Gastric cancer(GC)is a malignant tumor originating from the gastric epithelium,and its incidence and mortality rates rank third among all malignant tumors worldwide.It is also one of the most common cancers in China a...Gastric cancer(GC)is a malignant tumor originating from the gastric epithelium,and its incidence and mortality rates rank third among all malignant tumors worldwide.It is also one of the most common cancers in China and is treated predominantly by Western medicine in clinical practice.However,with the advancements in medical technology and informatics,the values of traditional Chinese medicine(TCM)in preventing and treating GC and improving prognosis have increasingly been recognized.According to TCM,clinical manifestations of GC can be divided into Yege(dysphagia),regurgitation,stomach pain,and Zhengxia(abdominal mass).Due to the unbalanced distribution of health care resources in China,most GC patients already have progressive or advanced-stage disease at the first diagnosis.As a result,most GC patients have poor physical function,and surgery or chemotherapy alone will aggravate the impairment to the immune function and seriously affect the quality of life.In contrast,TCM therapies have shown promising efficacy in the management of these patients.Here we review the role of the integrated TCM and Western medicine in treating advanced GC.展开更多
Owing to its heterogeneous and highly aggressive nature,hepatocellular carcinoma(HCC)has a high recurrence rate,which is a non-negligible problem despite the increasing number of available treatment options.Recent cli...Owing to its heterogeneous and highly aggressive nature,hepatocellular carcinoma(HCC)has a high recurrence rate,which is a non-negligible problem despite the increasing number of available treatment options.Recent clinical trials have attempted to reduce the recurrence and develop innovative treatment options for patients with recurrent HCC.In the event of liver remnant recurrence,the currently available treatment options include repeat hepatectomy,salvage liver transplantation,tumor ablation,transcatheter arterial chemoembolization,stereotactic body radiotherapy,systemic therapies,and combination therapy.In this review,we summarize the strategies to reduce the recurrence of high-risk tumors and aggressive therapies for recurrent HCC.Additionally,we discuss methods to prevent HCC recurrence and prognostic models constructed based on predictors of recurrence to develop an appropriate surveillance program.展开更多
Quercus is the largest genus within the Fagaceae and has a rich fossil record.Most of the fossil material is attributed to the subgenus Quercus based on leaves,pollen or rarely acorns and nuts.Fossil records of Q.sect...Quercus is the largest genus within the Fagaceae and has a rich fossil record.Most of the fossil material is attributed to the subgenus Quercus based on leaves,pollen or rarely acorns and nuts.Fossil records of Q.section Cyclobalanopsis characterized by ring-cupped acorns are relatively few and especially those described based on nuts are scant.In this study,we described four new species of Quercus section Cyclobalanopsis based on mummified acorns and nuts:Q.paleodisciformis X.Y.Liu et J.H.Jin sp.nov.,Q.paleohui X.Y.Liu et J.H.Jin sp.nov.,Q.nanningensis X.Y.Liu et J.H.Jin sp.nov.and Q.yongningensis X.Y.Liu et J.H.Jin sp.nov.These species closely resemble the extant species Q.disciformis,Q.hui,Q.kerrii,and Q.dinghuensis.The occurrence of Q.section Cyclobalanopsis in the Oligocene stratum of Guangxi,South China,suggests that the section has diversified within its extant distribution center since the Oligocene.By combining records from other areas,we propose that the section first appeared in the middle Eocene of East Asia(Sino-Japan),has diversified in situ with a few elements scattering into West Asia and southern Europe since the Oligocene and Pliocene,respectively,and finally became restricted in East Asia since the Pleistocene.This indicates that the section originated and diversified in East Asia,before spreading into West Asia no later than the Oligocene and into southern Europe by the Pliocene.Subsequently it disappeared from South Europe and West Asia due to the appearance of the(summer dry)Mediterranean climate and widespread cooling during the Pleistocene.展开更多
BACKGROUND Colorectal cancer(CRC)is the third most common cancer worldwide,with the fourth highest mortality among all cancers.Reportedly,in addition to adenomas,serrated polyps,which account for 15%-30%of CRCs,can al...BACKGROUND Colorectal cancer(CRC)is the third most common cancer worldwide,with the fourth highest mortality among all cancers.Reportedly,in addition to adenomas,serrated polyps,which account for 15%-30%of CRCs,can also develop into CRCs through the serrated pathway.Sessile serrated adenomas/polyps(SSAs/Ps),a type of serrated polyps,are easily misdiagnosed during endoscopy.AIM To observe the difference in the Wnt signaling pathway expression in SSAs/Ps patients with different syndrome types.METHODS From January 2021 to December 2021,patients with SSAs/Ps were recruited from the Endoscopy Room of Shanghai Traditional Chinese Medicine-Integrated Hospital,affiliated with Shanghai University of Traditional Chinese Medicine.Thirty cases each of large intestine damp-heat(Da-Chang-Shi-Re,DCSR)syndrome and spleen-stomach weakness(Pi-Wei-Xu-Ruo)syndrome were reported.Baseline comparison of the general data,typical tongue coating,colonoscopy findings,and hematoxylin and eosin findings was performed in each group.The expression of the Wnt pathway-related proteins,namelyβ-catenin,adenomatous polyposis coli,and mutated in colorectal cancer,were analyzed using immunohistochemistry.RESULTS Significant differences were observed with respect to the SSAs/Ps size between the two groups of patients with different syndrome types(P=0.001).The other aspects did not differ between the two groups.The Wnt signaling pathway was activated in patients with SSAs/Ps belonging to both groups,which was manifested asβ-catenin protein translocation into the nucleus.However,SSAs/Ps patients with DCSR syndrome had more nucleation,higherβ-catenin expression,and negative regulatory factor(adenomatous polyposis coli and mutated in colorectal cancer)expression(P<0.0001)than SSA/P patients with Pi-Wei-Xu-Ruo syndrome.In addition,the SSA/P size was linearly correlated with the related protein expression.CONCLUSION Patients with DCSR syndrome had a more obvious Wnt signaling pathway activation and a higher risk of carcinogenesis.A high-quality colonoscopic diagnosis was essential.The thorough assessment of clinical diseases can be improved by combining the diseases of Western medicine with the syndromes of traditional Chinese medicine.展开更多
Major ozonated autohemotherapy has been shown to promote recovery of upper limb motor function in patients with acute cerebral infarction,but whether major ozonated autohemotherapy affects remote injury remains poorly...Major ozonated autohemotherapy has been shown to promote recovery of upper limb motor function in patients with acute cerebral infarction,but whether major ozonated autohemotherapy affects remote injury remains poorly understood.Here,we assumed that major ozonated autohemotherapy contributes to recovery of clinical function,possibly by reducing remote injury after acute cerebral infarction.Sixty acute cerebral infarction patients aged 30–80 years were equally and randomly allocated to ozone treatment and control groups.Patients in the ozone treatment group received medical treatment and major ozonated autohemotherapy(47 mg/L,100 m L ozone) for 10 ± 2 days.Patients in the control group received medical treatment only.National Institutes of Health Stroke Scale score,modified Rankin scale score,and reduced degree of fractional anisotropy values of brain magnetic resonance diffusion tensor imaging were remarkably decreased,brain function improved,clinical efficiency significantly increased,and no obvious adverse reactions detected in the ozone treatment group compared with the control group.These findings suggest that major ozonated autohemotherapy promotes recovery of neurological function in acute cerebral infarction patients by reducing remote injury,and additionally,exhibits high safety.展开更多
