Impact of metabolic dysfunction-associated steatotic liver disease on the efficacy of immunotherapy in patients with chronic hepatitis B-related hepatocellular carcinoma

Objective:To investigate the impact of metabolic dysfunction-associated steatotic liver disease(MASLD)on the efficacy of immune checkpoint inhibitor(ICI)-based therapy in patients with chronic hepatitis B(CHB)-related hepatocellular carcinoma(HCC).Methods:A total of 155 patients with CHB-related HCC who received ICI–based therapy(in the Department of Hepatology,Tianjin Second People’s Hospital and Department of Hepatobiliary Oncology,Tianjin Medical University Cancer Institute&Hospital)between April 2021 and December 2023 were evaluated.Patients were divided into two groups:MASLD concurrent with CHB[MASLD-CHB](n=38),and CHB(n=117).Results:The median progression-free survival(PFS,6.9 months vs.9.3 months;P=0.001),progressive disease(57.89%vs.37.61%;P=0.028),and disease control rate(42.11%vs.62.39%;P=0.028)in the MASLD-CHB group were significantly worse than the CHB group.The median overall survival was not attained.The percentage of CD4+PD1+(17.56%vs.8.89%;P<0.001)and CD8+PD1+T cells(10.50%vs.7.42%;P=0.005)in patient samples from the MASLD-CHB group were significantly higher than the CHB group.Concurrent MASLD[hazard ratio(HR)=1.921;95%CI,1.138–3.245;P=0.015]and alpha-fetoprotein levels after 3 months of treatment(HR=2.412;95%CI,1.360–4.279;P=0.003)were independent risk factors for PFS in all patients.Conclusions:ICI-based therapy in patients with CHB-related HCC and concurrent MASLD resulted in poorer efficacy and shorter PFS compared to patients with CHB-related HCC alone.

A contradictory phenomenon of thicken pericardium and cardiac compression without inferior vena cava dilation:sign of IVC escape

A 77-year-old female presented with shortness of breath and tightness of chest was admitted.Her past medical history included hypertension and she has been taking nifedipine regularly.Two years before,she was diagnosed with pericardial effusion(Figure 1)and had pericardiocentesis drainage.On physical examination,her blood pressure was 151/100 mm-Hg and her pulse rate was 91 beats/min.

Mechanism of action of Linggui Zhugan Decoction in treating non-alcoholic fatty liver disease using untargeted metabolomics approach

Background:Non-alcoholic fatty liver disease(NAFLD)is a liver disorder characterized by the accumulation and degeneration of fat in the liver cells,a condition that may further deteriorate and lead to cirrhosis and liver cancer.Numerous studies showed that metabolic dysfunction can promote NAFLD development.Linggui Zhugan Decoction(LGZGD)has therapeutic effects on NAFLD.The mechanism of LGZGD still remains unclear.This study was to examine the impact of LGZGD on the metabolic processes involved in the development of NAFLD.Methods:A mice model of NAFLD was treated with LGZGD.The therapeutic potential of LGZGD was evaluated by assessing the activity of transaminases,lipids levels of blood,and pathological changes in the liver of the mice model of NAFLD.Additionally,this study also evaluated the influence of LGZGD on liver inflammation and oxidative stress.Results:The results of untargeted metabolomics analysis showed that LGZGD reduced the disordered lipid metabolism in NAFLD mice.LGZGD improved the oxidative stress and also reduced the levels of pro-inflammatory cytokines in the liver.Untargeted metabolomics analysis of liver samples revealed that LGZGD treatment improved metabolic disorders,including alanine,aspartate,glutamate,glycerophospholipid metabolism,and citrate cycle.Further RT-qPCR and Western blot results showed that LGZGD could regulate the expression of key enzymes in the metabolic pathway of the citrate cycle,including ATP-citrate lyase(ACLY),alanine-glyoxylate aminotransferase-2(AGXT2),phosphatidylethanolamine N-methyltransferase(PEMT),and succinate dehydrogenase(SDH).Conclusion:We found that LGZGD can treat NAFLD by reducing inflammatory responses,inhibiting oxidative stress,regulating alanine,aspartate,glutamate,and glycerophospholipid metabolism,and citrate cycle pathways.

