BACKGROUND The diagnostic specificity of conventional ultrasound for breast non-mass lesions(NMLs)is low at approximately 21%-43%.Shear wave elastography(SWE)can distinguish benign from malignant lesions by evaluating...BACKGROUND The diagnostic specificity of conventional ultrasound for breast non-mass lesions(NMLs)is low at approximately 21%-43%.Shear wave elastography(SWE)can distinguish benign from malignant lesions by evaluating the internal and peripheral stiffness.SWE has good reproducibility and high diagnostic efficacy.However,there are very few independent studies on the diagnostic value of SWE in breast NMLs.AIM To determine the value of SWE in the differential diagnosis of breast NMLs.METHODS This study enrolled a total of 118 patients with breast NMLs who underwent SWE examinations in the Beijing Shijitan Hospital Affiliated to Capital Medical University and The Second Hospital of Shandong University from January 2019 to January 2020.The internal elastic parameters of the lesions were recorded,including maximum(Emax),mean(Emean)and minimum elastic values and the standard deviation.The following peripheral parameters were noted:Presence of a“stiff rim”sign;Emax,and Emean elasticity values within 1 mm,1.5 mm,2 mm,2.5 mm and 3 mm from the edge of NMLs.The receiver operating characteristic curve of each parameter was drawn,and the areas under the curve were calculated.RESULTS Emax,Emean and elastic values,and the standard deviation of the internal elastic values in malignant NMLs were significantly higher than those in benign NMLs(P<0.05).The percentage with the“stiff rim”sign in malignant NMLs was significantly higher than that in the benign group(P<0.05),and Emax and Emean at the shell of 1 mm,1.5 mm,2 mm,2.5 mm and 3 mm in the malignant group were all higher than those in the benign group(P<0.05).Of the surrounding elasticity values,Emax of the shell at 2.5 mm in malignant NMLs had maximum areas under the curve of 0.900,and the corresponding sensitivity and specificity were 94.57%and 85.86%,respectively.CONCLUSION The“stiff rim”sign and multiple quantitative elastic values within and around the lesion had good diagnostic performance in the differential diagnosis of breast NMLs.Emax in peripheral tissue had better diagnostic efficiency than other parameters.展开更多
Helicobacter pylori(H. pylori) is a kind of chronic infectious pathogen which can cause chronic gastritis, peptic ulcer, gastric cancer and other diseases. The genetic structure of the pathogenic genes of H. pylori va...Helicobacter pylori(H. pylori) is a kind of chronic infectious pathogen which can cause chronic gastritis, peptic ulcer, gastric cancer and other diseases. The genetic structure of the pathogenic genes of H. pylori varies largely, which contributes to the differences in virulence among various strains, and in clinical symptoms. Virulence genes of H. pylori can be categorized into three main classes: those related to adhesion and colonization, those related to gastric mucosal injury, and others. This review focuses on the relationship between genetic polymorphisms of the three classes of virulence genes of H. pylori and diseases. Most of the genetic polymorphisms of the main virulence factors of H. pylori are summarized in this paper.展开更多
Neoadjuvant chemoradiotherapy(nCRT)and total rectal mesenteric excision are the main standards of treatment for locally advanced rectal cancer(LARC).Lymph node regression grade(LRG)is an indicator of prognosis and res...Neoadjuvant chemoradiotherapy(nCRT)and total rectal mesenteric excision are the main standards of treatment for locally advanced rectal cancer(LARC).Lymph node regression grade(LRG)is an indicator of prognosis and response to preoperative nCRT based on postsurgical metastatic lymph node pathology.Common histopathological findings in metastatic lymph nodes after nCRT include necrosis,hemorrhage,nodular fibrosis,foamy histiocytes,cystic cell reactions,areas of hyalinosis,residual cancer cells,and pools of mucin.A number of LRG systems designed to classify the amount of lymph node regression after nCRT is mainly concerned with the relationship between residual cancer cells and regressive fibrosis and with estimating the number of lymph nodes existing with residual cancer cells.LRG offers significant prognostic information,and in most cases,LRG after nCRT correlates with patient outcomes.In this review,we describe the systematic classification of LRG after nCRT,patient prognosis,the correlation with tumor regression grade,and the typical histopathological findings of lymph nodes.This work may serve as a reference to help predict the clinical complete response and determine lymph node regression in patients based on preservation strategies,allowing for the formulation of more accurate treatment strategies for LARC patients,which has important clinical significance and scientific value.展开更多
BACKGROUND The Rex shunt was widely used as the preferred surgical approach for cavernous transformation of the portal vein(CTPV)in children that creates a bypass between the superior mesenteric vein and the intrahepa...BACKGROUND The Rex shunt was widely used as the preferred surgical approach for cavernous transformation of the portal vein(CTPV)in children that creates a bypass between the superior mesenteric vein and the intrahepatic left portal vein(LPV).This procedure can relieve portal hypertension and restore physiological hepatopetal flow.However,the modified procedure is technically demanding because it is difficult to make an end-to-end anastomosis of a bypass to a hypoplastic LPV.Many studies reported using a recanalized umbilical vein as a conduit to resolve this problem.However,the feasibility of umbilical vein recanalization for a Rex shunt has not been fully investigated.AIM To investigate the efficacy of a recanalized umbilical vein as a conduit for a Rex shunt on CTPV in children by ultrasonography.METHODS A total of 47 children who were diagnosed with CTPV with prehepatic portal hypertension in the Second Hospital,Cheeloo College of Medicine,Shandong University,were enrolled in this study.Fifteen children received a recanalized umbilical vein as a conduit for a Rex