Diagnosis and treatment experience of atypical hepatic cystic echinococcosis type 1 at a tertiary center in China

BACKGROUND Some hydatid cysts of cystic echinococcosis type 1(CE1)lack well-defined cyst walls or distinctive endocysts,making them difficult to differentiate from simple hepatic cysts.AIM To investigate the diagnostic methods for atypical hepatic CE1 and the clinical efficacy of laparoscopic surgeries.METHODS The clinical data of 93 patients who had a history of visiting endemic areas of CE and were diagnosed with cystic liver lesions for the first time at the People's Hospital of Xinjiang Uygur Autonomous Region(China)from January 2018 to September 2023 were retrospectively analyzed.Clinical diagnoses were made based on findings from serum immunoglobulin tests for echinococcosis,routine abdominal ultrasound,high-frequency ultrasound,abdominal computed tomography(CT)scan,and laparoscopy.Subsequent to the treatments,these patients underwent reexaminations at the outpatient clinic until October 2023.The evaluations included the diagnostic precision of diverse examinations,the efficacy of surgical approaches,and the incidence of CE recurrence.RESULTS All 93 patients were diagnosed with simple hepatic cysts by conventional abdominal ultrasound and abdominal CT scan.Among them,16 patients were preoperatively diagnosed with atypical CE1,and 77 were diagnosed with simple hepatic cysts by high-frequency ultrasound.All the 16 patients preoperatively diagnosed with atypical CE1 underwent laparoscopy,of whom 14 patients were intraoperatively confirmed to have CE1,which was consistent with the postoperative pathological diagnosis,one patient was diagnosed with a mesothelial cyst of the liver,and the other was diagnosed with a hepatic cyst combined with local infection.Among the 77 patients who were preoperatively diagnosed with simple hepatic cysts,4 received aspiration sclerotherapy of hepatic cysts,and 19 received laparoscopic fenestration.These patients were intraoperatively diagnosed with simple hepatic cysts.During the followup period,none of the 14 patients with CE1 experienced recurrence or implantation of hydatid scolices.One of the 77 patients was finally confirmed to have CE complicated with implantation to the right intercostal space.CONCLUSION Abdominal high-frequency ultrasound can detect CE1 hydatid cysts.The laparoscopic technique serves as a more effective diagnostic and therapeutic tool for CE.

Identification of a novel inflammatory-related gene signature to evaluate the prognosis of gastric cancer patients

BACKGROUND Gastric cancer(GC)is a highly aggressive malignancy with a heterogeneous nature,which makes prognosis prediction and treatment determination difficult.Inflammation is now recognized as one of the hallmarks of cancer and plays an important role in the aetiology and continued growth of tumours.Inflammation also affects the prognosis of GC patients.Recent reports suggest that a number of inflammatory-related biomarkers are useful for predicting tumour prognosis.However,the importance of inflammatory-related biomarkers in predicting the prognosis of GC patients is still unclear.AIM To investigate inflammatory-related biomarkers in predicting the prognosis of GC patients.was constructed using the least absolute shrinkage and selection operator Cox regression model based on the GEO database.GC patients from the GSE26253 cohort were used for validation.Univariate and multivariate Cox analyses were used to determine the independent prognostic factors,and a prognostic nomogram was established.The calibration curve and the area under the curve based on receiver operating characteristic analysis were utilized to evaluate the predictive value of the nomogram.The decision curve analysis results were plotted to quantify and assess the clinical value of the nomogram.Gene set enrichment analysis was performed to explore the potential regulatory pathways involved.The relationship between tumour immune infiltration status and risk score was analysed via Tumour Immune Estimation Resource and CIBERSORT.Finally,we analysed the association between risk score and patient sensitivity to commonly used chemotherapy and targeted therapy agents.RESULTS A prognostic model consisting of three inflammatory-related genes(MRPS17,GUF1,and PDK4)was constructed.Independent prognostic analysis revealed that the risk score was a separate prognostic factor in GC patients.According to the risk score,GC patients were stratified into high-and low-risk groups,and patients in the high-risk group had significantly worse prognoses according to age,sex,TNM stage and Lauren type.Consensus clustering identified three subtypes of inflammation that could predict GC prognosis more accurately than traditional grading and staging.Finally,the study revealed that patients in the low-risk group were more sensitive to certain drugs than were those in the high-risk group,indicating a link between inflammation-related genes and drug sensitivity.CONCLUSION In conclusion,we established a novel three-gene prognostic signature that may be useful for predicting the prognosis and personalizing treatment decisions of GC patients.