Changes of mitochondrial dynamics during the progression of non-alcoholic fatty liver disease: a review

Non-alcoholic fatty liver disease(NAFLD)is a chronic liver disease closely related to metabolic disorders that pose a serious threat to human health.Currently,no specific drugs are available for treating the aetiology of NAFLD in clinical practice.Mitochondria have various biological functions inside the cell.Studies have found that mitochondrial fission and fusion are closely related to NAFLD.Therefore,identifying therapeutic targets for NAFLD through mitochondrial fission and fusion is crucial.Particularly in the field of traditional Chinese medicine,good therapeutic effects have been achieved in the treatment of NAFLD by protecting mitochondrial fusion and fission.Therefore,this article reviews the relationship between mitochondrial dynamics and NAFLD as well as the treatment of NAFLD through the regulation of mitochondrial fission and fusion with traditional Chinese medicine to provide a reference for the clinical application of traditional Chinese medicine in regulating mitochondrial fission and fusion functions to treat NAFLD.

Modulating the crosstalk between macrophage and Th17: potential mechanism of natural products on acute lung injury

Sepsis is a life-threatening multiple organ dysfunction syndrome caused by the imbalance of the immune response to infection,featuring complex and variable conditions,and is one of the leading causes of mortality in ICU patients.Lung injury is a common organ damage observed in sepsis patients.Macrophages and Th17 cells,as crucial components of innate and adaptive immunity,play pivotal roles in the development of sepsis-induced acute lung injury(ALI).This review summarizes the alterations and mechanisms of macrophages and Th17 cells in sepsis-induced ALI.By focusing on the“cross-talk”between macrophages and Th17 cells,this review aims to provide a solid theoretical foundation for further exploring the therapeutic targets of traditional Chinese medicine formulas in the treatment of sepsis complicated with ALI,thereby offering insights and guidance for the clinical application of traditional Chinese medicine in managing sepsis-associated ALI.

Atomically bonding Na anodes with metallized ceramic electrolytes by ultrasound welding for high-energy/power solid-state sodium metal batteries

A solid-state sodium metal battery has cut a striking figure in next-generation large-scale energy storage technology on account of high safety,high energy density,and low cost.Nevertheless,the large interfacial resistance and sodium dendrite growth originating from the poor interface contact seriously hinder its practical application.Herein,a modified ultrasound welding was proposed to atomically bond Na anodes and Au-metalized Na_(3)Zr_(2)Si_(2)PO_(12) electrolytes associated with the in situ formation of Na–Au alloy interlayers.Thereupon,intimate Na_(3)Zr_(2)Si_(2)PO_(12)-Au/Na interfaces with a low interfacial resistance(~23Ωcm^(2))and a strong dendrite inhibition ability were constructed.The optimized Na symmetric battery can cycle steadily for more than 900 h at 0.3 mA cm^(-2) under a low overpotential(<50 mV)of Na electroplating/stripping and deliver a high critical current density of 0.8 mAcm^(-2) at room temperature.By incorporating the above interface into the solid-state Na metal battery,taking three-dimensional Na_(3)V_(2)(PO_(4))_(3) as the cathode,the full battery offers a high energy density of 291 Wh kg^(-1) at a high power density of 1860Wkg^(-1).A pouch-type solid-state sodium metal full battery based on a ceramic electrolyte was assembled for the first time,and it lit a 3 V LED lamp.Such a strategy of the ultrasound welding metalized solid-state electrolyte/Na interface by engineering the Na-Au interlayer would pave a new pathway to engineer a low-resistance and highly stable interface for high-energy/density solid-state sodium metal batteries.