AIM:To evaluate the safety and efficacy of granulocyte-colony stimulating factor(G-CSF) therapy in patients with hepatitis B virus(HBV)-associated acuteon-chronic liver failure(ACLF).METHODS:Fifty-five patients with H...AIM:To evaluate the safety and efficacy of granulocyte-colony stimulating factor(G-CSF) therapy in patients with hepatitis B virus(HBV)-associated acuteon-chronic liver failure(ACLF).METHODS:Fifty-five patients with HBV-associated ACLF were randomized into two groups:the treatment group and the control group.Twenty-seven patients in the treatment group received G-CSF(5 μg/kg per day,six doses) treatment plus standard therapy,and 28 patients in the control group received standard therapy only.The peripheral CD34 + cell count was measured consecutively by flow cytometry.Circulating white blood cell count,biochemical parameters,and other clinical data of these patients were recorded and analyzed.All patients were followed up for a period of 3 mo to evaluate the changes in liver function and survival rate.RESULTS:The peripheral neutrophil and CD34 + cell counts in the G-CSF group increased on day 3 from the onset of therapy,continued to rise on day 7,and remained elevated on day 15 compared to those of the control group.Child-Turcotte-Pugh score of patients in the treatment group was improved on day 30 from the onset of G-CSF therapy,compared to that in the controls(P = 0.041).Model for End-Stage of Liver Disease score of patients in the treatment group was improved on day 7(P = 0.004) and remained high on day 30 from the onset of G-CSF therapy(P < 0.001) compared to that in controls.After 3 mo of follow-up observation,the survival rate in the treatment group(48.1%) was significantly higher than that in the control group(21.4%)(P = 0.0181).CONCLUSION:G-CSF therapy promoted CD34 + cell mobilization in patients with HBV-associated ACLF,and improved the liver function and the survival rate of these patients.展开更多
AIM:To investigate the survival rates and prognostic factors in patients with hepatitis B virus-related acuteon-chronic liver failure(HBV-ACLF).METHODS:Clinical data in hospitalized patients with HBV-ACLF admitted fro...AIM:To investigate the survival rates and prognostic factors in patients with hepatitis B virus-related acuteon-chronic liver failure(HBV-ACLF).METHODS:Clinical data in hospitalized patients with HBV-ACLF admitted from 2006 to 2009 were retrospectively analyzed.Their general conditions and survival were analyzed by survival analysis and Cox regression analysis.RESULTS:A total of 190 patients were included in this study.The overall 1-year survival rate was 57.6%.Patients not treated with antiviral drugs had a significantly higher mortality[relative risk(RR)=0.609,P=0.014].The highest risk of death in patients with ACLF was associated with hepatorenal syndrome(HRS)(RR=2.084,P=0.026),while other significant factors were electrolyte disturbances(RR=2.062,P=0.010),and hepatic encephalopathy(HE)(RR=1.879,P<0.001).CONCLUSION:Antiviral therapy has a strong effect on the prognosis of the patients with HBV-ACLF by improving their 1-year survival rate.HRS,electrolyte disturbances,and HE also affect patient survival.展开更多
AIM To investigate the value of the gamma-glutamyltraspeptidase(GGT)-to-platelet(PLT) ratio(GPR) in the diagnosis of hepatic fibrosis in patients with chronic hepatitis B(CHB). METHODS We included 390 untreated CHB pa...AIM To investigate the value of the gamma-glutamyltraspeptidase(GGT)-to-platelet(PLT) ratio(GPR) in the diagnosis of hepatic fibrosis in patients with chronic hepatitis B(CHB). METHODS We included 390 untreated CHB patients in this study. The GPR, aspartate aminotransferase(AST)-to-PLT ratio index(APRI), and fibrosis-4(FIB-4) of all patients were analysed to determine if these parameter were correlated with age, gender, medical history, liver function [total bilirubin(TBil), alanine aminotransferase(ALT), and AST], GGT, PLT count, or hepatic fibrosis stage. The GPR, APRI, and FIB-4, as well as the combination of the GPR and APRI or the GPR and FIB-4 were assessed in different cirrhosis stages using receiver operating characteristic(ROC) curve analysis to evaluate their value in diagnosing hepatic fibrosis in CHB patients. RESULTS The GPR, APRI, and FIB-4 were not correlated withCHB patients' age, gender, or disease duration(P > 0.05), but all of these parameters were positively correlated with serum ALT, AST, GGT, and PLT count(P < 0.01). Additionally, the GPR, APRI, and FIB-4 were positively correlated with hepatic fibrosis(P < 0.01); the areas under the ROC curve for the GPR in F1, F2, F3, and F4 stages were 0.723, 0.741, 0.826, and 0.833, respectively, which were significantly higher than the respective values for the FIB-4 and APRI(F1: 0.581, 0.612; F2: 0.706, 0.711; F3: 0.73, 0.751; and F4: 0.799, 0.778). The respective diagnostic cut-off points for each stage were 0.402, 0.448, 0.548, and 0.833, respectively. The diagnostic sensitivity and specificity were, respectively, 88.8% and 87.5% in F1, 72.7% and 89.7% in F2, 81.3% and 98.6% in F3, and 80% and 97.4% in F4 when the GPR and APRI were connected in parallel; 86.6% and 90.2%, 78.4% and 96%, 78.6% and 97.4%, and 73.2% and 97.9%, respectively, when the GPR and APRI were connected in series; 80.2% and 89%, 65% and 89%, 70.3% and 98.5%, and 78.8% and 96.8%, respectively, when the GPR and FIB-4 were connected in parallel; and 83.6% and 87.9%, 76.8% and 96.6%, 72.7% and 98%, and 74.4% and 97.7%, respectively, when the GPR and FIB-4 were connected in series.CONCLUSION The GPR, as a serum diagnostic index of liver fibrosis, is more accurate, sensitive, and easy to use than the FIB-4 and APRI, and the GPR can significantly improve the sensitivity and specificity of hepatic fibrosis diagnosis in CHB when combined with the FIB-4 or APRI.展开更多
AIM: To investigate the regulatory effect of Vδ1 T cells and the antitumor activity of Vδ2 T cells in rectal cancer.METHODS: Peripheral blood, tumor tissues and paracarcinoma tissues from 20 rectal cancer patients w...AIM: To investigate the regulatory effect of Vδ1 T cells and the antitumor activity of Vδ2 T cells in rectal cancer.METHODS: Peripheral blood, tumor tissues and paracarcinoma tissues from 20 rectal cancer patients were collected. Na?ve CD4 T cells from the peripheral blood of rectal cancer patients were purified by negative selection using a Naive CD4+ T Cell Isolation Kit Ⅱ(Miltenyi Biotec). Tumor tissues and para-carcinoma tissues were minced into small pieces and digested in a triple enzyme mixture containing collagenase type Ⅳ, hyaluronidase, and deoxyribonuclease for 2 h at room temperature. After digestion, the cells were washed twice in RPMI1640 and cultured in RPMI1640 containing 10% human serum supplemented with L-glutamine and 2-mercaptoethanol and 1000 U/m L of IL-2 for the generation of T cells. Vδ1 T cells and Vδ2 T cells from tumor tissues and para-carcinoma tissues were expanded by anti-TCR gδ antibodies. The inhibitory effects of Vδ1 T cells on na?ve CD4 T cells were analyzed using the CFSE method. The cytotoxicity of Vδ2 T cells on rectal cancer lines was determined by the LDH method.RESULTS: The percentage of Vδ1 T cells in rectal tumortissues from rectal cancer patients was significantly increased, and positively correlated with the T stage. The percentage of Vδ2 T cells in rectal tumor tissues from rectal cancer patients was significantly decreased, and negatively correlated with the T stage. After culture for 14 d with 1 mg/m L anti-TCR gδ antibodies, the percentage of Vδ1 T cells from para-carcinoma tissues was 21.45% ± 4.64%, and the percentage of Vδ2 T cells was 38.64% ± 8.05%. After culture for 14 d, the percentage of Vδ1 T cells from rectal cancer tissues was 67.45% ± 11.75% and the percentage of Vδ2 T cells was 8.94% ± 2.85%. Tumor-infiltrating Vδ1 T cells had strong inhibitory effects, and tumor-infiltrating Vδ2 T cells showed strong cytolytic activity. The inhibitory effects of Vδ1 T cells from para-carcinoma tissues and from rectal cancer tissue were not significantly different. In addition, the cytolytic activities of Vδ2 T cells from para-carcinoma tissues and from rectal cancer tissues were not significantly different.CONCLUSION: A percentage imbalance in Vδ1 and Vδ2 T cells in rectal cancer patients may contribute to the development of rectal cancer.展开更多
Objective To examine and follow up cervical cytology of pregnant and postpartum women and study their cytopathologic characteristics, so as to determine screening and managing programs for abnormal cervical cytology. ...Objective To examine and follow up cervical cytology of pregnant and postpartum women and study their cytopathologic characteristics, so as to determine screening and managing programs for abnormal cervical cytology. Methods Totally 5296 patients in pregnancy and postpartum, in which 3729 by computer-assisted cytology test and 1567 by liquid-based monolayers cytology test, were examined and diagnosed by the Bethesda System made in 2001. Those proven epithelial abnormalities patients were followed up until the lesions regressed to normal. The remaining patients, who exhibited persistent abnormalities or progression, were given further examinations. Results The positive rate of cervical cytological test was 8.72% (462/5296), including squamous carcinoma (SCA) 1 case(0.02%), high grade squamous intraepithelial lesion (HSIL) 34 cases(0.64%), low grade squamous intraepithelial lesion (LSIL) 145 cases(2.74%),atypical glandular cells (AGC) 5 cases(0.09%),atypical squamous cells cannot exclude HSIL (ASC-H) 14 cases(0.26%), atypical squamous cells of undetermined significance (ASC-US) 263 cases(4.97%). The 419 proven cytological abnormality cases were followed up successfully. The total transnegative rate in three months was 73.74% (309/419), in which 303 cases (72.32%) persisted normal status for more than six months after regression. And the transnegative rate of ASC-US, ASC-H, AGC, LSIL, and HSIL were 79.56%, 64.29%, 100%, 72.14% and 44.12%, respectively. Forty-six cases received biopsy directed by colposcopy. The distribution of coincidence of cytopathologic and histopathologic diagnosis was: SCA 1 case (100%), HSIL 10 cases (76.92%), LSIL 13 cases (65%),ASC-H 2 cases (50%), ASC-US 3 cases (37.50%), total 29 cases (63.04%). Conclusions We should cast more attention to screening cervix lesions in pregnant and postpartum women. Their cytopathologic characteristics are liable to make the clinician give a false positive diagnosis. So we propose to follow up them closely and to lower the indication of biopsy.展开更多