Study of the OPG/RANKL/RANK signaling pathway in mice treated with sepsis-related acute kidney injury

Objective:The objective of this study was to investigate the alterations and potential implications of the Osteoprotegerin(OPG)/Receptor Activator of Nuclear Factor-kappa B Ligand(RANKL)/Receptor Activator of Nuclear Factor-kappa B(RANK)signaling pathway factors in a murine model of sepsis-associated acute kidney injury(SA-AKI).This research aimed to offer novel insights into the mechanistic exploration of SA-AKI.Methods:The SA-AKI model group(CLP group)was established through cecal ligation and puncture surgery(CLP),while the control group consisted of sham-operated animals(Sham group)subjected only to laparotomy without cecal ligation and puncture.Blood samples were collected 24 h post-surgery,and murine kidney tissues were harvested upon euthanasia.Serum levels of Serum Creatinine(Scr)and Blood Urea Nitrogen(BUN)were quantified using assay kits.Furthermore,serum levels of interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α),and interleukin-1 beta(IL-1β)were assessed through enzyme-linked immunosorbent assay(ELISA).Renal tissue pathological alterations were examined employing hematoxylin-eosin staining(HE),and the mRNA and protein levels of OPG,RANKL,and RANK in murine kidney tissues were determined via reverse transcription-quantitative polymerase chain reaction(RT-qPCR)and Western blotting.Results:Comparative analysis revealed that,in comparison to the Sham group,the CLP group demonstrated a significant elevation in the levels of Scr,BUN,IL-6,TNF-α,and IL-1β,with statistically significant disparities(all P<0.05).Histopathological examination of the CLP group's kidneys unveiled glomerular congestion,edema,partial ischemic wrinkling,enlargement of interstitial spaces,the presence of necrotic epithelial cells in select renal tubules,tubular luminal dilation,varying degrees of interstitial edema,and infiltration by a limited number of inflammatory cells.In parallel,relative to the Sham group,the CLP group exhibited substantial upregulation in mRNA expression of OPG and RANK in renal tissues,while RANKL mRNA expression experienced marked downregulation,with statistically significant distinctions(all P<0.05).Moreover,in comparison with the Sham group,the CLP group demonstrated an elevation in protein expression of OPG and RANK in kidney tissues,whereas RANKL protein expression displayed significant downregulation,with statistically significant differences(all P<0.05).Conclusion:In a murine sepsis model,augmented expression of OPG and RANK,coupled with diminished RANKL expression,suggests the potential involvement of the OPG/RANKL/RANK signaling pathway in the pathophysiological progression of SA-AKI.

Genotypic analysis on the ORF-K1 gene of human herpesvirus 8 from patients with Kaposi's sarcoma in Xinjiang,China

Human herpesvirus 8 （HHV-8） is thought to be essential for the development of all forms of Kaposi＇s sarcoma （KS）. HHV-8 DNA is present virtually in all KS tumor biopsy samples. Genes at both ends of the HHV-8 genome have been shown to vary considerably. Seven major molecular subtypes of HHV-8 were defined based on the amino acid sequence of the open reading frame K1 （ORF-K1）, generally known as A, B, C, D, E, F, and Z. Most strains collected worldwide were clustered into two subtypes （A and C）. Here, the K1/VRI region of HHV-8 was amplified by nested PCR in 22 （81.48%） of 27 cases from Xinjiang Uygur Autonomous Region, a province in northwestern China. Phylogenetic analysis on the basis of the K1/VR1 amino acid sequence indicated that the majority of these KS patients were infected by subtype C HHV-8 （n = 18, including 15 belonging to the C2 group）, and several by subtype A （n = 4, including 3 being the A1 group）. This is the first report of subtype A HHV-8 in China. Furthermore, the correlations between different forms and lesions of KS and different subtypes of HHV-8 were analyzed. The findings showed that subtype A HHV-8 resulted in significantly more frequent mucosal KS lesions than subtype C. However, there was no obvious correlation between different forms of KS and different subtypes of HHV-8.