Direct detection of a single[4Fe-4S]cluster in a tungsten-containing enzyme:Electrochemical conversion of CO_(2) into formate by formate dehydrogenase

The conversion of CO_(2) into fuels and valuable chemicals is one of the central topics to combat climate change and meet the growing demand for renewable energy.Herein,we show that the formate dehydrogenase from Clostridium ljungdahlii(ClFDH)adsorbed on electrodes displays clear characteristic voltammetric signals that can be assigned to the reduction and oxidation potential of the[4Fe-4S]^(2+/+)cluster under nonturnover conditions.Upon adding substrates,the signals transform into a specific redox center that engages in catalytic electron transport.ClFDH catalyzes rapid and efficient reversible interconversion between CO_(2) and formate in the presence of substrates.The turnover frequency of electrochemical CO_(2) reduction is determined as 1210 s^(-1) at 25℃ and pH 7.0,which can be further enhanced up to 1786 s^(-1) at 50℃.The Faradaic efficiency at−0.6 V(vs.standard hydrogen electrode)is recorded as 99.3%in a 2-h reaction.Inhibition experiments and theoretical modeling disclose interesting pathways for CO_(2) entry,formate exit,and OCN−competition,suggesting an oxidation-state-dependent binding mechanism of catalysis.Our results provide a different perspective for understanding the catalytic mechanism of FDH and original insights into the design of synthetic catalysts.

Circulation patterns and molecular characteristics of respiratory syncytial virus among hospitalized children in Tianjin,China,before and during the COVID-19 pandemic(2017–2022)

Respiratory syncytial virus(RSV)is the main pathogen that causes hospitalization for acute lower respiratory tract infections(ALRIs)in children.With the reopening of communities and schools,the resurgence of RSV in the COVID-19 post-pandemic era has become a major concern.To understand the circulation patterns and genotype variability of RSV in Tianjin before and during the COVID-19 pandemic,a total of 19,531 nasopharyngeal aspirate samples from hospitalized children in Tianjin from July 2017 to June 2022 were evaluated.Direct immunofluorescence and polymerase chain reaction(PCR)were used for screening RSV-positive samples and subtyping,respectively.Further analysis of mutations in the second hypervariable region(HVR2)of the G gene was performed through Sanger sequencing.Our results showed that 16.46%(3215/19,531)samples were RSV positive and a delayed increase in the RSV infection rates occurred in the winter season from December 2020 to February 2021,with the average RSV-positive rate of 35.77%(519/1451).The ON1,with H258Q and H266L substitutions,and the BA9,with T290I and T312I substitutions,are dominant strains that alternately circulate every 1–2 years in Tianjin,China,from July 2017 to June 2022.In addition,novel substitutions,such as N296Y,K221T,N230K,V251A in the BA9 genotype,and L226I in the ON1 genotype,emerged during the COVID-19 pandemic.Analysis of clinical characteristics indicated no significant differences between RSV-A and RSV-B groups.This study provides a theoretical basis for clinical prevention and treatment.However,further studies are needed to explore the regulatory mechanism of host immune responses to different lineages of ON1 and BA9 in the future.

Indocyanine green clearance test combined with MELD score in predicting the short-term prognosis of patients with acute liver failure