BACKGROUND Acute-on-chronic liver failure(ACLF),which includes hepatic and multiple extrahepatic organ failure,is a severe emergency condition that has high mortality.ACLF can rapidly progress and requires an urgent a...BACKGROUND Acute-on-chronic liver failure(ACLF),which includes hepatic and multiple extrahepatic organ failure,is a severe emergency condition that has high mortality.ACLF can rapidly progress and requires an urgent assessment of condition and referral for liver transplantation.Bacterial infections(BIs)trigger ACLF and play pivotal roles in the deterioration of clinical course.AIM To investigate the clinical characteristics and 28-d outcomes of first BIs either at admission or during hospitalization in patients with hepatitis B virus(HBV)-ACLF as defined by the Chinese Group on the Study of Severe Hepatitis B(COSSH).METHODS A total of 159 patients with HBV-ACLF and 40 patients with acute decompensation of HBV-related chronic liver disease combined with first BIs were selected for a retrospective analysis between October 2014 and March 2016.The characteristics of BIs,the 28-d transplant-free survival rates,and the independent predictors of the 28-d outcomes were evaluated.RESULTS A total of 194 episodes of BIs occurred in 159 patients with HBV-ACLF.Among the episodes,13.4%were community-acquired,46.4%were healthcare-associated,and 40.2%belonged to nosocomial BIs.Pneumonia(40.7%),spontaneous bacterial peritonitis(SBP)(34.5%),and bloodstream infection(BSI)(13.4%)were the most prevalent.As the ACLF grade increased,the incidence of SBP showed a downward trend(P=0.021).Sixty-one strains of bacteria,including 83.6%Gramnegative bacteria and 29.5%multidrug-resistant organisms,were cultivated from 50 patients with ACLF.Escherichia coli(44.3%)and Klebsiella pneumoniae(23.0%)were the most common bacteria.As the ACLF grade increased,the 28-d transplant-free survival rates showed a downward trend(ACLF-1,55.7%;ACLF-2,29.3%;ACLF-3,5.4%;P<0.001).The independent predictors of the 28-d outcomes of patients with HBV-ACLF were COSSH-ACLF score(hazard ratio[HR]=1.371),acute kidney injury(HR=2.187),BSI(HR=2.339),prothrombin activity(HR=0.967),and invasive catheterization(HR=2.173).CONCLUSION For patients with HBV-ACLF combined with first BIs,pneumonia is the most common form,and the incidence of SBP decreases with increasing ACLF grade.COSSH-ACLF score,acute kidney injury,BSI,prothrombin activity,and invasive catheterization are the independent predictors of 28-d outcomes.展开更多
AIM:To investigate the relationship between increases in expression time of ABCG2 mRNA driven by cisplatin and efficacy of platinum-containing chemotherapy for gastric cancer.METHODS:Tumor specimens and normal control...AIM:To investigate the relationship between increases in expression time of ABCG2 mRNA driven by cisplatin and efficacy of platinum-containing chemotherapy for gastric cancer.METHODS:Tumor specimens and normal control tissues were collected from 78 patients with gastric cancer treated from January 2008 to December 2011.Fresh tumor tissue obtained from the surgically resected specimens was tested within 6 h.Polymerase chain reaction products were run on 2%agarose gels and analyzed under ultraviolet light after ethidium bromide staining.Increases in ABCG2 mRNA expression time cisplatin,and were divided into terciles and compared in relation to clinical outcomes.RESULTS:Among groups classified by expression time of ABCG2 mRNA,no significant differences in baseline clinical characteristics and pathological findings were detected.The median overall time was 14.2(95%CI:9.7-18.6),11.4(95%CI:6.3-16.5)and 8.1(95%CI:5.4-10.8)in patients with low,intermediate and high increases in ABCG2 mRNA expression times(P<0.05),respectively.Median survival associated with performance status and tumor node metastasis(TNM)stage showed a similar trend,with longer survival and higher risk for mortality associated with lower performance status score and TNM stage.In a multivariate analysis for survival with Cox proportional-hazards model,increased ABCG2 mRNA expression time was an independent predictor for overall survival.Overall survival was longer with increased ABCG2 mRNA expression times≤0.71 than increased ABCG2 mRNA expression times>0.71,with a hazard ratio for death of 0.855(95%CI:0.615-0.962,P=0.038).CONCLUSION:Increased ABCG2 mRNA expression time driven by cisplatin is associated with survival of gastric cancer patients,and this may help modify the therapeutic strategies.展开更多
AIM: To investigate the effect of quercetin (3,3’,4’,5, 7-pentahydroxy flavone), a major flavonoid in human diet, on hyper-proliferation of gastric mucosal cells in rats treated with chronic oral ethanol. METHODS: F...AIM: To investigate the effect of quercetin (3,3’,4’,5, 7-pentahydroxy flavone), a major flavonoid in human diet, on hyper-proliferation of gastric mucosal cells in rats treated with chronic oral ethanol. METHODS: Forty male Sprague-Dawley rats, weighing 200-250 g, were randomly divided into control group (tap water ad libitum), ethanol treatment group (6 mL/L ethanol), quercetin treatment group (intragastric gavage with 100 mg/kg of quercetin per day), and ethanol plus quercetin treatment group (quercetin and 6 mL/L ethanol). Expression levels of proliferating cell nuclear antigen (PCNA) and Cyclin D1 were detected by Western blot to assay gastric mucosal cell proliferation in rats. To demonstrate the influence of quercetin on the production of extra-cellular reactive oxygen species/ nitrogen species (ROS/RNS) in rats, changes in levels of thiobarbituric acid reactive substance (TBARS), protein carbonyl, nitrite and nitrate (NOx) and nitrotyrosine (NT) were determined. The activity of inducible nitric oxide synthase (NOS) including iNOS and nNOS was also detected by Western blot. RESULTS: Compared to control animals, cell proliferationin the gastric mucosa of animals subjected to ethanol treatment for 7 days was significant increased (increased to 290% for PCNA density P < 0.05, increased to 150 for Cyclin D1 density P < 0.05 and 21.6 ± 0.8 vs 42.3 ± 0.7 for PCNA positive cells per view field), accompanied by an increase in ROS generation (1.298 ± 0.135 μmol vs 1.772 ± 0.078 μmol for TBARS P < 0.05; 4.36 ± 0.39 mmol vs 7.48 ± 0.40 mmol for carbonyl contents P < 0.05) and decrease in NO generation (11.334 ± 0.467 μmol vs 7.978 ± 0.334 μmol P < 0.01 for NOx; 8.986 ± 1.351 μmol vs 6.854 ± 0.460 μmol for nitrotyrosine P < 0.01) and nNOS activity (decreased to 43% P < 0.05). This function was abolished by the co-administration of quercetin. CONCLUSION: The antioxidant action of quercetin relies, in part, on its ability to stimulate nNOS and enhance production of NO that would interact with endogenously produced reactive oxygen to inhibit hyper-proliferation of gastric mucosal cells in rats treated with chronic oral ethanol.展开更多
High-dependency units(HDUs)provide high-level care to patients who suffer from single organ failure,with the exception of respiratory failure requiring mechanical ventilation;HDUs serve as an intermediary between gene...High-dependency units(HDUs)provide high-level care to patients who suffer from single organ failure,with the exception of respiratory failure requiring mechanical ventilation;HDUs serve as an intermediary between general wards and Intensive Care Units.Due to military and civilian needs,our hospital has established a unique HDU for patients with liver disease in China.A Chinese military officer in the United Nations Peacekeeping Forces in South Sudan was transferred to our HDU for liver failure treatment in 2018.The patient’s disease status,nutrition,sleep habits,and psychological behaviour were monitored on different scales.The patient was provided with vascular monitoring,telemetry,pulse oximetry,drug treatment,nutritional support,sleep intervention,psychological intervention,and humanistic care by a multidisciplinary treatment team.After treatment,the patient recovered and avoided liver transplantation.Based on the experience with this HDU,this new model may create an efficient treatment process for military and civilian patients with severe liver disease at home or abroad.展开更多