Evaluating patients' perception of service quality at hospitals in nine Chinese cities by use of the ServQual scale

Objective: To investigate patients' perception of service quality at hospitals in nine Chinese cities and propose some measures for improvement. Methods: The ServQ ual scale method was used in a survey involving patients at out-patient and in-patient facilities in Shanghai, Chongqing, Chengdu, Nanning, Guilin and Laibin of Guangxi, Honghezhou of Yunnan, Wulumuqi of Xinjiang and Zhongshan of Guangdong. The data collected were entered and analyzed using SPSS 20.0. Statistical analyses included descriptive statistics, factor analyses, reliability analyses, product-moment correlations, independent-sample t-tests, One-way ANOVA and regression analyses. Results: The Kaiser-Meyer-Olkin value for the factor analysis of the scale was 0.979. The Cronbach's α for the reliability analysis was 0.978. All the Pearson correlation coei cients were positive and statistically signii cant. Visitors to out-patient facilities reported more positive perception tacilities on tangibles(t = 4.168, P(t = 1.979, P <han visitors to in-patient f 0.05). Patients of 60 years of age and above reported mor< 0.001) and reliability e positive perception th<an those between 40 and 49 on reliability(F = 3.311, P = 0.010), assurances(F = 2.751, P 0.05) and empathy(F = 4.009, P = 0.003). For the i ve dimensions of the scale, patients in Laibin, Guangxi reported the most positive perceived service quality, followed by patients in Shanghai. On the other hand, patients in Chongqing and Nanning and Guilin of Guangxi reported relatively poor perceptions of service quality. Standardized regression coei cients showed statistically significant(P < 0.001) positive values for all Serv Qual dimensions. Empathy(β = 0.267) and reliability(β uality. = 0.239) most strongly predicted perception of service qConclusions: Chinese patients perceived service quality as satisfactory. Hospitals in various regions of China should enhance their awareness and ability to serve their patients.

Fecal microbiota of three bactrian camels(Camelus ferus and Camelus bactrianus) in China by high throughput sequencing of the V3-V4 region of the 16S rRNA gene

This study aimed to reveal the microbial diversity in the fecal samples of bactrian camels using the 16 S r RNA sequencing analysis on the Illumina Mi Seq platform. Three fecal samples were collected from two geographical regions in China. Operational taxonomic unit（OTU） clustering was performed by identifying an OTU at 97% sequence identity. The alpha and beta diversities were applied to estimate the differences in microbial diversity among the three fecal samples. Totally, 4409, 3151 and 4075 OTUs in the fecal samples were identified in the Lop Nor wild camel（Camelus ferus）, the domestic camel（C. bactrianus） and Dunhuang wild camel（C. ferus）, respectively. The majority of bactreria were affiliated with phylum Firmicutes and Bacteroidetes in the three samples. The wild camels had higher gastrointestinal tract microbial diversity than the domestic one, while the microbial composition of the Lop Nor wild camel shared higher similarity with domestic camel at the genus and family levels than that of the Dunhuang wild camel did. Our results may provide a theoretical basis for assessing their health conditions and may thus be useful for protecting the critically endangered species of C. ferus.

Folate level and prevalence of folate deficiency in population from agriculture and stock-raising regions and its correlation with hypertension

Objective:To compare the plasma folate level,prevalence of folate deficiency and the related influencing factors of hypertension in Xinjiang agricultural and pastoral areas.Methods:We enrolled 1926 study subjects with 447 hypertensive and non-hypertensive 1479 ones aged≥15 years old using multi-stage stratified sampling in Emin Xinjiang between January and December 2014,conducted the health behavior questionnaire and physical examination,and collected blood samples.The plasma folate level were measured by chemiluminescence method.Results:(1)There were significant differences(P<0.05)in age,gender,ethnic composition,marital status,education level,smoking consumption,drinking data,overweight and obesity and hyperhomocysteinemia(HHcy)between hypertension group and non hypertension group.(2)The folate deficiency rate of hypertension group was higher than that of non hypertension group(P=0.003);the folate deficiency rate of systolic and diastolic hypertension was the highest(P=0.008);the folate level of hypertension with HHcy was the lowest(P<0.001)and the folate deficiency rate was the highest(P=0.023).(3)Partial correlation analysis showed that folate was negatively correlated with systolic blood pressure and pulse pressure(P<0.05).(4)Multivariate logistic regression analysis showed that age 45-59(OR=3.78,95%CI:2.45-5.82),age≥60(OR=6.87,95%CI:4.35-5.10.87),male gender(OR=6.96,95%CI:3.86-12.54),Kazakhs(OR=2.12,95%CI:1.52-2.96),Mongolian(OR=2.38,95%CI:1.25-4.53),smoking(OR=4.21,95%CI:2.05-8.63),drinking(OR=6.36,36%CI:3.00-13.48),overweight and obesity(OR=2.11,95%CI:1.58-2.81),and folate deficiency(OR=1.72,95%CI:1.05-2.80)were the related factors of hypertension.Conclusions:The prevalence of folate deficiency in the population with hypertension in Xinjiang is higher than that in the non hypertension group,and the highest prevalence of folate deficiency is in hypertension with HHcy.Therefore,folate supplementation in the prevention of hypertension may be helpful,especially for the elderly,men and Kazakhs,and at the same time,healthy life style has an important reference value for reducing the level of hypertension and preventing and controlling cardiovascular diseases.

