提取工作,用Rev Man5.3软件进行meta分析.结果：①共纳入7篇RCT,485例患者,其中试验组262例,对照组223例.3分的文献2篇,其余文献均为1～2分.纳入的研究均明确指出组间基线具有可比性.②薏苡仁汤联合西药组总有效率高于单纯西药组（RR=0.85,95%CI[0.78,0.92]）;关节压痛个数（MD=-2.79,95%CI[-3.47,-2.12]）、红细胞沉降率（MD=-9.5,95%CI[15.67,-3.33]）、C反应蛋白（MD=-3.36,95%CI[-5.45,-1.27]）改善情况均优于对照组.药物的不良反应及类风湿因子方面两组差异无统计学意义.结论：薏苡仁汤联合西药较单纯西药对类风湿关节炎患者的临床症状及实验室指标的改善上有-定优势,由于受纳入研究质量限制和可能存在的发表偏倚影响,尚需要大样本、多中心、随机双盲对照试验进一步证实.

Effects of the ABCB1 genetic polymorphism on vancomycin blood concentration in critically ill patients of Chinese

To investigate the clinical application of vancomycin blood concentration monitoring in critically ill patients and the influence of the ABCB1 gene polymorphism on vancomycin dnug concentrations to guide clinically rational usage of vancomycin.The vancomycin blood concentration monitoring data on 141 critically ill patients in our hospital from November 2016 to March 2017 were analyzed and 68 patients who received the same dosages of vancomycin were subjected to ABCB1 genotyping.The results showed that among the 141 critically ill patients,68(48.22%)showed sub-target concentrations of vancomycin,averaging 5.58±2.54μg/mL;29 patients(20.56%)had higher than target concentrations,with an average value of 33.01±9.38μg/mL;and 44 cases(31.21%)were in the normal concentration range,with an average of 14.72±2.75μg/mL.The vancomycin concentrations in 1236TT-genotype patients were significantly higher than those of the 1236CC and 1236CT-genotype patients.The concentrations in the 2677AA-genotype patients were significantly higher than those in the 2677AT,2677GA,2677GG and 2677GT patients.Vancomycin concentrations in 3435CT patients were significantly higher than those in 3435CC,but slightly lower than those in 3435TT patients.The ABCB11236C>T,2677G>T/A and 3435C>T gene mutations may affect vancomycin blood concentrations.At the same time,other factors such as gender,age,co-morbidities and other transporters possiblely play the roles in influencing the concentration of vancomycin in patients.All these factors finally cause individual differences.

Aerosolized Amikacin as Adjunctive Therapy of Ventilator-associated Pneumonia Caused by Multidrug-resistant Gram-negative Bacteria： A Single-center Randomized Controlled Trial

Background： Aerosolized amikacin （AA） is a current option for the management of ventilator-associated pneumonia （VAP） caused by multidrug-resistant Gram-negative bacteria （MDR-GNB）, as it is reported that AA could increase the alveolar level of the drug without increasing systemic toxicity. This study aimed to evaluate the efficacy and safety of AA as an adjunctive therapy for VAP caused by MDR-GNB. Methods： In this single-center, double-blind study conducted in a 36-bed general Intensive Care Unit （ICU） in a tertiary hospital from June 2014 to June 2016, 52 ICU patients with confirmed MDR-GNB VAP were randomized to two groups （AA group, n - 27 and placebo group, n = 25）. Amikacin （400 rag, q8h） or saline placebo （4 ml, q8h） was aerosolized for 7 days. The attending physician determined the administration of systemic antibiotics for VAP. Patients were tbllowed up for 28 days. Bacteriological eradication, clinical pulmonary infection score （CP1S）, and serum creatinine were assessed on day 7 of therapy. New resistance to amikacin, cure rate of VAP, weaning rate, and mortality were assessed on day 28. Results： The baseline characteristics of patients in both groups were similar. At the end of the treatment, 13 of the 32 initially detected bacterial isolates were eradicated in AA group, compared to 4 of 28 in placebo group （41% vs. 14%, P - 0.024）. As for patients, 11 of 27 patients treated with AA and 4 of 25 patients treated with placebo have eradication （41% vs. 16%, P = 0.049）. The adjunction of AA reduced CPIS （4.2 ± 1.6 vs. 5.8 ± 2.1, P = 0.007）. New drug resistance to amikacin and the change in serum creatinine were not detected in AA group. No significant differences in the clinical cure rate in survivors （48% vs. 35%, P = 0.444）, weaning rate （48% vs. 32%, P = 0.236）, and mortality （22% vs. 32%, P = 0.427） were detected between the two groups on day 28. Conclusions： As an adjunctive therapy of MDR-GNB VAP, AA successfully eradicated existing MDR organisms without inducing new resistance to amikacin or change in serum creatinine. However, the improvement of mortality was not found.

A novel nomogram provides improved accuracy for predicting biochemical recurrence after radical prostatectomy

Background:Various prediction tools have been developed to predict biochemical recurrence(BCR)after radical prostatectomy(RP);however,few of the previous prediction tools used serum prostate-specific antigen(PSA)nadir after RP and maximum tumor diameter(MTD)at the same time.In this study,a nomogram incorporating MTD and PSA nadir was developed to predict BCR-free survival(BCRFS).Methods:A total of 337 patients who underwent RP between January 2010 and March 2017 were retrospectively enrolled in this study.The maximum diameter of the index lesion was measured on magnetic resonance imaging(MRI).Cox regression analysis was performed to evaluate independent predictors of BCR.A nomogram was subsequently developed for the prediction of BCRFS at 3 and 5 years after RP.Time-dependent receiver operating characteristic(ROC)curve and decision curve analyses were performed to identify the advantage of the new nomogram in comparison with the cancer of the prostate risk assessment post-surgical(CAPRA-S)score.Results:A novel nomogram was developed to predict BCR by including PSA nadir,MTD,Gleason score,surgical margin(SM),and seminal vesicle invasion(SVI),considering these variables were significantly associated with BCR in both univariate and multivariate analyses(P<0.05).In addition,a basic model including Gleason score,SM,and SVI was developed and used as a control to assess the incremental predictive power of the new model.The concordance index of our model was slightly higher than CAPRA-S model(0.76 vs.0.70,P=0.02)and it was significantly higher than that of the basic model(0.76 vs.0.66,P=0.001).Time-dependent ROC curve and decision curve analyses also demonstrated the advantages of the new nomogram.Conclusions:PSA nadir after RP and MTD based on MRI before surgery are independent predictors of BCR.By incorporating PSA nadir and MTD into the conventional predictive model,our newly developed nomogram significantly improved the accuracy in predicting BCRFS after RP.