AIM:To investigate the role of α-fetoprotein(AFP),a cancer-associated fetal glycoprotein,in glucocorticoidinduced precocious maturation in rat colon.METHODS:Colons from suckling Sprague-Dawley rats were used in this ...AIM:To investigate the role of α-fetoprotein(AFP),a cancer-associated fetal glycoprotein,in glucocorticoidinduced precocious maturation in rat colon.METHODS:Colons from suckling Sprague-Dawley rats were used in this study.Corticosterone acetate at a dose of 100 μg/g body weight was given to normal pups on days 7,9 and 11 after birth to induce hypercorticoidism.Control animals were injected with identical volumes of normal saline.Some rats receiving corticosterone 7 d after birth were also treated with mifepristone(RU38486),a glucocorticoid cytoplasm receptor antagonist to investigate the effects of glucocorticoids(GCs).The morphological changes of the crypt depth and villous height of the villous zone in colon were observed as indicesof colon maturation.Expression levels of AFP in colons were detected by reverse transcriptase polymerase chain reaction and Western blotting.To identify the cellular localization of AFP in developing rat colons,double-immunofluorescent staining was performed using antibodies to specific mesenchymal cell marker and AFP.RESULTS:Corticosterone increased the crypt depth and villous height in the colon of 8-and 10-d-old rats with hypercorticoidism compared with that in the control animals(120% in 8-d-old rats and 118% in 10-d-old rats in villous height,P = 0.021;145% in 8-d-old rats and 124% in 10-d-old rats in crypt depth,P = 0.017).These increases were accompanied by an increase of AFP expression in both mRNA and protein(2.5-folds in 8-dold and 2.5-folds in 10-d-old rats higher than in control animals,P = 0.035;1.8-folds in 8-d-old and 1.3-folds in 10-d-old rats higher than in control animals,P = 0.023).Increased crypt depth and villous height and increased expression of AFP in the colon of rats with hypercorticoidism were blocked by mifepristone.Both had positive staining for AFP or vimentin,and overlapped in mesenchymal cells at each tested colon.CONCLUSION:GCs promote the development of rat colon.AFP appears to be involved,in part,in mediating the effects of GCs in the developmental colon.展开更多
As the theory of the fractional order differential equation becomes mature gradually, the fractional order neural networks become a new hotspot.The robust stability of a class of fractional order Hopfield neural netwo...As the theory of the fractional order differential equation becomes mature gradually, the fractional order neural networks become a new hotspot.The robust stability of a class of fractional order Hopfield neural network with the Caputo derivative is investigated in this paper. The sufficient conditions to guarantee the robust stability of the fractional order Hopfield neural networks are derived by making use of the property of the Mittag-Leffler function, comparison theorem for the fractional order system, and method of the Laplace integral transform. Furthermore, a numerical simulation example is given to illustrate the correctness and effectiveness of our results.展开更多
Most amorphous carbon(a-C)applications require films with ultra-thin thicknesses;however,the electronic structure and opto-electronic characteristics of such films remain unclear so far.To address this issue,we develo...Most amorphous carbon(a-C)applications require films with ultra-thin thicknesses;however,the electronic structure and opto-electronic characteristics of such films remain unclear so far.To address this issue,we developed a theoretical model based on the density functional theory and molecular dynamic simulations,in order to calculate the electronic structure and opto-electronic characteristics of the ultra-thin a-C films at different densities and temperatures.Temperature was found to have a weak influence over the resulting electronic structure and opto-electronic characteristics,whereas density had a significant influence on these aspects.The volume fraction of sp3 bonding increased with density,whereas that of sp2 bonding initially increased,reached a peak value of 2.52 g/cm^(3),and then decreased rapidly.Moreover,the extinction coefficients of the ultra-thin a-C films were found to be density-sensitive in the long-wavelength regime.This implies that switching the volume ratio of sp2 to sp3 bonding can effectively alter the transmittances of ultra-thin a-C films,and this can serve as a novel approach toward photonic memory applications.Nevertheless,the electrical resistivity of the ultra-thin a-C films appeared independent of temperature.This implicitly indicates that the electrical switching behavior of a-C films previously utilized for non-volatile storage applications is likely due to an electrically induced effect and not a purely thermal consequence.展开更多
The genus Woodwardia,which together with the genera Anchistea and Lorinseria comprise the subfamily Woodwardioideae of Blechnaceae,has a disjunct distribution across Central and North America,Europe and the temperate ...The genus Woodwardia,which together with the genera Anchistea and Lorinseria comprise the subfamily Woodwardioideae of Blechnaceae,has a disjunct distribution across Central and North America,Europe and the temperate to tropical areas of Asia.Fossil records of Woodwardia occur throughout the Paleogene and Neogene of North America,Europe and Asia.However,well-preserved fertile pinna fossils of this genus have not yet been reported in South China.In this paper,a new species,W.changchangensis Naugolnykh et Song,sp.nov.is described from the middle Eocene of the Changchang Basin,Hainan Island,South China.Macromorphological and micromorphological features of the fertile pinna show a straight pinna rachis,alternate,subtriangular pinnules,acute pinnule apices,almost entire or slightly undulate pinnule margins,long-ovoid sori,stalked sporangia and spores with wing-like folds on the surface,which are characterised in detail.Overall,the present fossil is most similar to the extant species Woodwardia japonica,which mostly grows in warm and moist environments.The discovery of this new species from the Changchang Basin of Hainan Island indicates that this genus has been distributed in the low-latitude tropical regions of South China from as early as the middle Eocene.Based on this find,and previous studies of other ferns from the same site,we infer that the climate of the Palaeo-Hainan landscape during deposition of the Changchang Formation was warm and humid,similar to conditions prevailing today across this region.展开更多
Objective Paroxysmal kinesigenic dyskinesia(PKD)is a rare movement disorder PRRT2 gene mutations have been reported to cause PKD.However,the pathophysiological mechanism of PKD remains unclear,and it is unknown whethe...Objective Paroxysmal kinesigenic dyskinesia(PKD)is a rare movement disorder PRRT2 gene mutations have been reported to cause PKD.However,the pathophysiological mechanism of PKD remains unclear,and it is unknown whether an inflammatory response is involved in the occurrence of this disease.We aimed to investigate the symptomatology,genotype,and serum cytokines of patients with PKD.Methods We recruited 21 patients with PKD,including 7 with familial PKD and 14 with sporadic PKD.Their clinical features were investigated,and blood samples were collected,and PRRT2 mutations and cytokine levels were detected.Results The mean age at PKD onset was 12.3±2.2 years old.Dystonia was the most common manifestation of dyskinesia,and the limbs were the most commonly affected parts.All attacks were induced by identifiable kinesigenic triggers,and the attack durations were brief(<1 min).Four different mutations from 9 probands were identified in 7 familial cases(71.4%)and 14 sporadic cases(28.6%).Two of these mutations(c.649dupC,c.620_621delAA)had already been reported,while other 2(c.1018_1019delAA,c.1012+1G>A)were previously undocumented.The tumor necrosis factor(TNF)-αlevel in the PKD group was significantly higher than that in the age-and sex-matched control group(P=0.025).There were no significant differences in the interleukin(IL)-1β,IL-2R,IL-6,IL-8,or IL-10 levels between the two groups.Conclusion In this study,we summarized the clinical and genetic characteristics of PKD.We found that the serum TNF-αlevels were elevated in patients clinically diagnosed with PKD,suggesting that an inflammatory response is involved in the pathogenesis of PKD.展开更多
文摘Gastric cancer(GC)is a malignant tumor originating from the gastric epithelium,and its incidence and mortality rates rank third among all malignant tumors worldwide.It is also one of the most common cancers in China and is treated predominantly by Western medicine in clinical practice.However,with the advancements in medical technology and informatics,the values of traditional Chinese medicine(TCM)in preventing and treating GC and improving prognosis have increasingly been recognized.According to TCM,clinical manifestations of GC can be divided into Yege(dysphagia),regurgitation,stomach pain,and Zhengxia(abdominal mass).Due to the unbalanced distribution of health care resources in China,most GC patients already have progressive or advanced-stage disease at the first diagnosis.As a result,most GC patients have poor physical function,and surgery or chemotherapy alone will aggravate the impairment to the immune function and seriously affect the quality of life.In contrast,TCM therapies have shown promising efficacy in the management of these patients.Here we review the role of the integrated TCM and Western medicine in treating advanced GC.