Spinal cord biological safety of image-guided radiation therapy versus conventional radiation therapy

Tumor models were simulated in purebred Beagles at the T9-10 levels of the spinal cord and treated with spinal image-guided radiation therapy or conventional radiation therapy with 50 or 70 Gy total radiation. Three months after radiation, neuronal injury at the T9-10 levels was observed, including reversible injury induced by spinal image-guided radiation therapy and apoptosis induced by conventional radiation therapy. The number of apoptotic cells and expression of the proapoptotic protein Fas were significantly reduced, but expression of the anti-apoptotic protein heat shock protein 70 was significantly increased after image-guided radiation therapy compared with the conventional method of the same radiation dose. Moreover, the spinal cord cell apoptotic index positively correlated with the ratio of Fas/heat shock protein 70. These findings indicate that 3 months of radiation therapy can induce a late response in the spinal cord to radiation therapy; image-guided radiation therapy is safer and results in less neuronal injury compared with conventional radiation therapy.

Incidence and Risk Factors of Cognitive Impairment 3 Months after First-ever Stroke: A Cross-sectional Study of 5 Geographic Areas of China

This study examined the incidence, neuropsychological characteristics and risk factors of cognitive impairment 3 months after stroke in China. Five regions that differed in geography and economy in China were selected. Patients from the hospitals located in the five regions were prescreened at admission, and the demographic data, vascular risk factors and clinical characteristics of stroke were obtained. A battery of cognitive-specific domain tests was performed in the patients who failed to pass cognitive screening 3 months post stroke. Patients were diagnosed as having post-stroke cognitive impairment (PSCI) or no cognitive impairment (NCI) based on the results of the neuropsy-chological tests. Univariate analysis was performed for suspect risk factors, and significant variables were entered in multivariable logistic regression analysis. Our results showed that a total of 633 patients were recruited 3 months after stroke; complete cognitive tests were performed in 577 of the stroke pa-tients. The incidence of PSCI in these Chinese patients was 30.7%. There were 129 (22.4%) patients with visuospatial impairment, 67 (11.6%) with executive impairment, 60 (10.4%) with memory impairment and 18 (3.1%) with attention impairment. The risk factors associated with PSCI were older age (odds ratio [OR] 1.76, 95% confidence interval [CI] 1.20–2.58), low education level (OR 2.45, 95% CI 1.65–3.64), depressive symptom (OR 1.69, 95% CI 1.09–2.61), obesity (OR 2.57, 95% CI 1.41–4.71), stroke severity 3 months post stroke (OR 1.62, 95%CI 1.10–2.37) and cortex lesion (OR 1.55, 95% CI 1.04–2.31). It was concluded that PSCI occurs commonly 3 months after first-ever stroke in Chinese patients. Visuospatial ability may be the most frequently impaired cognitive domain for the patients with stroke. The critical risk factors of PSCI are older age, low education level, depressive symptom, obesity, stroke severity 3 months post stroke and cortex lesion.

An animal model of cerebral palsy induced by prenatal exposure to lipopolysaccharide and hypoxia

BACKGROUND： Neonatal cerebral palsy is mainly caused by prenatal factors. At present, an animal model of prenatal infection and early postnatal hypoxia does not exist. OBJECTIVE： To observe morphology and motor performance following prenatal infection and hypoxic insult-induced brain damage of neonatal rats to verify the feasibility to establish a model of cerebral palsy. DESIGN, TIME AND SETTING： A randomized, controlled, animal experiment was performed at the Laboratories of Xinjiang Center for Disease Control and Prevention from September 2007 to June 2008. MATERIALS： The hypoxic incubator was purchased from Shanghai Pediatric Medical Institute, China. Lipopolysaccharide （LPS, Escherichia coil, 055： B5） was purchased from Sigma-Aldrich （St. Louis, MO, USA）. METHODS： A total of 27 Wistar rats, aged 7 days, were randomly assigned to sham-surgery group （n = 15） with no carotid artery incision or hypoxia treatment, hypoxia/ischemia （H/I） group （n = 12） undergoing ligature of the right common carotid artery followed by exposure to hypoxia at postnatal day 7 （P7）, and LPS/H group （n = 19）, in which pregnant rats were exposed in utero to LPS followed by prenatal hypoxia at embryonic day 16. MAIN OUTCOME MEASURES： Behavior, compound muscle action potential, and pathological changes were observed in 28-day-old rats. RESULTS： The footprint repeat space showed that left limb footprint repeatability in the H/I and LPS/H groups was lower than in the sham-surgery group （P 〈 0.05）. The space between the footprints was larger and unstable. Hind limb quadricep compound muscle action potential in the H/I and LPS/H groups showed lower wave amplitude compared with the sham-surgery group （P〈 0.05） Hematoxylin and eosin staining showed irregular cells around the ventricle, as well as periventricular leukomalacia. CONCLUSION： An animal model of cerebral palsy was established, which simulated the human condition most likely associated with occurrence of this disease. This model could be used for experimental studies related to cerebral palsy.