BACKGROUND: Acute liver failure(ALF) is an acute severe deterioration of liver function with high mortality. Early and accurate prognostic assessment of patients with ALF is critically important. Although the model for end-stage liver disease(MELD) scores and King’s College Hospital(KCH) criteria are well-accepted as predictive tools, their accuracy is unsatisfactory.The indocyanine green(ICG) clearance test(ICGR15, ICG retention rate at the 15 minutes) is a sensitive indicator of liver function. In this study, we investigated the efficacy of the ICGR15 for the short-term prognosis in patients with ALF. We compared the predictive value of ICGR15 with the MELD scores and KCH criteria.METHODS: Sixty-nine patients who had been diagnosed with ALF were recruited retrospectively. ICGR15 had been performed by ICG pulse spectrophotometry and relevant clinical and laboratory indices were analyzed within 24 hours of diagnosis.In addition, the MELD scores and KCH criteria were calculated.RESULTS: The three-month mortality of all patients was 47.83%.Age, serum total bilirubin and creatinine concentrations,international normalized ratio for prothrombin time, ICGR15,MELD scores and KCH criteria differed significantly between surviving and deceased patients. A positive correlation was observed between ICGR15 and MELD scores(r=0.328, P=0.006).The ICGR15-MELD model, Logit(P)=0.096×ICGR15+0.174 ×MELD score–9.346, was constructed by logistic regression analysis. The area under the receiver operating characteristic curve was 0.855. When set the cut-off point to-0.4684, the sensitivity was 87.90% and specificity, 72.20%. The area under the receiver operating characteristic curve of the ICGR15-MELD model(0.855) was significantly higher than that of the ICGR15(0.793), MELD scores(0.776) and KCH criteria(0.659).Based on this cut-off value, the patients were divided into two groups. The mortality was 74.36% in the first group(ICGR15-MELD≥-0.4686) and 13.33% in the second group(ICGR15-MELD<-0.4686), with a significant difference between the two groups(χ2=25.307, P=0.000).CONCLUSION: The ICGR15-MELD model is superior to the ICGR15, MELD scores, and KCH criteria in predicting the shortterm prognosis of patients with ALF.

Translation and psychometric evaluation of the Chinese version of the Heart Failure-Specific Health Literacy Scale

Objective:Health literacy is closely associated with self-care behaviors in heart-failure patient.A reliable,valid,and practical measuring tool would evaluated the level of health literacy in Chinese patients with heart failure,and provide evidence for individualized education.Aim of this study was to translate Heart Failure-Specific Health Literacy Scale(HF-Specific HL Scale)into Chinese and test the reliability and validity of the Chinese version.Methods:The original HF-specific HL scale was translated into Chinese and modified for cultural adaption.Totally 164 HF inpatients were investigated with the Chinese version of HF-specific HL scale.To test the reliability and validity of the scale,item analysis,exploratory factor analysis(EFA),confirmatory factor analysis(CFA),and correlation analysis were conducted.Result:Cronbach's a value for the scale is 0.87;the correlation coefficients between each item and the total score ranged from 0.61 to 0.91.Three factors was extracted by EFA,which could explain 64.62%of the total variance.The result of CFA also showed that the scale demonstrated an acceptable model fit.The scale was significantly correlated with the Chinese version of the Heart Failure Knowledge Test(C-HFKT).Conclusion:The Chinese version of HF-specific HL scale is reliable and valid,and is suitable for assessment of HL in Chinese HF patients.

Preservation of non-heart-beating donor livers in extracorporeal liver perfusion and histidine-trytophan-ketoglutarate solution

AIM: To compare the preservation of non-heart- beating donor (NHBD) livers in cold histidine-trytophan- ketoglutarate (HTK) solution and extracorporeal liver perfusion (ECLP). METHODS: Livers harvested from health pigs were stored for 10 h in cold HTK solution (group A, n = 4) or perfused with oxygenated autologous blood at body temperature (group B, n = 4). Both groups were then tested on the circuit for 4 h. Bile production, hemodynamic parameters, hepatocyte markers and reperfusion injury of extracorporeal livers were tested in each group. Liver tissues from each group were examined at the end of reperfusion. RESULTS: At 1, 2, 3 and 4 h after reperfusion, bile production, hemodynamic parameters, hepatocyte markers and reperfusion injury of livers in group A were statistically different from those in group B (P < 0.05 or P < 0.01). CONCLUSION: ECLP is better than HTK solution to preserve NHBD livers. ECLP can assess the graft viabilitybefore liver transplantation.