shunt surgery and were enrolled in group I.Thirty-two children received the classic Rex shunt surgery and were enrolled in group II.The sonographic features of the two groups related to intraoperative and postoperative variation in terms of bypass vessel and the LPV were compared.RESULTS The patency rate of group I(60.0%,9/15)was significantly lower than that of group II(87.5%,28/32)7 d after(on the 8th d)operation(P<0.05).After clinical anticoagulation treatment for 3 mo,there was no significant difference in the patency rate between group I(86.7%,13/15)and group II(90.6%,29/32)(P>0.05).Moreover,3 mo after(at the beginning of the 4th mo)surgery,the inner diameter significantly widened and flow velocity notably increased for the bypass vessels and the sagittal part of the LPV compared to intraoperative values in both shunt groups(P<0.05).However,there was no significant difference between the two surgical groups 3 mo after surgery(P>0.05).CONCLUSION For children with hypoplastic LPV in the Rex recessus,using a recanalized umbilical vein as a conduit for a Rex shunt may be an effective procedure for CTPV treatment.展开更多
Soil nitrification is mediated by ammonia-oxidizing archaea (AOA) and bacteria (AOB), which occupy different specialized ecological niches. However, little is known about the diversification of AOA and AOB communities...Soil nitrification is mediated by ammonia-oxidizing archaea (AOA) and bacteria (AOB), which occupy different specialized ecological niches. However, little is known about the diversification of AOA and AOB communities in a large geographical scale. Here, eight paddy soils collected from different geographic regions in China were selected to investigate the spatial distribution of AOA and AOB, and their potential nitrification activity (PNA). The result showed that the abundance of AOA was predominant over AOB, indicating that the rice fields favor the growth of AOA. PNA highly varied from 0.43 to 3.57 μg NOX-N·g·dry·soil·h-1, and was positively related with soil NH3 content, the abundance of AOA community, and negatively related with the diversity of AOB community (P amoA genes revealed remarkable differences in the compositions of AOA and AOB community. Phylogenetic analyses of amoA genes showed that Nitrosospiracluster-3-like and Nitrosomonas cluster 7-like AOB extensively dominated the AOB communities, and 54d9-like AOA within the soil group 1.1b predominated in AOA communities in paddy soils. Redundancy analysis suggested that the spatial variations of AOA community structure were influenced by soil TN content (P < 0.01), while no significant correlation between AOB community structure and soil properties was found. Findings highlight that ammonia oxidizers exhibit spatial variations in complex paddy fields due to the joint influence of soil variables associated with N availability.展开更多
Objective:This study aims to determine the knowledge and attitudes of nurses concerning climate change and their role in addressing health-related impacts of climate change in Central China.Method:The cross-sectional ...Objective:This study aims to determine the knowledge and attitudes of nurses concerning climate change and their role in addressing health-related impacts of climate change in Central China.Method:The cross-sectional study was conducted in 2014.The study randomly selected nurses from hospitals in Central of China and they were asked to complete a questionnaire about climate change Descriptive statistical analysis was used to analyze the data.Results:Majority of nurses(76%)knew about the climate change would affect public health.But more than half of the nurses did not know their work could also affect the development of climate change;83e96%of the nurses thought it were necessary and would like to learn the knowledge about climate change.Conclusion:The education program about this issue in Chinese colleges or universities is still very weak nursing courses and needs to be emphasized in the future.展开更多
BACKGROUND Hyponatremia is a common clinical electrolyte disorder.However,the association between hyponatremia and acute hypothyroidism is unclear.Acute hypothyroidism is usually seen in patients who undergo preparati...BACKGROUND Hyponatremia is a common clinical electrolyte disorder.However,the association between hyponatremia and acute hypothyroidism is unclear.Acute hypothyroidism is usually seen in patients who undergo preparation for radioactive iodine therapy.AIM To analyze the incidence and influencing factors of hyponatremia in a condition of iatrogenic acute hypothyroidism in patients with differentiated thyroid cancer(DTC)before ^(131)I treatment.METHODS The study group consisted of 903 DTC patients who received ^(131)I treatment.The clinical data before and after surgery,as well as on the day of ^(131)I treatment were analyzed.According to the blood sodium level before ^(131)I treatment,patients were divided into the non-hyponatremia group and hyponatremia group.Correlations between serum sodium levels before ^(131)I treatment and baseline data were analyzed.Univariate analysis and binary logistic regression were performed to identify the influencing factors of hyponatremia.RESULTS A total of 903 patients with DTC,including 283(31.3%)males and 620(68.7%)females,with an average age of 43.8±12.7 years,were included in this study.The serum sodium levels before surgery and ^(131)I treatment were 141.3±2.3 and 140.5±2.1 mmol/L,respectively(P=0.001).However,the serum sodium levels in males and females before ^(131)I treatment were lower than those before surgery.Patients aged more than 60 years and less than 60 years also showed decreased serum sodium levels before ^(131)I treatment.In addition,the estimated glomerular filtration rate(eGFR)in males and females decreased before ^(131)I treatment compared with those before surgery(P=0.001).Moreover,eGFR in patients over 60 years and under 60 years decreased before ^(131)I treatment,when compared with that before surgery.There were no significant differences in serum potassium,calcium,albumin,hemoglobin,and blood glucose in patients before surgery and ^(131)I treatment(P>0.05).Among the 903 patients,23(2.5%)were diagnosed