Impact of main vessel calcification on procedural and clinical outcomes of bifurcation lesion undergoing provisional single-stenting intervention: a multicenter, prospective, observational study

Background Few data on the combined effects of bifurcation and calcification on coronary artery disease(CAD)patients undergoing percutaneous coronary intervention(PCI)are available.This study evaluated the impact of main vessel(MV)calcification on the procedural and long-term outcomes in patients with CAD who underwent provisional single stent PCI.Methods This is a multicenter,prospective,observational study.Patients with bifurcation lesions were enrolled at 10 PCI centers in China from January 2015 to December 2017.Intravascular ultrasound or optical coherence tomography was performed in all patients to evaluate the MV calcification.Patients were treated with provisional single stent strategy using drug eluting stents and followed-up at 1 month,6 months and 12 months after discharge by telephone contact or outpatient visit.Repeated coronary imaging was performed within one year.We compared the procedural success rates in MV and in side branch(SB),and target lesion failure(TLF),defined as a composite of cardiac death,non-fatal myocardial infarction,definite or possible stent thrombosis and target lesion revascularization between patients with and without MV calcification.Results A total of 185 subjects were enrolled according to the inclusion and exclusion criteria of this study.MV calcification was detected in 119(64.3%,calcification group)and not found in 66(35.7%,non-calcification group)patients.The angiographic success rate of MV was 95.8%in the calcification group and 97.0%in the non-calcification group(P=0.91);the angiographic success rate of SB was 32.8%in the calcification group and 53.0%in the non-calcification group(P<0.05).During the one-year follow-up period,TLF occurred in 14(11.8%)patients in the calcification group and in 13(19.7%)in the non-calcification group{P=0.31).Multivariate regression analysis showed the same result(HR=1.23,95%CI:0.76-1.52,P=0.47).Calcification on group had higher recurrent angina than non-calcification group(13.51%vs.17.65%,P<0.05).Conclusions In patients with coronary bifurcation lesion treated with provisional one stent approach,calcification of MV is associated with lower SB procedural success rate,it could increase recurrence of angina;however,it was not associated with an increased risk of TLF.

Efficacy and safety of glucocorticoids in the treatment of community-acquired pneumonia: A meta-analysis of randomized controlled trials

BACKGROUND: Community-acquired pneumonia(CAP) is pneumonia acquired infectiously from normal social contact as opposed to being acquired during hospitalization. CAP is a leading cause of illness and death. This review aims to determine the efficacy and safety of glucocorticoids in the treatment of community-acquired pneumonia(CAP).DATA SOURCES: We searched randomized controlled trials(RCTs) from Pubmed, EMBASE, Cochrane Library, Chinese Journal Full-text Database, and Chinese Biomedical Literature Database to obtain the information by using steroids, glucocorticoids, cortisol, corticosteroids, community-acquired pneumonia and CAP as key words. The quality of RCTs was evaluated. A Meta-analysis was made using Rev Man 5.0 provided by the Cochrance Collaboration.RESULTS: Seven RCTs involving 944 patients were included in the meta-analysis. The mean length of hospital stay in glucocorticoids treatment group was significantly shorter than that in standard treatment group(WMD=–1.70, 95%CI 2.01–1.39, Z=10.81, P<0.00001). No statistically significant differences were found in the mortality rate(RR=0.77,95%CI 0.46–1.27, Z=1.03, P=0.30), the mean length of hospital stay in ICU(WMD=1.17, 95%CI 1.68–4.02, Z=0.81, P=0.42), the incidence of super infection(RR=1.32, 95%CI 0.66–2.63, Z=0.79, P=0.43), the incidence of hyperglycemia(RR=1.84, 95%CI 0.76–4.41, Z=1.36, P=0.17), the incidence of upper gastrointestinal bleeding(RR=1.98, 95%CI 0.37–10.59, Z=0.80, P=0.42) between the standard treatment group and the glucocorticoids treatment group.CONCLUSIONS: The use of glucocorticoids in patients with community-acquired pneumonia can significantly shorten the duration of illness and have a favorable safety profile. However, it could not reduce the overall mortality.