Endogenous adult neurogenesis and cognitive function recovery following traumatic brain injury in the rat hippocampus

BACKGROUND：Endogenous neural progenitor cells play a beneficial role for cognitive recovery following traumatic brain injury.However,there are few classification-control studies aimed at varying graded brain trauma.OBJECTIVE：To observe the effects of adult endogenous neurogenesis on cognitive function repair and regeneration of neural progenitor cells following varying graded traumatic hippocampal injury to determine the significance of endogenous neurogenesis in the repair of brain injury.DESIGN,TIME AND SETTING：A randomized,controlled,animal experiment was performed at the Key Laboratory of Injuries,Variations and Regeneration of Nervous System,Tianjin Medical University General Hospital,from February to October 2009.MATERIALS：Mouse anti-rat 5-bromodeoxyuridine （BrdU） and neuronal nuclei （NeuN） monoclonal antibodies were purchased from Millipore Corporation,USA.METHODS：A total of 45 Wistar rats were randomly assigned to three groups.Mild and severe injury groups were respectively subjected to （182 ± 2） kPa and （284 ± 4） kPa lateral fluid percussion to establish models of brain injury,and the control group was subjected to surgery with no lateral fluid percussion.MAIN OUTCOME MEASURES：Cognitive function was estimated using the Morris water maze.Proliferation,survival,and differentiation of newly generated cells in the injured hippocampus were observed through the use of immunofluorescent staining.RESULTS：At 7 days post-injury,the number of BrdU＋ cells in the hippocampal dentate gyrus significantly increased in the mild and severe injury groups compared with the control group （P〈0.01）.At 61 days post-injury,the number of BrdU7NeuN＋ cells in the hippocampal dentate gyrus was significantly greater in the mild injury group compared with the severe injury and control groups （P〈 0.01）.In addition,the control group exhibited the greatest proportion of surviving cells that differentiated into mature neurons compared with the injury groups （P〈 0.01）.Moreover,at 61 days post-injury,cognitive function in rats with mild injury recovered to normal levels,whereas the severe injury group exhibited cognitive deficits （P〈 0.01）.CONCLUSION：Traumatic brain injury may be a stimulation factor for proliferation of neural progenitor cells in the adult hippocampus but severe brain trauma does not lead to an increased number of newly generated cells.Endogenous adult neurogenesis repairs neurological functions to an extent.However,recovery of neurological function remains limited following severe traumatic brain injury.

Role of nutritional status and nutritional support in outcome of hepatitis B virus-associated acute-on-chronic liver failure

BACKGROUNDHepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) is animportant type of liver failure in Asia. There is a direct relationship between HBVACLFand gastrointestinal barrier function. However, the nutritional status ofHBV-ACLF patients has been poorly studied.AIMTo investigate the nutritional risk and nutritional status of HBV-ACLF patientsand evaluated the impact of nutritional support on the gastrointestinal barrier and28-d mortality.METHODSNutritional risk screening assessment and gastrointestinal barrier biomarkers ofpatients with HBV-ACLF (n = 234) and patients in the compensatory period ofliver cirrhosis (the control group) (n = 234) were compared during the periodbetween 2016 and 2018. Changes were analyzed after nutritional support in HBVACLFpatients. Valuable biomarkers have been explored to predict 28-d death.The 28-d survival between HBV-ACLF patients with nutritional support (n = 234)or no nutritional support (2014-2016) (n = 207) was compared.RESULTSThe nutritional risk of the HBV-ACLF patients was significantly higher than thatof the control group. The nutritional intake of the patients with HBV-ACLF waslower than that of the control group. The decrease in skeletal muscle and fatcontent and the deficiency of fat intake were more obvious (P < 0.001). Thecoccus-bacillus ratio, secretory immunoglobulin A, and serum D-lactate weresignificantly increased in HBV-ACLF patients. The survival group had a lowernutritional risk, lower D-lactate, and cytokine levels (endotoxin, tumor necrosisfactor alpha, interleukin-10, and interleukin-1). Interleukin-10 may be a potentialpredictor of death in HBV-ACLF patients. The 28-d survival of the nutritionalsupport group was better than that of the non-nutritional support group (P =0.016).CONCLUSIONPatients with HBV-ACLF have insufficient nutritional intake and high nutritionalrisk, and their intestinal barrier function is impaired. Individualized and dynamicnutritional support is associated with a better prognosis of 28-d mortality in HBVACLFpatients.