with hyponatremia before ^(131)I treatment,including 21 cases(91.3%)of mild hyponatremia and 2 cases(8.7%)of moderate hyponatremia.Clinical data showed that patients with mild hyponatremia had no specific clinical manifestations,while moderate hyponatremia cases were mainly characterized by fatigue and dizziness,which were similar to neurological symptoms caused by hypothyroidism and were difficult to distinguish.Correlation analysis showed a correlation between serum sodium before ^(131)I treatment and the preoperative level(r=0.395,P=0.001).There was no significant correlation between blood sodium and thyroid-stimulating hormone(TSH)levels and urine iodine before ^(131)I treatment(r=0.045,P=0.174;r=0.013,P=0.697).Univariate analysis showed that there were significant differences in age,sex,history of diuretic use,distant metastasis,preoperative blood sodium,blood urea nitrogen(BUN),eGFR,TSH and urinary iodine between the two groups(all P<0.05).Logistic regression analysis showed that factors such as history of diuretic use,distant metastases,preoperative sodium and BUN were all influencing factors of hyponatremia.The Hosmer and Lemeshow test(c2=2.841,P=0.944)suggested a high fit of the model.Omnibus tests of model coefficients indicated the overall significance of the model in this fitted model(P<0.05).Preoperative serum sodium was a significant factor associated with pre-^(131)I therapy hyponatremia(OR=0.763;95%CI:0.627-0.928;P=0.007).CONCLUSION The incidence of hyponatremia induced by ^(131)I treatment preparation was not high.Preparation for radioactive iodine therapy was not a risk factor for the development of hyponatremia in thyroid cancer patients.展开更多
Objective:To study the effect of lithium carbonate combined with131I therapy on thyroid function as well as the Fas/FasL expression in peripheral blood of patients with Graves disease and leukopenia.Methods:124 patien...Objective:To study the effect of lithium carbonate combined with131I therapy on thyroid function as well as the Fas/FasL expression in peripheral blood of patients with Graves disease and leukopenia.Methods:124 patients with Graves disease and leukopenia treated in our hospital between May 2012 and October 2015 were randomly divided into the observation group (n=62) who received lithium carbonate combined with131I therapy and control group (n=62) who received131I therapy, and the outcome, autoantibody content, proportion of T lymphocyte subsets as well as the expression levels of Fas and FasL were compared between two groups of patients.Results: 3 months and 6 months after treatment, serum thyroid hormones free triiodothyronine (FT3) and serum free thyroxine (FT4) levels as well as autoantibodies TSAb, TGAb and TPOAb content of observation group were significantly lower than those of control group (P<0.05) while peripheral blood white blood cell count was significantly higher than that of control group (P<0.05);proportion of Treg cells in peripheral blood of observation group was significantly higher than that of control group (P<0.05) while the proportion of Th1 and Th2 cells as well as the expression levels of Fas and FasL were significantly lower than those of control group (P<0.05).Conclusions: Lithium carbonate combined with131I treatment of Graves disease complicated with leukopenia can reduce the thyroid hormone synthesis, increase white blood cell count and regulate the proportion of T lymphocyte subsets as well as the expression of Fas/FasL.展开更多
BACKGROUND Autoimmune atrophic gastritis(AAG)is a type of chronic gastritis that mainly affects the gastric corpus.Due to the lack of standard diagnostic criteria and overlaps with the courses of Helicobacter pylori-r...BACKGROUND Autoimmune atrophic gastritis(AAG)is a type of chronic gastritis that mainly affects the gastric corpus.Due to the lack of standard diagnostic criteria and overlaps with the courses of Helicobacter pylori-related atrophic gastritis,reports on the diagnostic strategy of AAG at an early stage are limited.CASE SUMMARY A 71-year-old woman with severe anemia was diagnosed with AAG.Endoscopic views and pathological findings showed the coexistence of normal mucosa in the gastric antrum and atrophic mucosa in the gastric fundus.Serological tests showed that anti-parietal cell antibodies and anti-intrinsic factor antibodies were both positive.Immunohistochemical results,which showed negative H^(+)-K^(+)ATPase antibody staining and positive chromogranin A(CgA)staining,confirmed the mechanism of this disease.After vitamin B12 and folic acid supplementation,the patient recovered well.CONCLUSION Successful diagnosis of AAG includes serological tests,endoscopic characteristics,and immunohistochemistry for H^(+)-K^(+)ATPase and CgA antibodies.展开更多
Objective:To study the value of serum PCSK9 for evaluating the severity in patients with type 2 diabetes mellitus and atherosclerosis. Methods:Type 2 diabetic patients with carotid atherosclerosis who were treated in ...Objective:To study the value of serum PCSK9 for evaluating the severity in patients with type 2 diabetes mellitus and atherosclerosis. Methods:Type 2 diabetic patients with carotid atherosclerosis who were treated in our hospital between May 2014 and September 2016 were selected as group A (n=69), type 2 diabetic patients without carotid atherosclerosis were selected as group B (n=79) and healthy subjects were selected as group C (n=55). Serum levels of SPCSK9, lipid metabolism indexes and oxidative stress indexes of three groups of subjects were detected. Results:Serum proprotein convertase subtilisin kexin 9 (PCSK9), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), CyPA, paraoxonase-1 (PON-1), PON-3, malondialdehyde (MDA) and 8-iso-prostaglandin F-2α(8-iso-PGF2α) levels of group A and group B were significantly higher than those of group C (P<0.05) while high-density lipoprotein cholesterol (HDL-C) and apolipoprotein AI (ApoAI) levels were significantly lower than those of group C (P<0.05);serum PCSK9, TG, TC, LDL-C, ApoB, CyPA, PON-1, PON-3, MDA and 8-iso-PGF2αlevels of group A were significantly higher than those of group B (P<0.05) while HDL-C and ApoAI levels were significantly lower than those of group B (P<0.05);serum TG, TC, LDL-C, ApoB, CyPA, PON-1, PON-3, MDA and 8-iso-PGF2αlevels of high PCSK9 level subgroup in group A were significantly higher than those of low PCSK9 level subgroup (P<0.05) while HDL-C and ApoAI levels were significantly lower than those of low PCSK9 level subgroup (P<0.05). Conclusions:Abnormally elevated serum PCSK9 can affect lipid metabolism and enhance oxidative stress in patients with type 2 diabetes mellitus and atherosclerosis.展开更多