A rat pup model of cerebral palsy induced by prenatal inflammation and hypoxia

Animal models of cerebral palsy established by simple infection or the hypoxia/ischemia method cannot effectively simulate the brain injury of a premature infant. Healthy 17-day-pregnant Wistar rats were intraperitoneally injected with lipopolysaccharide then subjected to hypoxia. The pups were used for this study at 4 weeks of age. Simultaneously, a hypoxia/ischemia group and a control group were used for comparison. The results of the footprint test, the balance beam test, the water maze test, neuroelectrophysiological examination and neuropathological examination demonstrated that, at 4 weeks after birth, footprint repeat space became larger between the forelimbs and hindlimbs of the rats, the latency period on the balance beam and in the Morris water maze was longer, place navigation and ability were poorer, and the stimulus intensity that induced the maximal wave amplitude of the compound muscle action potential was greater in the lipopolysaccharide/hypoxia and hypoxia/ischemia groups than in the control group. We observed irregular cells around the periventricular area, periventricular leukomalacia and breakage of the nuclear membrane in the lipopolysacchadde/hypexia and hypoxia/ischemia groups. These results indicate that we successfully established a Wistar rat pup model of cerebral palsy by intraperitoneal injection of lipopolysaccharide and hypoxia.

Reliability and validity of the Chinese version of spiritual needs questionnaire with 27 items (SpNQ-Ch-27) in cancer patients

Objective: To evaluate the reliability and validity of the Chinese version of the Spiritual Needs Questionnaire with 27 items (SpNQ-Ch-27) for cancer patients.Methods: A total of 457 cancer patients in a tertiary hospital in Xinjiang from March to July in 2017 were investigated by using the SpNQ-Ch-27 and convenient sampling method.They were recruited to validate the discrimination,reliability,and validity of the scale.According to the odd and even questionnaire numbers,data were divided into two groups to do exploratory factor analysis group and confirmatory factor analysis,respectively.Results: SpNQ-Ch-27 included 27 items and six factors,which were extracted by using factor analysis.It could explain 63.08% of the total variance.The total scores of each dimension and the SpNQ-Ch-27 were highly correlated,and the correlation coefficient was from 0.58 to 0.78.For the CFA,the overall fitting ideal was x2/df=2.00,RMSEA =0.07,IFI =0.93,NFI =0.86,CFI =0.92,TLI =0.90;Cronbach's α =0.90;the dimensions of Cronbach's α =0.63-0.95;split-half reliability was 0.82,dimensions were 0.68-0.95.Conclusion: SpNQ-Ch-27 is applicable for Chinese cancer patients with better validity and higher internal consistency,and it can be used as a tool to assess the spiritual needs of cancer patients.

Combined use of Y-tube conduits with human umbilical cord stem cells for repairing nerve bifurcation defects

Given the anatomic complexity at the bifurcation point of a nerve trunk,enforced suturing between stumps can lead to misdirection of nerve axons,thereby resulting in adverse consequences.We assumed that Y-tube conduits injected with human umbilical cord stem cells could be an effective method to solve such problems,but studies focused on the best type of Y-tube conduit remain controversial.Therefore,the present study evaluated the applicability and efficacy of various types of Y-tube conduits containing human umbilical cord stem cells for treating rat femoral nerve defects on their bifurcation points.At 12 weeks after the bridging surgery that included treatment with different types of Y-tube conduits,there were no differences in quadriceps femoris muscle weight or femoral nerve ultrastructure.However,the Y-tube conduit group with longer branches and a short trunk resulted in a better outcome according to retrograde labeling and electrophysiological analysis.It can be concluded from the study that repairing a mixed nerve defect at its bifurcation point with Y-tube conduits,in particular those with long branches and a short trunk,is effective and results in good outcomes.