Gemcitabine and cisplatin combined with the Chinese herbal medicine compound Fuzhenggubenfang improve quality of life and progression-free survival in patients with advanced non-small cell lung cancer

Objective： To assess the role of chemotherapy combined with the compound Chinese herbal medicine,Fuzhenggubenfang （FZGBF）, for treating advanced non-small-cell lung cancer. Methods： A total of 84 eligible patientswere enrolled from October 2013 to July 2016. Patients were randomized to receive either chemotherapy alone as thecontrol group or chemotherapy combined with FZGBF as the experimental group. The primary endpoint of the study wasquality of life （QOL） and progression-free survival （PFS）. Secondary endpoints were tumor response rate, toxicity,dropout rate, and univariate and multivariate analyses of clinicopathologic factors for QOL and PFS. Results： There wasa significant improvement in QOL, including better overall health （P 〈 0.001）, physical function （P 〈 0.001）, rolefunction （P 〈 0.001）, emotional function （P 〈 0.001）, cognitive function （P 〈 0.001）, and social function （P = 0.031）.Less fatigue, nausea or vomiting, insomnia, appetite loss, constipation, and alopecia were noted （All P 〈 0.001） whenFZGBF was combined with chemotherapy in comparison to chemotherapy alone. The experimental group had a betterPFS compared with the control group （P = 0.032）. There was no significant difference in tumor response rate. FZGBFsignificantly reduced chemotherapy-induced anemia （P 〈 0.001）, neutropenia （P = 0.023）, nausea and vomiting （P 〈0.001）. The use of Chinese herbal compounds had only mild side effects. In this study, factors influencing QOL were theuse of the Chinese herbal compounds （P 〈 0.001）, performance status score （P = 0.027）, clinical staging of cancer （P =0.009）, and sex （P = 0.044）. Use of traditional Chinese medicine （P = 0.043） and the number of previous chemotherapysessions （P = 0.003） were the factors influencing PFS in this study. Conclusion： FZGBF could improve QOL,compliance to treatment, relieved chemotherapy-related toxicities of patients, and consequently improved PFS, which isa promising drug combination in complementary medicine for the treatment of advanced NSCLC.

Impact of the number of examined lymph nodes on outcomes in patients with lymph node-negative gallbladder carcinoma

AIM To determine whether the number of examined lymph nodes(LNs) is correlated with the overall survival of gallbladder carcinoma(GBC) patients. METHODS Patients were collected from the Surveillance Epidemiology and End Results database(2004-2013) and categorized by the number of LNs into six groups: 1 LN, 2 LNs, 3 LNs, 4 LNs, 5 LNs, and ≥ 6 LNs. Survival curves for overall survival were plotted with a KaplanMeier analysis. The log-rank test was used for univariate comparisons.RESULTS In a cohort of 893 patients, the median number of examined LNs was two for the entire cohort. The survival for the 1 LN group was significantly poorer than those of the stage Ⅰ and Ⅱ disease groups and for the entire cohort. By dichotomizing the number of LNs from 1 to 6, we found that the minimum number of LNs that should be examined was four for stage Ⅰ, four or five for stage Ⅱ, and six for stage ⅢA disease. Therefore, for the entire cohort, the number of examined LNs should be at least six, which is exactly consistent with the American Joint Committee on Cancer criteria.CONCLUSION The examination of higher numbers of LNs is associated with improved survival after resection surgery for N0 GBC. The guidelines for GBC surgery, which recommend that six LNs be examined at least, are statistically valid and should be applied in clinical practice widely.