Background Progressive pseudorheumatoid dysplasia(PPRD)is a rare genetic disease with autosomal recessive inherit-ance.There was a lack of genotype-phenotype correlation data from the Chinese population.This study aim...Background Progressive pseudorheumatoid dysplasia(PPRD)is a rare genetic disease with autosomal recessive inherit-ance.There was a lack of genotype-phenotype correlation data from the Chinese population.This study aimed to identify the genotype and phenotype characteristics of Chinese PPRD patients and to conduct a genotype-phenotype analysis of Chinese PPRD patients.Methods Genetic analysis was performed for suspected PPRD patients from Peking Union Medical College Hospital.Medi-cal records were collected from the electronic medical record system and patient-held portable health records.Published Chinese PPRD cases were gathered from both international and Chinese local databases.We collected demographic infor-mation,genetic variants,clinical manifestations,and imaging characteristics for further analysis.Results We included 105 Chinese PPRD patients in the current study.Thirty-three variants,including nine novels and five hotspot variants,were identified,with 26/33(79%)variants exclusively seen in the Chinese population.Chinese PPRD patients share a phenotype similar to that in international reports.Joint involvement may progress with age(R2=0.2541).Long bone shortening and severe deformities occur in three patients with biallelic null variants,of which at least one vari-ant is located in exon 2.Among hotspot variants,c.624dupA(p.C209Mfs*21)were associated with later onset and more involved joints.Elbow joints were more likely to be affected in patients carrying c.624dupA(p.C209Mfs*21)and c.866dupA(p.S209Efs*13).Shoulder joints are more likely to be involved in patients with biallelic null variants(P=0.027).Conclusions Chinese PPRD patients share a unique mutation spectrum.Among the five hotspot variants,c.624dupA is associated with later onset of disease,more extensive joint involvement,and a tendency to affect elbow joints.Biallelic null variants with at least one variant in exon 2 could be a likely cause of long bone shortening and severe deformities.展开更多
Objective The purpose of this work is to evaluate the in vitro inhibitory effect of magnolol(MN) and honokiol(HN) on rat / human cytochrome P450(CYP) enzymes(1A2/1A2, 2D/2D6, 3A/3A4, 2E1/2E1, and 2C/2C9). Methods Rat ...Objective The purpose of this work is to evaluate the in vitro inhibitory effect of magnolol(MN) and honokiol(HN) on rat / human cytochrome P450(CYP) enzymes(1A2/1A2, 2D/2D6, 3A/3A4, 2E1/2E1, and 2C/2C9). Methods Rat liver microsomes(RLM) and human liver microsomes(HLM) were used as the enzyme sources. After the probe substrate of each CYP isoforms was co-incubated individually with MN or HN in RLM or HLM, the metabolite production of each probe substrate in RLM and HLM incubation medium was determined and used to evaluate the activity of corresponding CYP isoforms. Results MN inhibited rat CYP1A2 and human CYP3A4 with the IC50 values of 10.0 and 56.2 μmol/L, respectively. HN inhibited rat CYP1A2 and CYP2E1, human CYP1A2 and CYP3A4 with the IC50 values of 12.1, 12.6, 17.8, and 43.9 μmol/L, respectively. Conclusion HN is a moderate or weak inhibitor of human CYP1A2. Both MN and HN are weak or non inhibitors of the other tested human CYP isoforms. The results suggest that no significant metabolic interaction seems likely to occur when the substrate drugs of CYP isoforms tested in the present work are co-administered with MN and HN.展开更多
Objective To investigate the metabolism of strychnine(STN)and the metabolic interaction between STN and glycyrrhetic acid(GA)in vitro.Methods Human liver microsomes(HLM)and human recombinant cytochrome P450(CYP)isofor...Objective To investigate the metabolism of strychnine(STN)and the metabolic interaction between STN and glycyrrhetic acid(GA)in vitro.Methods Human liver microsomes(HLM)and human recombinant cytochrome P450(CYP)isoforms were employed to study the metabolism of STN and the metabolic interaction of STN with GA in vitro.Results In HLM,the Km,Vmax,and clearance of STN were 88.50μmol/L,0.88 nmol/(mg·min),and 9.93 mL/(mg·min),respectively.STN was metabolized mainly by CYP3A4.However,STN noncompetitively inhibited CYP3A4-catalyzed testosterone 6β-hydroxylation with IC50 value of 5.9μmol/L and Ki value of 5.5 μmol/L.Moreover,GA competitively inhibited STN metabolism with IC50 value of 10.6μmol/L and Ki value of 17.7μmol/L.Conclusion Although STN is mainly metabolized by CYP3A4 in vitro,STN has noncompetitive inhibition on CYP3A4-catalyzed testosterone 6β-hydroxylation.Moreover,GA could competitively inhibit STN metabolism.The present work is helpful to elucidate the metabolic interaction between STN and GA.展开更多
Papillary thyroid carcinoma(PTC)is the most common type(accounting for over 80%)of thyroid cancer.[1]Although PTC is a well-differentiated endocrine neoplasm,unfortunately,certain PTCs show malignant characteristics s...Papillary thyroid carcinoma(PTC)is the most common type(accounting for over 80%)of thyroid cancer.[1]Although PTC is a well-differentiated endocrine neoplasm,unfortunately,certain PTCs show malignant characteristics such as aggressiveness and metastasis;these characteristics contribute to a poor 5-year survival rate.[1]However,the fundamental molecular mechanism of extra-thyroid metastasis remains unclear.展开更多
基金This project was supported by grants from National Natural Science Foundation of China （Nos. 81701476 and 81200354）, Hubei Provincial Population and Family Planning Commission of China （No. JS-20130017）, and Applied Basic Research Plan of Wuhan （No. 2015060101010037）.