Primary myelofibrosis with thrombophilia as first symptom combined with thalassemia and Gilbert syndrome:A case report

BACKGROUND A 46-year-old Han man first had sigmoid sinus and transverse sinus venous thrombosis at the age of 42.At the age of 44,he once again developed thrombosis.Genetic testing showed heterozygous SERPINC1 mutation,bone marrow biopsy showed fibrosis grade 1(MF-1),and JAK2 V617F mutation was positive,accompanied by UGT1A1 mutation andβ-thalassemia gene mutation.CASE SUMMARY A 46-year-old Han man was first found to have sigmoid sinus and transverse sinus venous thrombosis at the age of 42 but had no individual or family thrombosis history,and he had been regularly taking warfarin anticoagulant therapy for a long period of time.At the age of 44,venous thrombosis reappeared in parts of the intrahepatic vein,main portal vein,splenic vein,and superior mesenteric vein,and his spleen was obviously enlarged.He had a history of jaundice for many years,and genetic testing revealed that he carried a heterozygous SERPINC1 mutation.Bone marrow biopsy showed multifocal fibrous tissue hyperplasia among trabeculae and focal fibrosis.He was positive for the JAK2 V617F mutation.At the same time,UGT1A1 andβ-thalassemia gene mutations existed,and a SERPINC1 mutation and UGT1A1 mutation were both found in his parents.CONCLUSION The patient in this case had thrombophilia as the primary symptom,JAK2V617-positive myeloproliferative neoplasm(MPN)was the main potential cause,and hereditary AT-III deficiency may have been one of multiple secondary causes.It remains to be determined whether UGT1A1 andβ-thalassemia gene mutations are related to thrombophilia.However,the clinical features of MPN in this patient were hidden,and the relevant clinical features of coexisting thalassemia and hereditary Gilbert syndrome,reported here for the first time domestically and abroad,were complicating factors,causing great difficulties for a clear diagnosis.Thus,when thrombophilia has been determined,it is necessary to screen the relevant latent problems overall.When the clinical features cannot be perfectly explained by one etiology,a relevant comprehensive examination should also be initiated from the perspective of multiple etiologies.

Effect of Acacetin on flagellin induced NLRC4 inflammasome activation in mouse bone marrow-derived macrophages

Objective:To investigate the effect of acacetin on flagellin induced NLRC4 inflammasome activation in mouse bone marrow-derived macrophages(BMDMs).Methods:Mouse BMDMs were divided into control group,LPS group,LPS+flagellin group and LPS+acacetin+flagellin group.All groups were added with complete medium,then primed with LPS(50 ng/mL)for 3 hrs except the control group,whereafter,LPS+flagellin group was treated with flagellin(10μmol/L)for 0.5 hr and LPS+acacetin+flagellin group was treated with acacetin(10μmol/L)for 0.5 hr following by flagellin(10μmol/L)for 0.5 hr.Pro-caspase-1,pro-IL-1βin cell lysate and caspase-1,IL-1βin supernatant were detected by Western blot(WB).IL-1β,IL-18 and TNF-αin supernatant were measured by enzyme-linked immunosorbent assay(ELISA).And the activity of LDH in supernatant was assessed by LDH test kit.Results:Compared with the control group,in LPS+flagellin group,the expression of caspase-1,IL-1βprotein in supernatant were significantly increased(all P-values<0.05),but the differences of the expression of pro-caspase-1 and pro-IL-1βprotein in cell lysate were not significant.Compared with LPS+flagellin group,in LPS+acacetin+flagellin group,the expression of caspase-1,IL-1βprotein in supernatant were significantly reduced(all P-values<0.05),while the differences of the expression of pro-caspase-1 and pro-IL-1βprotein in cell lysate were not significant.ELISA showed that compared with the control group,the levels of IL-1β,IL-18,and TNF-αand the activity of LDH in supernatant of LPS+flagellin group were significantly increased(all P-values<0.05).Compared with LPS+flagellin group,in LPS+Acacetin+flagellin group,the level of IL-1βin supernatant was significantly decreased(P<0.05),meanwhile,the decreases of the levels IL-18,TNF-αand the activity of LDH were not significant.Conclusions:We found that Acacetin can effectively inhibit flagellin induced NLRC4 inflammasome activation and reduce cell damage in mouse BMDMs.