Multi-scale phase average waveform of electroencephalogram signals in childhood absence epilepsy using wavelet transformation

BACKGROUND： Recent studies have focused on various methods of wavelet transformation for electroencephalogram （EEG） signals. However, there are very few studies reporting characteristics of multi-scale phase waves during epileptic discharge.OBJECTIVE： To extract multi-scale phase average waveforms from childhood absence epilepsy EEG signals between time and frequency domains using wavelet transformation, and to compare EEG signals of absence seizure with pre-epileptic seizure and normal children, and to quantify multi-scale phase average waveforms from childhood absence epilepsy EEG signals. DESIGN, TIME AND SETTING： The case-comparative experiment was performed at the Department of Neuroelectrophysiology, Tianjin Medical University from August 2002 to May 2005. PARTICIPANTS： A total of 15 patients with childhood absence epilepsy from the General Hospital of Tianjin Medical University were enrolled in the study. The patients were not administered anti-epileptic drugs or sedatives prior to EEG testing. In addition, 12 healthy, age- and gender-matched children were also enrolled.METHODS： EEG signals were tested on 15 patients with childhood absence epilepsy and 12 normal children. Epileptic discharge signals during clinical and subclinical seizures were collected 10 and 20 times, respectively. The collected EEG signals were treated with wavelet transformation to extract multi-scale characteristics during absence epilepsy seizure using a conditional sampling method. Multi-scale phase average waveforms were collected using a conditional phase averaging technique. Amplitude of phase average waveform from EEG signals of epilepsy seizure, subclinical epileptic discharge, and EEG signals of normal children were compared and statistically analyzed in the first half-cycle.MAIN OUTCOME MEASURES： Multi-scale wavelet coefficient and the evolution of EEG signals were observed during childhood absence epilepsy seizures using wavelet transformation. Multi-scale phase average waveforms from EEG signals were observed using a conditional sampling method and phase averaging technique.RESULTS： Multi-scale characteristics of EEG signals demonstrated that 12-scale （3 Hz） rhythmical activity was significantly enhanced during childhood absence epilepsy seizure and co-existed with background structure （〈1 Hz, low frequency discharge）. The phase average wave exhibited opposed phase abnormal rhythm at 3 Hz. Prior to childhood absence epilepsy seizure, EEG detected opposed abnormal a rhythm and 3 Hz composition, which were not detected with traditional EEG. Compared to EEG signals from normal children, epileptic discharges from clinical and subclinical childhood absence epilepsy seizures were positive and amplitude was significantly greater （P〈0.05）.CONCLUSION： Wavelet transformation was used to analyze EEG signals from childhood absence epilepsy to obtain multi-scale quantitative characteristics and phase average waveforms. Multi-scale wavelet coefficients of EEG signals correlated with childhood absence epilepsy seizure, and multi-scale waveforms prior to epilepsy seizure were similar to characteristics during the onset period. Compared to normal children, EEG signals during epilepsy seizure exhibited an opposed phase model.

Outcomes and prognostic factors of patients with stage? ⅠB and? ⅡA pancreatic cancer according to the 8^(th) edition American Joint Committee on Cancer criteria

AIM To evaluate the changes in the 8^(th) edition American Joint Committee on Cancer(AJCC) for defining stage?ⅠB and?ⅡA pancreatic cancer and identify their prognostic factors.METHODS Pancreatic cancer patients were selected from the Surveillance Epidemiology and End Results database(1973-2013). The enrolled patients were divided into?ⅠB and?ⅡA groups based on tumor size according to the 8^(th) edition AJCC criteria. Clinical characteristics, including age, gender, race, tumor size, primary site, and grade were summarized. Univariate and multivariate analyses were performed to explore the prognostic factors of the?ⅠB and?ⅡA stages of pancreatic cancer under new criteria.RESULTS A total of 1349 pancreatic cancer patients were included. More patients had stage?ⅠB rather than stage?ⅡA. Stage?ⅠB tumors(54.85%) were mainly located in the head of the pancreas, while stage?ⅡA tumors were more often located in the tail and head of the pancreas(35.21% and 31.75%, respectively). The survival time of stage?ⅠB and?ⅡA patients had no significant difference. Univariate and multivariate analyses indicated that the prognostic factors of survival for stage?ⅠB and?ⅡA patients were different. for stage?ⅠB patients, age and primary site were the independent prognostic factors; for stage?ⅡA patients, age and grade were the independent prognostic factors. The risk of death was lower among patients aged ≤ 65 years than those aged > 65 years.CONCLUSION The prognostic factors for stage?ⅠB and?ⅡA patients are different, but age is the independent prognostic factor for all patients. The survival time of stage?ⅠB and?ⅡA patients has no significant difference.

