Clinical Effect of Modified Ultrasound-Guided Subclavian Vein Puncture.

Objective: This study compared the effect of ultrasound-guided subclavian vein puncture with traditional blind puncture and the double-screen control method by evaluating the one-time puncture success and total success rates, the completion time for puncture and catheterization, and short-term complications. Methods: From January 2020 to January 2021, 72 patients with right subclavian venipuncture catheterization were collected, 12 of whom were excluded (including 3 cases of pneumothorax, 2 cases of hemothorax, 1 case of difficult positioning of thoracic deformity, 1 case of severe drug eruption, 3 cases of clavicle fracture, and 1 case of severe coagulation dysfunction). The remaining 60 cases were randomly divided into the traditional group (n = 30) and the improved group (n = 30). We record two sets of ultrasound localization time, puncture time, one-time puncture power, total puncture success rate, and short-term (24-hour) complications. Results: Compared with the traditional group, the ultrasound positioning time and puncture time in the improved group were significantly reduced and the puncture success rate was higher. There were no complications, such as incorrect arterial puncture and the occurrence of pneumothorax, in either group. Conclusion: The improved ultrasound-guided subclavian vein catheterization technique can greatly reduce the catheterization time and improve the success rate of puncture and catheterization. It can also reduce the occurrence of complications and damage to adjacent tissues. The operation is simple, fast, and easy to master, and it has a high popularization clinical value.

MUC20 as a novel prognostic biomarker in ccRCC correlating with tumor immune microenvironment modulation.

Tumor microenvironment (TME) broadly participates in genesis development of clear cell renal cell carcinoma (ccRCC). To recognize the immune and stromal modulation in TME, we screened the differentially expressed TME-related genes generated by the ESTIMATE algorithm in ccRCC specimens. Following the construction of protein-protein interaction (PPI) network and univariate COX regression, mucin 20 (MUC20) was judged to be a predictive factor. Further analysis, including immunohistochemistry (IHC) showed that MUC20 was positively correlated with survival and negatively correlated with the clinicopathologic characteristics (grade, clinical and TNM stages) in ccRCC patients. Gene Set Enrichment Analysis suggested that the low-expression MUC20 group was primarily enriched in immune-related activities, inflammation and epithelial-mesenchymal transition. Based on the CIBERSORT analysis for tumor-infiltrating immune cells (TICs), MUC20 was positively correlated with CD8+ T cells and resting mast cells and negatively correlated with activated CD4+ memory T cells, Treg cells, and plasma cells, implying that MUC20 may contribute to immune component in TME. Additionally, the patients with low MUC20 expression had better response to immune checkpoint blockades (ICBs) and 17 potential anticancer drugs were screened regarding calculating IC50 value. Thus, MUC20 may contain a value of prognosis assessment for ccRCC patients and indicate the immune modulation status of TME, which provided a novel insight for comprehensive immunotherapy.

Clinical characteristics and survival analysis of patients with hepatocellular carcinoma after hepatitis B virus turning negative.

BACKGROUND: Hepatitis B virus (HBV) infection is one of the most common infections, affecting 248 million people worldwide. Hepatitis B virus can progress to cirrhosis, liver failure and hepatocellular carcinoma (HCC). OBJECTIVES: To analyze the clinical characteristics and survival time of HCC occurrence in patients with HBV infection after virus turning negative. MATERIAL AND METHODS: The Kaplan-Meier and log rank survival analysis were performed to compare the overall survival (OS) of the patients with HCC in different groups. RESULTS: The 1-, 3- and 5-year OS rates of the 104 investigated patients were 76.4%, 54.4% and 20.5%, respectively. The median survival time was 37 months. The median survival time of HBV-DNA-negative group was longer than that of the HBV-DNA-positive group (negative compared to positive: 42 compared to 36, p = 0.003). The 5-year OS rate of patients receiving antiviral therapy before HCC diagnosis in the HBV-DNA-negative group was higher than that in the HBV-DNA-positive group (negative compared to positive: 53.0% compared to 0%, p = 0.022). There was no significant difference in the 5-year OS rate in patients who did not receive antiviral therapy before HCC diagnosis between HBV-DNA-negative and HBV-DNA-positive groups (p = 0.195). CONCLUSIONS: Among HBV-infected patients, a significant proportion of virus-negative patients develop liver cancer and require long-term continuous monitoring. A long-term effective antiviral therapy can improve the survival rate of patients with liver cancer. This study revealed important clinical characteristics of HCC patients and provided useful information for their clinical management and monitoring.

[Investigation on an outbreak of trichinosis and clinical analysis].

An outbreak of trichinosis occurred in Lhingchi Prefecture of Tibet with 9 cases identified among 10 people. They consumed collectively raw or undercooked pork. Two cases died because of misdiagnosis and mistreatment. In the 9 cases, 3 had eosinophilia, 3 showed positive anti-Trichinella IgG. Trichinella larvae were found in gastrocnemius muscle of 3 cases by biopsy including the 2 died cases.Seven cases were successfully treated with albendazole.