文摘BACKGROUND The diagnostic specificity of conventional ultrasound for breast non-mass lesions(NMLs)is low at approximately 21%-43%.Shear wave elastography(SWE)can distinguish benign from malignant lesions by evaluating the internal and peripheral stiffness.SWE has good reproducibility and high diagnostic efficacy.However,there are very few independent studies on the diagnostic value of SWE in breast NMLs.AIM To determine the value of SWE in the differential diagnosis of breast NMLs.METHODS This study enrolled a total of 118 patients with breast NMLs who underwent SWE examinations in the Beijing Shijitan Hospital Affiliated to Capital Medical University and The Second Hospital of Shandong University from January 2019 to January 2020.The internal elastic parameters of the lesions were recorded,including maximum(Emax),mean(Emean)and minimum elastic values and the standard deviation.The following peripheral parameters were noted:Presence of a“stiff rim”sign;Emax,and Emean elasticity values within 1 mm,1.5 mm,2 mm,2.5 mm and 3 mm from the edge of NMLs.The receiver operating characteristic curve of each parameter was drawn,and the areas under the curve were calculated.RESULTS Emax,Emean and elastic values,and the standard deviation of the internal elastic values in malignant NMLs were significantly higher than those in benign NMLs(P<0.05).The percentage with the“stiff rim”sign in malignant NMLs was significantly higher than that in the benign group(P<0.05),and Emax and Emean at the shell of 1 mm,1.5 mm,2 mm,2.5 mm and 3 mm in the malignant group were all higher than those in the benign group(P<0.05).Of the surrounding elasticity values,Emax of the shell at 2.5 mm in malignant NMLs had maximum areas under the curve of 0.900,and the corresponding sensitivity and specificity were 94.57%and 85.86%,respectively.CONCLUSION The“stiff rim”sign and multiple quantitative elastic values within and around the lesion had good diagnostic performance in the differential diagnosis of breast NMLs.Emax in peripheral tissue had better diagnostic efficiency than other parameters.
基金Supported by National Natural Science Foundation of China,No.31460023Natural Science Foundation of Guangxi,No.2014GXNSFAA118206+2 种基金Guangxi Key Discipline Fund(Pathogenic Microbiology)No.[2013]16Key Laboratory Fund of Colleges and Universities in Guangxi,No.Gui Jiao Ke Yan[2014]6
文摘Helicobacter pylori(H. pylori) is a kind of chronic infectious pathogen which can cause chronic gastritis, peptic ulcer, gastric cancer and other diseases. The genetic structure of the pathogenic genes of H. pylori varies largely, which contributes to the differences in virulence among various strains, and in clinical symptoms. Virulence genes of H. pylori can be categorized into three main classes: those related to adhesion and colonization, those related to gastric mucosal injury, and others. This review focuses on the relationship between genetic polymorphisms of the three classes of virulence genes of H. pylori and diseases. Most of the genetic polymorphisms of the main virulence factors of H. pylori are summarized in this paper.
基金Supported by Chengdu Science and Technology Project,No. 2021-YF05-01484-SNExcellent Youthof Sichuan Cancer Hospital,No. YB2021037Health Commission of Sichuan Province,No. 20PJ112
文摘Neoadjuvant chemoradiotherapy(nCRT)and total rectal mesenteric excision are the main standards of treatment for locally advanced rectal cancer(LARC).Lymph node regression grade(LRG)is an indicator of prognosis and response to preoperative nCRT based on postsurgical metastatic lymph node pathology.Common histopathological findings in metastatic lymph nodes after nCRT include necrosis,hemorrhage,nodular fibrosis,foamy histiocytes,cystic cell reactions,areas of hyalinosis,residual cancer cells,and pools of mucin.A number of LRG systems designed to classify the amount of lymph node regression after nCRT is mainly concerned with the relationship between residual cancer cells and regressive fibrosis and with estimating the number of lymph nodes existing with residual cancer cells.LRG offers significant prognostic information,and in most cases,LRG after nCRT correlates with patient outcomes.In this review,we describe the systematic classification of LRG after nCRT,patient prognosis,the correlation with tumor regression grade,and the typical histopathological findings of lymph nodes.This work may serve as a reference to help predict the clinical complete response and determine lymph node regression in patients based on preservation strategies,allowing for the formulation of more accurate treatment strategies for LARC patients,which has important clinical significance and scientific value.