Advances in Studies on Prevalence and Interaction Mechanism of Acquired Immunodeficiency Syndrome and Tuberculosis Coinfection

Human immunodeficiency virus(HIV) and tuberculosis(TB) coinfection is a serious public health problem. HIV and TB promote each other, accelerating development of HIV to acquired immunodeficiency syndrome(AIDS) and heightening TB mortality. Determining interaction mechanism between HIV and Mycobacterium tuberculosis can lead to development of effective treatments. This study summarizes prevalence status of AIDS and TB coinfection and research advances concerning their interaction mechanism.

Multicenter Clinical Study for Evaluation of Efficacy and Safety of Transdermal Fentanyl Matrix Patch in Treatment of Moderate to Severe Cancer Pain in 474 Chinese Cancer Patients

Objective: Although a new matrix formulation fentanyl has been used throughout the world for cancer pain management, few data about its efficacy and clinical outcomes associated with its use in Chinese patients have been obtained. This study aimed to assess the efficacy and safety of the new system in Chinese patients with moderate to severe cancer pain. Methods: A total of 474 patients with moderate to severe cancer pain were enrolled in this study and were treated with the new transdermal fentanyl matrix patch (TDF) up to 2 weeks. All the patients were asked to record pain intensity, side effects, quality of life (QOL), adherence and global satisfaction. The initial dose of fentanyl was 25 ?g/h titrated with opioid or according to National Comprehensive Cancer Network (NCCN) guidelines. Transdermal fentanyl was changed every three days. Results: After 2 weeks. The mean pain intensity of the 459 evaluated patients decreased significantly from 5.63?1.26 to 2.03?1.46 (P<0.0001). The total remission rate was 91.29%, of which moderate remission rate 53.16%, obvious remission rate 25.49% and complete remission rate 12.64%. The rate of adverse events was 33.75%, 18.78% of which were moderate and 3.80% were severe. The most frequent adverse events were constipation and nausea. No fatal events were observed. The quality of life was remarkably improved after the treatment (P<0.0001). Conclusion: The new TDF is effective and safe in treating patients with moderate to severe cancer pain, and can significantly improve the quality of life.

Chinese herbal protocol anti-fibrosis 1 improves radiation induced fibrosis and its related dysfunctions

Objective: Radiotherapy is the main modality for treatment of malignancies, but radiation fibrosis is a severe side effect of radiotherapy which may cause severe dysfunction of patients. We design a new tr aditional Chinese her bal pr otocol, which is named as Anti-fibrosis 1, and use it in patients with severe radiation fibrosis. Methods: From Feb 2013 to Feb 2014, 23 patients with severe radiation fibrosis and apparent dysfunction were treated with anti-fib rosis 1. The re were 7 pa ti ents with nasopharyngeal car cinoma, 7 with oral cavity and oral pharyngeal carcinoma, 2 with pharyngeal carcinoma, 2 with breast carcinoma, 2 with esophageal carcinoma and 3 patients with pelvic malignancies. All patients received radiothe rapy at least 0.5-8 years ago, and 22 pa ti ents with complete response, but all patients suffered with severe radiation fibrosis. The radiation dosage was among 50-74Gy/25-37f/35-70d. Patients status of fibrosis and recovery of tissue and organ were evaluated after 0.5, 1.5 and 3 months of herbal treatment. Results: 22 of 23 patients were head and neck car cinoma, 20 pati ents had got par tial r elief afte r 15 days medication with anti-fib rosis 1, nea rly all pa ti ents had got appa rent r elief afte r 1.5 month of medication. But, there was no apparent difference between 1.5 month and 3 months group. There were no apparent side effects after the herbal treatment. Conclusions: The traditional Chinese herbal protocol anti-fibrosis 1 is an effective and safe modality for radiation fibrosis. And the apparent effect occurred after 1.5 month of herbal medication.