文摘Owing to its heterogeneous and highly aggressive nature,hepatocellular carcinoma(HCC)has a high recurrence rate,which is a non-negligible problem despite the increasing number of available treatment options.Recent clinical trials have attempted to reduce the recurrence and develop innovative treatment options for patients with recurrent HCC.In the event of liver remnant recurrence,the currently available treatment options include repeat hepatectomy,salvage liver transplantation,tumor ablation,transcatheter arterial chemoembolization,stereotactic body radiotherapy,systemic therapies,and combination therapy.In this review,we summarize the strategies to reduce the recurrence of high-risk tumors and aggressive therapies for recurrent HCC.Additionally,we discuss methods to prevent HCC recurrence and prognostic models constructed based on predictors of recurrence to develop an appropriate surveillance program.
基金This study was supported by the National Natural Science Foundation of China(Nos.41872015,31770241,41820104002,and 41661134049)the grant of the Natural Environment Research Council of Research Councils UK(No.NE/P013805/1).
文摘Quercus is the largest genus within the Fagaceae and has a rich fossil record.Most of the fossil material is attributed to the subgenus Quercus based on leaves,pollen or rarely acorns and nuts.Fossil records of Q.section Cyclobalanopsis characterized by ring-cupped acorns are relatively few and especially those described based on nuts are scant.In this study,we described four new species of Quercus section Cyclobalanopsis based on mummified acorns and nuts:Q.paleodisciformis X.Y.Liu et J.H.Jin sp.nov.,Q.paleohui X.Y.Liu et J.H.Jin sp.nov.,Q.nanningensis X.Y.Liu et J.H.Jin sp.nov.and Q.yongningensis X.Y.Liu et J.H.Jin sp.nov.These species closely resemble the extant species Q.disciformis,Q.hui,Q.kerrii,and Q.dinghuensis.The occurrence of Q.section Cyclobalanopsis in the Oligocene stratum of Guangxi,South China,suggests that the section has diversified within its extant distribution center since the Oligocene.By combining records from other areas,we propose that the section first appeared in the middle Eocene of East Asia(Sino-Japan),has diversified in situ with a few elements scattering into West Asia and southern Europe since the Oligocene and Pliocene,respectively,and finally became restricted in East Asia since the Pleistocene.This indicates that the section originated and diversified in East Asia,before spreading into West Asia no later than the Oligocene and into southern Europe by the Pliocene.Subsequently it disappeared from South Europe and West Asia due to the appearance of the(summer dry)Mediterranean climate and widespread cooling during the Pleistocene.
基金Supported by the National Natural Science Foundation of China,No.81873253the Shanghai Natural Science Foundation,No.22ZR1458800+1 种基金the Hongkou District Health Committee,No.HKZK2020A01the Xinglin Scholar Program of Shanghai University of Traditional Chinese Medicine,No.[2020]23.
文摘BACKGROUND Colorectal cancer(CRC)is the third most common cancer worldwide,with the fourth highest mortality among all cancers.Reportedly,in addition to adenomas,serrated polyps,which account for 15%-30%of CRCs,can also develop into CRCs through the serrated pathway.Sessile serrated adenomas/polyps(SSAs/Ps),a type of serrated polyps,are easily misdiagnosed during endoscopy.AIM To observe the difference in the Wnt signaling pathway expression in SSAs/Ps patients with different syndrome types.METHODS From January 2021 to December 2021,patients with SSAs/Ps were recruited from the Endoscopy Room of Shanghai Traditional Chinese Medicine-Integrated Hospital,affiliated with Shanghai University of Traditional Chinese Medicine.Thirty cases each of large intestine damp-heat(Da-Chang-Shi-Re,DCSR)syndrome and spleen-stomach weakness(Pi-Wei-Xu-Ruo)syndrome were reported.Baseline comparison of the general data,typical tongue coating,colonoscopy findings,and hematoxylin and eosin findings was performed in each group.The expression of the Wnt pathway-related proteins,namelyβ-catenin,adenomatous polyposis coli,and mutated in colorectal cancer,were analyzed using immunohistochemistry.RESULTS Significant differences were observed with respect to the SSAs/Ps size between the two groups of patients with different syndrome types(P=0.001).The other aspects did not differ between the two groups.The Wnt signaling pathway was activated in patients with SSAs/Ps belonging to both groups,which was manifested asβ-catenin protein translocation into the nucleus.However,SSAs/Ps patients with DCSR syndrome had more nucleation,higherβ-catenin expression,and negative regulatory factor(adenomatous polyposis coli and mutated in colorectal cancer)expression(P<0.0001)than SSA/P patients with Pi-Wei-Xu-Ruo syndrome.In addition,the SSA/P size was linearly correlated with the related protein expression.CONCLUSION Patients with DCSR syndrome had a more obvious Wnt signaling pathway activation and a higher risk of carcinogenesis.A high-quality colonoscopic diagnosis was essential.The thorough assessment of clinical diseases can be improved by combining the diseases of Western medicine with the syndromes of traditional Chinese medicine.
基金supported by the Science and Technology Project of Guangdong Province of China,No.2013B021800164the Scientific Research Project in Medicine of Guangdong Province of China,No.B200258
文摘Major ozonated autohemotherapy has been shown to promote recovery of upper limb motor function in patients with acute cerebral infarction,but whether major ozonated autohemotherapy affects remote injury remains poorly understood.Here,we assumed that major ozonated autohemotherapy contributes to recovery of clinical function,possibly by reducing remote injury after acute cerebral infarction.Sixty acute cerebral infarction patients aged 30–80 years were equally and randomly allocated to ozone treatment and control groups.Patients in the ozone treatment group received medical treatment and major ozonated autohemotherapy(47 mg/L,100 m L ozone) for 10 ± 2 days.Patients in the control group received medical treatment only.National Institutes of Health Stroke Scale score,modified Rankin scale score,and reduced degree of fractional anisotropy values of brain magnetic resonance diffusion tensor imaging were remarkably decreased,brain function improved,clinical efficiency significantly increased,and no obvious adverse reactions detected in the ozone treatment group compared with the control group.These findings suggest that major ozonated autohemotherapy promotes recovery of neurological function in acute cerebral infarction patients by reducing remote injury,and additionally,exhibits high safety.
基金Supported by National Natural Science Foundation of China,No. 81171641the Army Medical and Health Scientific Research Fund of China,No. 06H057
文摘AIM:To evaluate the safety and efficacy of granulocyte-colony stimulating factor(G-CSF) therapy in patients with hepatitis B virus(HBV)-associated acuteon-chronic liver failure(ACLF).METHODS:Fifty-five patients with HBV-associated ACLF were randomized into two groups:the treatment group and the control group.Twenty-seven patients in the treatment group received G-CSF(5 μg/kg per day,six doses) treatment plus standard therapy,and 28 patients in the control group received standard therapy only.The peripheral CD34 + cell count was measured consecutively by flow cytometry.Circulating white blood cell count,biochemical parameters,and other clinical data of these patients were recorded and analyzed.All patients were followed up for a period of 3 mo to evaluate the changes in liver function and survival rate.RESULTS:The peripheral neutrophil and CD34 + cell counts in the G-CSF group increased on day 3 from the onset of therapy,continued to rise on day 7,and remained elevated on day 15 compared to those of the control group.Child-Turcotte-Pugh score of patients in the treatment group was improved on day 30 from the onset of G-CSF therapy,compared to that in the controls(P = 0.041).Model for End-Stage of Liver Disease score of patients in the treatment group was improved on day 7(P = 0.004) and remained high on day 30 from the onset of G-CSF therapy(P < 0.001) compared to that in controls.After 3 mo of follow-up observation,the survival rate in the treatment group(48.1%) was significantly higher than that in the control group(21.4%)(P = 0.0181).CONCLUSION:G-CSF therapy promoted CD34 + cell mobilization in patients with HBV-associated ACLF,and improved the liver function and the survival rate of these patients.