文摘BACKGROUND The Rex shunt was widely used as the preferred surgical approach for cavernous transformation of the portal vein(CTPV)in children that creates a bypass between the superior mesenteric vein and the intrahepatic left portal vein(LPV).This procedure can relieve portal hypertension and restore physiological hepatopetal flow.However,the modified procedure is technically demanding because it is difficult to make an end-to-end anastomosis of a bypass to a hypoplastic LPV.Many studies reported using a recanalized umbilical vein as a conduit to resolve this problem.However,the feasibility of umbilical vein recanalization for a Rex shunt has not been fully investigated.AIM To investigate the efficacy of a recanalized umbilical vein as a conduit for a Rex shunt on CTPV in children by ultrasonography.METHODS A total of 47 children who were diagnosed with CTPV with prehepatic portal hypertension in the Second Hospital,Cheeloo College of Medicine,Shandong University,were enrolled in this study.Fifteen children received a recanalized umbilical vein as a conduit for a Rex shunt surgery and were enrolled in group I.Thirty-two children received the classic Rex shunt surgery and were enrolled in group II.The sonographic features of the two groups related to intraoperative and postoperative variation in terms of bypass vessel and the LPV were compared.RESULTS The patency rate of group I(60.0%,9/15)was significantly lower than that of group II(87.5%,28/32)7 d after(on the 8th d)operation(P<0.05).After clinical anticoagulation treatment for 3 mo,there was no significant difference in the patency rate between group I(86.7%,13/15)and group II(90.6%,29/32)(P>0.05).Moreover,3 mo after(at the beginning of the 4th mo)surgery,the inner diameter significantly widened and flow velocity notably increased for the bypass vessels and the sagittal part of the LPV compared to intraoperative values in both shunt groups(P<0.05).However,there was no significant difference between the two surgical groups 3 mo after surgery(P>0.05).CONCLUSION For children with hypoplastic LPV in the Rex recessus,using a recanalized umbilical vein as a conduit for a Rex shunt may be an effective procedure for CTPV treatment.
文摘Soil nitrification is mediated by ammonia-oxidizing archaea (AOA) and bacteria (AOB), which occupy different specialized ecological niches. However, little is known about the diversification of AOA and AOB communities in a large geographical scale. Here, eight paddy soils collected from different geographic regions in China were selected to investigate the spatial distribution of AOA and AOB, and their potential nitrification activity (PNA). The result showed that the abundance of AOA was predominant over AOB, indicating that the rice fields favor the growth of AOA. PNA highly varied from 0.43 to 3.57 μg NOX-N·g·dry·soil·h-1, and was positively related with soil NH3 content, the abundance of AOA community, and negatively related with the diversity of AOB community (P amoA genes revealed remarkable differences in the compositions of AOA and AOB community. Phylogenetic analyses of amoA genes showed that Nitrosospiracluster-3-like and Nitrosomonas cluster 7-like AOB extensively dominated the AOB communities, and 54d9-like AOA within the soil group 1.1b predominated in AOA communities in paddy soils. Redundancy analysis suggested that the spatial variations of AOA community structure were influenced by soil TN content (P < 0.01), while no significant correlation between AOB community structure and soil properties was found. Findings highlight that ammonia oxidizers exhibit spatial variations in complex paddy fields due to the joint influence of soil variables associated with N availability.
基金This work was supported by the Wuhan Middle-age and Young Talent Foundation and the Natural Science Foundation of Hubei Province of China(No.304132169).
文摘Objective:This study aims to determine the knowledge and attitudes of nurses concerning climate change and their role in addressing health-related impacts of climate change in Central China.Method:The cross-sectional study was conducted in 2014.The study randomly selected nurses from hospitals in Central of China and they were asked to complete a questionnaire about climate change Descriptive statistical analysis was used to analyze the data.Results:Majority of nurses(76%)knew about the climate change would affect public health.But more than half of the nurses did not know their work could also affect the development of climate change;83e96%of the nurses thought it were necessary and would like to learn the knowledge about climate change.Conclusion:The education program about this issue in Chinese colleges or universities is still very weak nursing courses and needs to be emphasized in the future.