Effect of dexmedetomidine against liver ischemia-reperfusion injury in rats by reducing endoplasmic reticulum stress

Objective:To investigate the effect of dexmedetomidine against liver ischemia-reperfusion injury in rats by reducing endoplasmic reticulum stress.Methods: A total of 24 adult male Sprague-Dawley rats were randomly divided into sham operation group (6 rats, Sham group), liver ischemia-reperfusion injury group (6 rats, I/R group), and liver ischemia-reperfusion injury +dexmedetomidine pretreatment group (6 rats, I/R +Dex pretreatment group) (25μg/kg intraperitoneally 30 min before ischemia), and liver ischemia-reperfusion injury +dexmedetomidine post-treatment group (6 rats, I/R +Dex post-treatment group) (25 μg/kg intraperitoneally 30 min after reperfusion). Hepatic ischemia-reperfusion injury model was performed by after clamping the hepatic hilum for 30 min and reperfusion for 6 h. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were measured by automatic biochemical analyzer. Malondialdehyde (MDA) and superoxide dismutase (SOD) activity were detected by enzyme-linked immunosorbent assay (ELISA). The pathological changes of each group were observed by HE staining. The expression of endoplasmic reticulum stress (P-PERK, P-IRE1 , CHOP) were detected by Western blot.Results: Compared with the Sham group, the serum levels of ALT and AST were significantly higher in the I/R group, compared with the I/R group, the serum ALT and AST in I/R+Dex pretreatment group and the I/R+Dex post-treatment group were significantly reduced;Compared with the Sham group, MDA activity in the liver tissue of the I/R group was significantly increased, while the SOD activity was significantly decreased, and the pathological score of the liver tissue was significantly increased;Compared with the I/R group, MDA activity and liver histopathology scores in I/R+Dex pretreatment group and the I/R+Dex post-treatment group were decreased, while SOD activity increased;The expression of P-PERK, P-IRE1 , CHOP in the I/R group were significantly higher than that in the Sham group, while the expression of the above indicators were reduced in I/R+Dex pretreatment group and the I/R+Dex post-treatment group. Conclusion: Dexmedetomidine can significantly attenuated liver ischemia-reperfusion injury in rats, which may be related to the reduction of endoplasmic reticulum stress.

Sex difference in the prevalence of metabolic syndrome and its relationship to BMI and age

Objective:To investigate the prevalence of metabolic syndrome (MetS) in primary aldosteronism(PA) patients with different genders and relationship between body mass index(BMI), age and MetS. Methods:This study included 168 PA patients who were hospitalized in hypertension treatment center of Xinjiang Uygur Autonomous Region People' Hospital, including 94 male patients and 74 female patients and the backgrounds and biochemical parameters of two groups were compared. Based on this, the relationship between BMI, age and MetS were also analyzed. Results:The prevalence of MetS was significantly higher in male patients with PA than female patients with PA(83.0% vs 58.1%,P<0.001). Compared to PA patients without MetS, PA patients with MetS had a higher level of BMI and greater prevalence of obesity (P<0.05). According to the BMI stratification analysis, we found the prevalence of MetS was higher in obese groups than non-obese groups (P<0.05). Moreover, the obese male patients with PA had higher prevalence of every component of MetS and prevalence of MetS with 5 metabolic factors compared to the non-obese group (P<0.05);while the obese female patients with PA only had higher prevalence of abdominal obesity compared to the non-obese group (P<0.001). Among the patients classified by age, the both prevalence of MetS was higher in male than female, and there was no male:female ratio inverted in patients with PA after menopause. Conclusions:The prevalence of MetS in male patients with PA was higher than female patients with PA. In addition, the obese groups had the higher prevalence of MetS than non-obese groups.

Correlation of thyroid papillary carcinoma CEUS characteristics with cancer cell proliferation and invasion

Objective:To study the correlation of thyroid papillary carcinoma CEUS characteristics with cancer cell proliferation and invasion.Methods:A total of 128 patients with thyroid papillary carcinoma who received surgical treatment in the hospital between May 2013 and May 2016 were collected, CEUS was used to make clear the peak intensity (PI) and area under the curve (AUC) of tumor tissue and surrounding normal tissue, and the median of PI and AUC was referred to further divide the patients into high PI group and low PI group as well as high AUC group and low AUC group, 64 cases in each group. Fluorescent quantitative PCR was used to determine proliferation and invasion gene mRNA expression in tumor tissues.Results: PI and AUC levels in tumor tissue were lower than those in surrounding normal tissue;proliferation genes EZH2, Livin, hTERT, HMGA1 and Wip1 mRNA expression of low PI group were higher than those of high PI group, and invasion gene Ki-67 mRNA expression was higher than that of high PI group while P53 and MRP-1 mRNA expression were lower than those of high PI group;proliferation genes EZH2, Livin, hTERT, HMGA1 and Wip1 mRNA expression of low AUC group were higher than those of high AUC group, and invasion gene Ki-67 mRNA expression was higher than that of high AUC group while P53 and MRP-1 mRNA expression were lower than those of high AUC group.Conclusion: Thyroid papillary carcinoma CEUS parameters PI and AUC levels can quantifiably reflect the cancer cell proliferation and invasion activity.