基金Supported by National 11th Five-Year Special Major Project for Infectious Diseases(No.2008zx10002-005-6)Collaborative Project between US and China on Major Liver Diseases(No. 2009DFA32450)+1 种基金The Capital Medical Research and Development(No.20072026)the Army Medical and Health Scientific Research Fund of China,No.06H057
文摘AIM:To investigate the survival rates and prognostic factors in patients with hepatitis B virus-related acuteon-chronic liver failure(HBV-ACLF).METHODS:Clinical data in hospitalized patients with HBV-ACLF admitted from 2006 to 2009 were retrospectively analyzed.Their general conditions and survival were analyzed by survival analysis and Cox regression analysis.RESULTS:A total of 190 patients were included in this study.The overall 1-year survival rate was 57.6%.Patients not treated with antiviral drugs had a significantly higher mortality[relative risk(RR)=0.609,P=0.014].The highest risk of death in patients with ACLF was associated with hepatorenal syndrome(HRS)(RR=2.084,P=0.026),while other significant factors were electrolyte disturbances(RR=2.062,P=0.010),and hepatic encephalopathy(HE)(RR=1.879,P<0.001).CONCLUSION:Antiviral therapy has a strong effect on the prognosis of the patients with HBV-ACLF by improving their 1-year survival rate.HRS,electrolyte disturbances,and HE also affect patient survival.
基金Supported by National Natural Science Foundation of China,No.81460301 and No.81760363Key Project of Natural Science Foundation of Ningxia,No.NZ15134
文摘AIM To investigate the value of the gamma-glutamyltraspeptidase(GGT)-to-platelet(PLT) ratio(GPR) in the diagnosis of hepatic fibrosis in patients with chronic hepatitis B(CHB). METHODS We included 390 untreated CHB patients in this study. The GPR, aspartate aminotransferase(AST)-to-PLT ratio index(APRI), and fibrosis-4(FIB-4) of all patients were analysed to determine if these parameter were correlated with age, gender, medical history, liver function [total bilirubin(TBil), alanine aminotransferase(ALT), and AST], GGT, PLT count, or hepatic fibrosis stage. The GPR, APRI, and FIB-4, as well as the combination of the GPR and APRI or the GPR and FIB-4 were assessed in different cirrhosis stages using receiver operating characteristic(ROC) curve analysis to evaluate their value in diagnosing hepatic fibrosis in CHB patients. RESULTS The GPR, APRI, and FIB-4 were not correlated withCHB patients' age, gender, or disease duration(P > 0.05), but all of these parameters were positively correlated with serum ALT, AST, GGT, and PLT count(P < 0.01). Additionally, the GPR, APRI, and FIB-4 were positively correlated with hepatic fibrosis(P < 0.01); the areas under the ROC curve for the GPR in F1, F2, F3, and F4 stages were 0.723, 0.741, 0.826, and 0.833, respectively, which were significantly higher than the respective values for the FIB-4 and APRI(F1: 0.581, 0.612; F2: 0.706, 0.711; F3: 0.73, 0.751; and F4: 0.799, 0.778). The respective diagnostic cut-off points for each stage were 0.402, 0.448, 0.548, and 0.833, respectively. The diagnostic sensitivity and specificity were, respectively, 88.8% and 87.5% in F1, 72.7% and 89.7% in F2, 81.3% and 98.6% in F3, and 80% and 97.4% in F4 when the GPR and APRI were connected in parallel; 86.6% and 90.2%, 78.4% and 96%, 78.6% and 97.4%, and 73.2% and 97.9%, respectively, when the GPR and APRI were connected in series; 80.2% and 89%, 65% and 89%, 70.3% and 98.5%, and 78.8% and 96.8%, respectively, when the GPR and FIB-4 were connected in parallel; and 83.6% and 87.9%, 76.8% and 96.6%, 72.7% and 98%, and 74.4% and 97.7%, respectively, when the GPR and FIB-4 were connected in series.CONCLUSION The GPR, as a serum diagnostic index of liver fibrosis, is more accurate, sensitive, and easy to use than the FIB-4 and APRI, and the GPR can significantly improve the sensitivity and specificity of hepatic fibrosis diagnosis in CHB when combined with the FIB-4 or APRI.
文摘AIM: To investigate the regulatory effect of Vδ1 T cells and the antitumor activity of Vδ2 T cells in rectal cancer.METHODS: Peripheral blood, tumor tissues and paracarcinoma tissues from 20 rectal cancer patients were collected. Na?ve CD4 T cells from the peripheral blood of rectal cancer patients were purified by negative selection using a Naive CD4+ T Cell Isolation Kit Ⅱ(Miltenyi Biotec). Tumor tissues and para-carcinoma tissues were minced into small pieces and digested in a triple enzyme mixture containing collagenase type Ⅳ, hyaluronidase, and deoxyribonuclease for 2 h at room temperature. After digestion, the cells were washed twice in RPMI1640 and cultured in RPMI1640 containing 10% human serum supplemented with L-glutamine and 2-mercaptoethanol and 1000 U/m L of IL-2 for the generation of T cells. Vδ1 T cells and Vδ2 T cells from tumor tissues and para-carcinoma tissues were expanded by anti-TCR gδ antibodies. The inhibitory effects of Vδ1 T cells on na?ve CD4 T cells were analyzed using the CFSE method. The cytotoxicity of Vδ2 T cells on rectal cancer lines was determined by the LDH method.RESULTS: The percentage of Vδ1 T cells in rectal tumortissues from rectal cancer patients was significantly increased, and positively correlated with the T stage. The percentage of Vδ2 T cells in rectal tumor tissues from rectal cancer patients was significantly decreased, and negatively correlated with the T stage. After culture for 14 d with 1 mg/m L anti-TCR gδ antibodies, the percentage of Vδ1 T cells from para-carcinoma tissues was 21.45% ± 4.64%, and the percentage of Vδ2 T cells was 38.64% ± 8.05%. After culture for 14 d, the percentage of Vδ1 T cells from rectal cancer tissues was 67.45% ± 11.75% and the percentage of Vδ2 T cells was 8.94% ± 2.85%. Tumor-infiltrating Vδ1 T cells had strong inhibitory effects, and tumor-infiltrating Vδ2 T cells showed strong cytolytic activity. The inhibitory effects of Vδ1 T cells from para-carcinoma tissues and from rectal cancer tissue were not significantly different. In addition, the cytolytic activities of Vδ2 T cells from para-carcinoma tissues and from rectal cancer tissues were not significantly different.CONCLUSION: A percentage imbalance in Vδ1 and Vδ2 T cells in rectal cancer patients may contribute to the development of rectal cancer.
文摘Objective To examine and follow up cervical cytology of pregnant and postpartum women and study their cytopathologic characteristics, so as to determine screening and managing programs for abnormal cervical cytology. Methods Totally 5296 patients in pregnancy and postpartum, in which 3729 by computer-assisted cytology test and 1567 by liquid-based monolayers cytology test, were examined and diagnosed by the Bethesda System made in 2001. Those proven epithelial abnormalities patients were followed up until the lesions regressed to normal. The remaining patients, who exhibited persistent abnormalities or progression, were given further examinations. Results The positive rate of cervical cytological test was 8.72% (462/5296), including squamous carcinoma (SCA) 1 case(0.02%), high grade squamous intraepithelial lesion (HSIL) 34 cases(0.64%), low grade squamous intraepithelial lesion (LSIL) 145 cases(2.74%),atypical glandular cells (AGC) 5 cases(0.09%),atypical squamous cells cannot exclude HSIL (ASC-H) 14 cases(0.26%), atypical squamous cells of undetermined significance (ASC-US) 263 cases(4.97%). The 419 proven cytological abnormality cases were followed up successfully. The total transnegative rate in three months was 73.74% (309/419), in which 303 cases (72.32%) persisted normal status for more than six months after regression. And the transnegative rate of ASC-US, ASC-H, AGC, LSIL, and HSIL were 79.56%, 64.29%, 100%, 72.14% and 44.12%, respectively. Forty-six cases received biopsy directed by colposcopy. The distribution of coincidence of cytopathologic and histopathologic diagnosis was: SCA 1 case (100%), HSIL 10 cases (76.92%), LSIL 13 cases (65%),ASC-H 2 cases (50%), ASC-US 3 cases (37.50%), total 29 cases (63.04%). Conclusions We should cast more attention to screening cervix lesions in pregnant and postpartum women. Their cytopathologic characteristics are liable to make the clinician give a false positive diagnosis. So we propose to follow up them closely and to lower the indication of biopsy.