文摘BACKGROUND Hyponatremia is a common clinical electrolyte disorder.However,the association between hyponatremia and acute hypothyroidism is unclear.Acute hypothyroidism is usually seen in patients who undergo preparation for radioactive iodine therapy.AIM To analyze the incidence and influencing factors of hyponatremia in a condition of iatrogenic acute hypothyroidism in patients with differentiated thyroid cancer(DTC)before ^(131)I treatment.METHODS The study group consisted of 903 DTC patients who received ^(131)I treatment.The clinical data before and after surgery,as well as on the day of ^(131)I treatment were analyzed.According to the blood sodium level before ^(131)I treatment,patients were divided into the non-hyponatremia group and hyponatremia group.Correlations between serum sodium levels before ^(131)I treatment and baseline data were analyzed.Univariate analysis and binary logistic regression were performed to identify the influencing factors of hyponatremia.RESULTS A total of 903 patients with DTC,including 283(31.3%)males and 620(68.7%)females,with an average age of 43.8±12.7 years,were included in this study.The serum sodium levels before surgery and ^(131)I treatment were 141.3±2.3 and 140.5±2.1 mmol/L,respectively(P=0.001).However,the serum sodium levels in males and females before ^(131)I treatment were lower than those before surgery.Patients aged more than 60 years and less than 60 years also showed decreased serum sodium levels before ^(131)I treatment.In addition,the estimated glomerular filtration rate(eGFR)in males and females decreased before ^(131)I treatment compared with those before surgery(P=0.001).Moreover,eGFR in patients over 60 years and under 60 years decreased before ^(131)I treatment,when compared with that before surgery.There were no significant differences in serum potassium,calcium,albumin,hemoglobin,and blood glucose in patients before surgery and ^(131)I treatment(P>0.05).Among the 903 patients,23(2.5%)were diagnosed with hyponatremia before ^(131)I treatment,including 21 cases(91.3%)of mild hyponatremia and 2 cases(8.7%)of moderate hyponatremia.Clinical data showed that patients with mild hyponatremia had no specific clinical manifestations,while moderate hyponatremia cases were mainly characterized by fatigue and dizziness,which were similar to neurological symptoms caused by hypothyroidism and were difficult to distinguish.Correlation analysis showed a correlation between serum sodium before ^(131)I treatment and the preoperative level(r=0.395,P=0.001).There was no significant correlation between blood sodium and thyroid-stimulating hormone(TSH)levels and urine iodine before ^(131)I treatment(r=0.045,P=0.174;r=0.013,P=0.697).Univariate analysis showed that there were significant differences in age,sex,history of diuretic use,distant metastasis,preoperative blood sodium,blood urea nitrogen(BUN),eGFR,TSH and urinary iodine between the two groups(all P<0.05).Logistic regression analysis showed that factors such as history of diuretic use,distant metastases,preoperative sodium and BUN were all influencing factors of hyponatremia.The Hosmer and Lemeshow test(c2=2.841,P=0.944)suggested a high fit of the model.Omnibus tests of model coefficients indicated the overall significance of the model in this fitted model(P<0.05).Preoperative serum sodium was a significant factor associated with pre-^(131)I therapy hyponatremia(OR=0.763;95%CI:0.627-0.928;P=0.007).CONCLUSION The incidence of hyponatremia induced by ^(131)I treatment preparation was not high.Preparation for radioactive iodine therapy was not a risk factor for the development of hyponatremia in thyroid cancer patients.
文摘Objective:To study the effect of lithium carbonate combined with131I therapy on thyroid function as well as the Fas/FasL expression in peripheral blood of patients with Graves disease and leukopenia.Methods:124 patients with Graves disease and leukopenia treated in our hospital between May 2012 and October 2015 were randomly divided into the observation group (n=62) who received lithium carbonate combined with131I therapy and control group (n=62) who received131I therapy, and the outcome, autoantibody content, proportion of T lymphocyte subsets as well as the expression levels of Fas and FasL were compared between two groups of patients.Results: 3 months and 6 months after treatment, serum thyroid hormones free triiodothyronine (FT3) and serum free thyroxine (FT4) levels as well as autoantibodies TSAb, TGAb and TPOAb content of observation group were significantly lower than those of control group (P<0.05) while peripheral blood white blood cell count was significantly higher than that of control group (P<0.05);proportion of Treg cells in peripheral blood of observation group was significantly higher than that of control group (P<0.05) while the proportion of Th1 and Th2 cells as well as the expression levels of Fas and FasL were significantly lower than those of control group (P<0.05).Conclusions: Lithium carbonate combined with131I treatment of Graves disease complicated with leukopenia can reduce the thyroid hormone synthesis, increase white blood cell count and regulate the proportion of T lymphocyte subsets as well as the expression of Fas/FasL.
文摘BACKGROUND Autoimmune atrophic gastritis(AAG)is a type of chronic gastritis that mainly affects the gastric corpus.Due to the lack of standard diagnostic criteria and overlaps with the courses of Helicobacter pylori-related atrophic gastritis,reports on the diagnostic strategy of AAG at an early stage are limited.CASE SUMMARY A 71-year-old woman with severe anemia was diagnosed with AAG.Endoscopic views and pathological findings showed the coexistence of normal mucosa in the gastric antrum and atrophic mucosa in the gastric fundus.Serological tests showed that anti-parietal cell antibodies and anti-intrinsic factor antibodies were both positive.Immunohistochemical results,which showed negative H^(+)-K^(+)ATPase antibody staining and positive chromogranin A(CgA)staining,confirmed the mechanism of this disease.After vitamin B12 and folic acid supplementation,the patient recovered well.CONCLUSION Successful diagnosis of AAG includes serological tests,endoscopic characteristics,and immunohistochemistry for H^(+)-K^(+)ATPase and CgA antibodies.
基金National Natural Science Foundation of China(81601373).
文摘Objective:To study the value of serum PCSK9 for evaluating the severity in patients with type 2 diabetes mellitus and atherosclerosis. Methods:Type 2 diabetic patients with carotid atherosclerosis who were treated in our hospital between May 2014 and September 2016 were selected as group A (n=69), type 2 diabetic patients without carotid atherosclerosis were selected as group B (n=79) and healthy subjects were selected as group C (n=55). Serum levels of SPCSK9, lipid metabolism indexes and oxidative stress indexes of three groups of subjects were detected. Results:Serum proprotein convertase subtilisin kexin 9 (PCSK9), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), CyPA, paraoxonase-1 (PON-1), PON-3, malondialdehyde (MDA) and 8-iso-prostaglandin F-2α(8-iso-PGF2α) levels of group A and group B were significantly higher than those of group C (P<0.05) while high-density lipoprotein cholesterol (HDL-C) and apolipoprotein AI (ApoAI) levels were significantly lower than those of group C (P<0.05);serum PCSK9, TG, TC, LDL-C, ApoB, CyPA, PON-1, PON-3, MDA and 8-iso-PGF2αlevels of group A were significantly higher than those of group B (P<0.05) while HDL-C and ApoAI levels were significantly lower than those of group B (P<0.05);serum TG, TC, LDL-C, ApoB, CyPA, PON-1, PON-3, MDA and 8-iso-PGF2αlevels of high PCSK9 level subgroup in group A were significantly higher than those of low PCSK9 level subgroup (P<0.05) while HDL-C and ApoAI levels were significantly lower than those of low PCSK9 level subgroup (P<0.05). Conclusions:Abnormally elevated serum PCSK9 can affect lipid metabolism and enhance oxidative stress in patients with type 2 diabetes mellitus and atherosclerosis.