基金Innovation Projects of The Fifth Medical Center of Chinese PLA General Hospital,No.YNKT2014007.
文摘BACKGROUND Acute-on-chronic liver failure(ACLF),which includes hepatic and multiple extrahepatic organ failure,is a severe emergency condition that has high mortality.ACLF can rapidly progress and requires an urgent assessment of condition and referral for liver transplantation.Bacterial infections(BIs)trigger ACLF and play pivotal roles in the deterioration of clinical course.AIM To investigate the clinical characteristics and 28-d outcomes of first BIs either at admission or during hospitalization in patients with hepatitis B virus(HBV)-ACLF as defined by the Chinese Group on the Study of Severe Hepatitis B(COSSH).METHODS A total of 159 patients with HBV-ACLF and 40 patients with acute decompensation of HBV-related chronic liver disease combined with first BIs were selected for a retrospective analysis between October 2014 and March 2016.The characteristics of BIs,the 28-d transplant-free survival rates,and the independent predictors of the 28-d outcomes were evaluated.RESULTS A total of 194 episodes of BIs occurred in 159 patients with HBV-ACLF.Among the episodes,13.4%were community-acquired,46.4%were healthcare-associated,and 40.2%belonged to nosocomial BIs.Pneumonia(40.7%),spontaneous bacterial peritonitis(SBP)(34.5%),and bloodstream infection(BSI)(13.4%)were the most prevalent.As the ACLF grade increased,the incidence of SBP showed a downward trend(P=0.021).Sixty-one strains of bacteria,including 83.6%Gramnegative bacteria and 29.5%multidrug-resistant organisms,were cultivated from 50 patients with ACLF.Escherichia coli(44.3%)and Klebsiella pneumoniae(23.0%)were the most common bacteria.As the ACLF grade increased,the 28-d transplant-free survival rates showed a downward trend(ACLF-1,55.7%;ACLF-2,29.3%;ACLF-3,5.4%;P<0.001).The independent predictors of the 28-d outcomes of patients with HBV-ACLF were COSSH-ACLF score(hazard ratio[HR]=1.371),acute kidney injury(HR=2.187),BSI(HR=2.339),prothrombin activity(HR=0.967),and invasive catheterization(HR=2.173).CONCLUSION For patients with HBV-ACLF combined with first BIs,pneumonia is the most common form,and the incidence of SBP decreases with increasing ACLF grade.COSSH-ACLF score,acute kidney injury,BSI,prothrombin activity,and invasive catheterization are the independent predictors of 28-d outcomes.
基金Supported by The Shanghai Municipal Health Bureau,No.20114296The National Natural Science Foundation of China,No.30901738Leading Academic Discipline Project of the State Administration of Traditional Chinese Medicine of China
文摘AIM:To investigate the relationship between increases in expression time of ABCG2 mRNA driven by cisplatin and efficacy of platinum-containing chemotherapy for gastric cancer.METHODS:Tumor specimens and normal control tissues were collected from 78 patients with gastric cancer treated from January 2008 to December 2011.Fresh tumor tissue obtained from the surgically resected specimens was tested within 6 h.Polymerase chain reaction products were run on 2%agarose gels and analyzed under ultraviolet light after ethidium bromide staining.Increases in ABCG2 mRNA expression time cisplatin,and were divided into terciles and compared in relation to clinical outcomes.RESULTS:Among groups classified by expression time of ABCG2 mRNA,no significant differences in baseline clinical characteristics and pathological findings were detected.The median overall time was 14.2(95%CI:9.7-18.6),11.4(95%CI:6.3-16.5)and 8.1(95%CI:5.4-10.8)in patients with low,intermediate and high increases in ABCG2 mRNA expression times(P<0.05),respectively.Median survival associated with performance status and tumor node metastasis(TNM)stage showed a similar trend,with longer survival and higher risk for mortality associated with lower performance status score and TNM stage.In a multivariate analysis for survival with Cox proportional-hazards model,increased ABCG2 mRNA expression time was an independent predictor for overall survival.Overall survival was longer with increased ABCG2 mRNA expression times≤0.71 than increased ABCG2 mRNA expression times>0.71,with a hazard ratio for death of 0.855(95%CI:0.615-0.962,P=0.038).CONCLUSION:Increased ABCG2 mRNA expression time driven by cisplatin is associated with survival of gastric cancer patients,and this may help modify the therapeutic strategies.
基金State Education Ministry Scientific Research Foundation for the Returned Overseas Chinese Scholars, No. 1999747
文摘AIM: To investigate the effect of quercetin (3,3’,4’,5, 7-pentahydroxy flavone), a major flavonoid in human diet, on hyper-proliferation of gastric mucosal cells in rats treated with chronic oral ethanol. METHODS: Forty male Sprague-Dawley rats, weighing 200-250 g, were randomly divided into control group (tap water ad libitum), ethanol treatment group (6 mL/L ethanol), quercetin treatment group (intragastric gavage with 100 mg/kg of quercetin per day), and ethanol plus quercetin treatment group (quercetin and 6 mL/L ethanol). Expression levels of proliferating cell nuclear antigen (PCNA) and Cyclin D1 were detected by Western blot to assay gastric mucosal cell proliferation in rats. To demonstrate the influence of quercetin on the production of extra-cellular reactive oxygen species/ nitrogen species (ROS/RNS) in rats, changes in levels of thiobarbituric acid reactive substance (TBARS), protein carbonyl, nitrite and nitrate (NOx) and nitrotyrosine (NT) were determined. The activity of inducible nitric oxide synthase (NOS) including iNOS and nNOS was also detected by Western blot. RESULTS: Compared to control animals, cell proliferationin the gastric mucosa of animals subjected to ethanol treatment for 7 days was significant increased (increased to 290% for PCNA density P < 0.05, increased to 150 for Cyclin D1 density P < 0.05 and 21.6 ± 0.8 vs 42.3 ± 0.7 for PCNA positive cells per view field), accompanied by an increase in ROS generation (1.298 ± 0.135 μmol vs 1.772 ± 0.078 μmol for TBARS P < 0.05; 4.36 ± 0.39 mmol vs 7.48 ± 0.40 mmol for carbonyl contents P < 0.05) and decrease in NO generation (11.334 ± 0.467 μmol vs 7.978 ± 0.334 μmol P < 0.01 for NOx; 8.986 ± 1.351 μmol vs 6.854 ± 0.460 μmol for nitrotyrosine P < 0.01) and nNOS activity (decreased to 43% P < 0.05). This function was abolished by the co-administration of quercetin. CONCLUSION: The antioxidant action of quercetin relies, in part, on its ability to stimulate nNOS and enhance production of NO that would interact with endogenously produced reactive oxygen to inhibit hyper-proliferation of gastric mucosal cells in rats treated with chronic oral ethanol.
文摘High-dependency units(HDUs)provide high-level care to patients who suffer from single organ failure,with the exception of respiratory failure requiring mechanical ventilation;HDUs serve as an intermediary between general wards and Intensive Care Units.Due to military and civilian needs,our hospital has established a unique HDU for patients with liver disease in China.A Chinese military officer in the United Nations Peacekeeping Forces in South Sudan was transferred to our HDU for liver failure treatment in 2018.The patient’s disease status,nutrition,sleep habits,and psychological behaviour were monitored on different scales.The patient was provided with vascular monitoring,telemetry,pulse oximetry,drug treatment,nutritional support,sleep intervention,psychological intervention,and humanistic care by a multidisciplinary treatment team.After treatment,the patient recovered and avoided liver transplantation.Based on the experience with this HDU,this new model may create an efficient treatment process for military and civilian patients with severe liver disease at home or abroad.