基金the CAMS Innovation Fund for Medical Sciences(CIFMS 2021-I2M-1-003)the National Key R&DProgramof China(2021YFC2702001,2016YFC0901500)National High Level Hospital Clinical Research Funding(2022-PUMCH-B-079).
文摘Background Progressive pseudorheumatoid dysplasia(PPRD)is a rare genetic disease with autosomal recessive inherit-ance.There was a lack of genotype-phenotype correlation data from the Chinese population.This study aimed to identify the genotype and phenotype characteristics of Chinese PPRD patients and to conduct a genotype-phenotype analysis of Chinese PPRD patients.Methods Genetic analysis was performed for suspected PPRD patients from Peking Union Medical College Hospital.Medi-cal records were collected from the electronic medical record system and patient-held portable health records.Published Chinese PPRD cases were gathered from both international and Chinese local databases.We collected demographic infor-mation,genetic variants,clinical manifestations,and imaging characteristics for further analysis.Results We included 105 Chinese PPRD patients in the current study.Thirty-three variants,including nine novels and five hotspot variants,were identified,with 26/33(79%)variants exclusively seen in the Chinese population.Chinese PPRD patients share a phenotype similar to that in international reports.Joint involvement may progress with age(R2=0.2541).Long bone shortening and severe deformities occur in three patients with biallelic null variants,of which at least one vari-ant is located in exon 2.Among hotspot variants,c.624dupA(p.C209Mfs*21)were associated with later onset and more involved joints.Elbow joints were more likely to be affected in patients carrying c.624dupA(p.C209Mfs*21)and c.866dupA(p.S209Efs*13).Shoulder joints are more likely to be involved in patients with biallelic null variants(P=0.027).Conclusions Chinese PPRD patients share a unique mutation spectrum.Among the five hotspot variants,c.624dupA is associated with later onset of disease,more extensive joint involvement,and a tendency to affect elbow joints.Biallelic null variants with at least one variant in exon 2 could be a likely cause of long bone shortening and severe deformities.
基金supported financially by the Hubei Province Natural Science Funds (No.2013ZR009)
文摘Objective The purpose of this work is to evaluate the in vitro inhibitory effect of magnolol(MN) and honokiol(HN) on rat / human cytochrome P450(CYP) enzymes(1A2/1A2, 2D/2D6, 3A/3A4, 2E1/2E1, and 2C/2C9). Methods Rat liver microsomes(RLM) and human liver microsomes(HLM) were used as the enzyme sources. After the probe substrate of each CYP isoforms was co-incubated individually with MN or HN in RLM or HLM, the metabolite production of each probe substrate in RLM and HLM incubation medium was determined and used to evaluate the activity of corresponding CYP isoforms. Results MN inhibited rat CYP1A2 and human CYP3A4 with the IC50 values of 10.0 and 56.2 μmol/L, respectively. HN inhibited rat CYP1A2 and CYP2E1, human CYP1A2 and CYP3A4 with the IC50 values of 12.1, 12.6, 17.8, and 43.9 μmol/L, respectively. Conclusion HN is a moderate or weak inhibitor of human CYP1A2. Both MN and HN are weak or non inhibitors of the other tested human CYP isoforms. The results suggest that no significant metabolic interaction seems likely to occur when the substrate drugs of CYP isoforms tested in the present work are co-administered with MN and HN.
基金National Natural Science Foundation of China (30630075)
文摘Objective To investigate the metabolism of strychnine(STN)and the metabolic interaction between STN and glycyrrhetic acid(GA)in vitro.Methods Human liver microsomes(HLM)and human recombinant cytochrome P450(CYP)isoforms were employed to study the metabolism of STN and the metabolic interaction of STN with GA in vitro.Results In HLM,the Km,Vmax,and clearance of STN were 88.50μmol/L,0.88 nmol/(mg·min),and 9.93 mL/(mg·min),respectively.STN was metabolized mainly by CYP3A4.However,STN noncompetitively inhibited CYP3A4-catalyzed testosterone 6β-hydroxylation with IC50 value of 5.9μmol/L and Ki value of 5.5 μmol/L.Moreover,GA competitively inhibited STN metabolism with IC50 value of 10.6μmol/L and Ki value of 17.7μmol/L.Conclusion Although STN is mainly metabolized by CYP3A4 in vitro,STN has noncompetitive inhibition on CYP3A4-catalyzed testosterone 6β-hydroxylation.Moreover,GA could competitively inhibit STN metabolism.The present work is helpful to elucidate the metabolic interaction between STN and GA.
基金This study was supported by the grants from the Research Development Fund of The Second Hospital of Shandong University(No.11681808)Jinan clinical medical science and technology innovation plan(No.202019194).
文摘Papillary thyroid carcinoma(PTC)is the most common type(accounting for over 80%)of thyroid cancer.[1]Although PTC is a well-differentiated endocrine neoplasm,unfortunately,certain PTCs show malignant characteristics such as aggressiveness and metastasis;these characteristics contribute to a poor 5-year survival rate.[1]However,the fundamental molecular mechanism of extra-thyroid metastasis remains unclear.