文摘AIM:To investigate the role of α-fetoprotein(AFP),a cancer-associated fetal glycoprotein,in glucocorticoidinduced precocious maturation in rat colon.METHODS:Colons from suckling Sprague-Dawley rats were used in this study.Corticosterone acetate at a dose of 100 μg/g body weight was given to normal pups on days 7,9 and 11 after birth to induce hypercorticoidism.Control animals were injected with identical volumes of normal saline.Some rats receiving corticosterone 7 d after birth were also treated with mifepristone(RU38486),a glucocorticoid cytoplasm receptor antagonist to investigate the effects of glucocorticoids(GCs).The morphological changes of the crypt depth and villous height of the villous zone in colon were observed as indicesof colon maturation.Expression levels of AFP in colons were detected by reverse transcriptase polymerase chain reaction and Western blotting.To identify the cellular localization of AFP in developing rat colons,double-immunofluorescent staining was performed using antibodies to specific mesenchymal cell marker and AFP.RESULTS:Corticosterone increased the crypt depth and villous height in the colon of 8-and 10-d-old rats with hypercorticoidism compared with that in the control animals(120% in 8-d-old rats and 118% in 10-d-old rats in villous height,P = 0.021;145% in 8-d-old rats and 124% in 10-d-old rats in crypt depth,P = 0.017).These increases were accompanied by an increase of AFP expression in both mRNA and protein(2.5-folds in 8-dold and 2.5-folds in 10-d-old rats higher than in control animals,P = 0.035;1.8-folds in 8-d-old and 1.3-folds in 10-d-old rats higher than in control animals,P = 0.023).Increased crypt depth and villous height and increased expression of AFP in the colon of rats with hypercorticoidism were blocked by mifepristone.Both had positive staining for AFP or vimentin,and overlapped in mesenchymal cells at each tested colon.CONCLUSION:GCs promote the development of rat colon.AFP appears to be involved,in part,in mediating the effects of GCs in the developmental colon.
基金supported by the Natural Science Foundation of Shandong Province under Grant No.ZR2014AM006
文摘As the theory of the fractional order differential equation becomes mature gradually, the fractional order neural networks become a new hotspot.The robust stability of a class of fractional order Hopfield neural network with the Caputo derivative is investigated in this paper. The sufficient conditions to guarantee the robust stability of the fractional order Hopfield neural networks are derived by making use of the property of the Mittag-Leffler function, comparison theorem for the fractional order system, and method of the Laplace integral transform. Furthermore, a numerical simulation example is given to illustrate the correctness and effectiveness of our results.
基金the NUPTSF(Grant Nos.NY220078,NY217116,and NY220112)the Science Foundation of Jiangsu Province,China(Grant Nos.BK20211273 and BZ2021031)+7 种基金the Dual Innovative Doctor of Jiangsu Province,China(Grant No.JSSCBS20210522)the Institution of Jiangsu Province,China(Grant No.20KJB510014)the National and Local Joint Engineering Laboratory of RF and Micro-assembly(Grant No.KFJJ20200203)the Industry Program of Huzhou City(Grant No.2020GG03)the Distinguished Professor Grant of Jiangsu Province,China(Grant No.RK106STP18003)the Jiangsu Province Research Foundation,China(Grant Nos.NLXZYZZ219001 and SZDG2020009)the National Natural Science Foundation of China(Grant No.61964012)the Foundation of Jiangxi Science and Technology Department,China(Grant No.20202ACBL212001).
文摘Most amorphous carbon(a-C)applications require films with ultra-thin thicknesses;however,the electronic structure and opto-electronic characteristics of such films remain unclear so far.To address this issue,we developed a theoretical model based on the density functional theory and molecular dynamic simulations,in order to calculate the electronic structure and opto-electronic characteristics of the ultra-thin a-C films at different densities and temperatures.Temperature was found to have a weak influence over the resulting electronic structure and opto-electronic characteristics,whereas density had a significant influence on these aspects.The volume fraction of sp3 bonding increased with density,whereas that of sp2 bonding initially increased,reached a peak value of 2.52 g/cm^(3),and then decreased rapidly.Moreover,the extinction coefficients of the ultra-thin a-C films were found to be density-sensitive in the long-wavelength regime.This implies that switching the volume ratio of sp2 to sp3 bonding can effectively alter the transmittances of ultra-thin a-C films,and this can serve as a novel approach toward photonic memory applications.Nevertheless,the electrical resistivity of the ultra-thin a-C films appeared independent of temperature.This implicitly indicates that the electrical switching behavior of a-C films previously utilized for non-volatile storage applications is likely due to an electrically induced effect and not a purely thermal consequence.
基金the National Natural Science Foundation of China (Grant Nos.41872015,42111530024, 41820104002,41661134049 to JHJ and XYL)a grant from the UK Natural Environment Research Council (Grant No.NE/P013805/1 to XYL)+3 种基金the Fundamental Research Funds for the Central Universities (Grant No.2021qntd18 to XKW)the Scientific Research Fund, Hongda Zhang,Sun Yat-sen Universitya subsidiary of the Russian Government that supports a Program of Competitive Growth of Kazan Federal University among World’s Leading Academic Centersthe State Program of Geological Institute of RAS (Grant No.0135-2019-0044 to SVN).
文摘The genus Woodwardia,which together with the genera Anchistea and Lorinseria comprise the subfamily Woodwardioideae of Blechnaceae,has a disjunct distribution across Central and North America,Europe and the temperate to tropical areas of Asia.Fossil records of Woodwardia occur throughout the Paleogene and Neogene of North America,Europe and Asia.However,well-preserved fertile pinna fossils of this genus have not yet been reported in South China.In this paper,a new species,W.changchangensis Naugolnykh et Song,sp.nov.is described from the middle Eocene of the Changchang Basin,Hainan Island,South China.Macromorphological and micromorphological features of the fertile pinna show a straight pinna rachis,alternate,subtriangular pinnules,acute pinnule apices,almost entire or slightly undulate pinnule margins,long-ovoid sori,stalked sporangia and spores with wing-like folds on the surface,which are characterised in detail.Overall,the present fossil is most similar to the extant species Woodwardia japonica,which mostly grows in warm and moist environments.The discovery of this new species from the Changchang Basin of Hainan Island indicates that this genus has been distributed in the low-latitude tropical regions of South China from as early as the middle Eocene.Based on this find,and previous studies of other ferns from the same site,we infer that the climate of the Palaeo-Hainan landscape during deposition of the Changchang Formation was warm and humid,similar to conditions prevailing today across this region.
基金This work was supported by the Natural Science Foundation of Hubei Province(No.2019CFB753)the Hubei Technological Innovation Special Fund(No.2019ACA132)the Hubei Natural Science Foundation(No.2020CFB805).
文摘Objective Paroxysmal kinesigenic dyskinesia(PKD)is a rare movement disorder PRRT2 gene mutations have been reported to cause PKD.However,the pathophysiological mechanism of PKD remains unclear,and it is unknown whether an inflammatory response is involved in the occurrence of this disease.We aimed to investigate the symptomatology,genotype,and serum cytokines of patients with PKD.Methods We recruited 21 patients with PKD,including 7 with familial PKD and 14 with sporadic PKD.Their clinical features were investigated,and blood samples were collected,and PRRT2 mutations and cytokine levels were detected.Results The mean age at PKD onset was 12.3±2.2 years old.Dystonia was the most common manifestation of dyskinesia,and the limbs were the most commonly affected parts.All attacks were induced by identifiable kinesigenic triggers,and the attack durations were brief(<1 min).Four different mutations from 9 probands were identified in 7 familial cases(71.4%)and 14 sporadic cases(28.6%).Two of these mutations(c.649dupC,c.620_621delAA)had already been reported,while other 2(c.1018_1019delAA,c.1012+1G>A)were previously undocumented.The tumor necrosis factor(TNF)-αlevel in the PKD group was significantly higher than that in the age-and sex-matched control group(P=0.025).There were no significant differences in the interleukin(IL)-1β,IL-2R,IL-6,IL-8,or IL-10 levels between the two groups.Conclusion In this study,we summarized the clinical and genetic characteristics of PKD.We found that the serum TNF-αlevels were elevated in patients clinically diagnosed with PKD,suggesting that an inflammatory response is involved in the pathogenesis of PKD.
