Effects of ferritin heavy chain on oxidative stress, cell proliferation and apoptosis in geese follicular granulosa cells.

1. The ferritin heavy chain (FHC) has a vital impact on follicular development in geese, due to its ability to regulate apoptosis of granulosa cells (GCs) and follicular atresia. However, its specific regulatory mechanisms remain unclear. The present study characterised how FHC regulates oxidative stress, cell proliferation and apoptosis in goose GCs by interfering with and overexpressing the FHC gene.2. After 72 h of interference with FHC expression, the activity of GCs decreased remarkably (p < 0.05), reactive oxygen species (ROS) levels and the expression levels of antioxidant enzyme genes catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) increased significantly (p < 0.05). The overexpression of FHC for 72 h was found to significantly reduce the expression of CAT and SOD genes (p < 0.05).3. Interfering with FHC expression revealed that the expression levels of the cell proliferation gene Aurora kinase A (AURORA-A) were significantly decreased (p < 0.05), while the expression levels of the apoptosis genes B-cell lymphoma-2 (BCL-2) and cysteine aspartate-specific protease 8 (CASPASE 8) increased (p < 0.05). Further research has shown that, when interfering with FHC expression for 72 h, apoptosis rate increased by 1.19-fold (p < 0.05), but the current data showed a lower apoptosis rate after FHC overexpression by 59.41%, 63.39%, and 52.31% at three different treatment times (p < 0.05).4. In conclusion, FHC improved the antioxidant capacity of GCs, promotes GCs proliferation, and inhibits GCs apoptosis of ovarian follicles in Sichuan white geese.

Impact of COVID-19 infection experience on mental health status of intensive care unit patients' family members: a real-world study.

PURPOSE: Family members of patients hospitalized in intensive care unit (ICU) are susceptible to adverse psychological outcomes. However, there is a paucity of studies specifically examining the mental health symptoms in ICU patients' family members with a prior history of coronavirus disease 2019 (COVID-19) infection. AIM: This study aimed to investigate mental health status and its influencing factors of ICU patients' family members with previous COVID-19 infection experience in China. DESIGN: Nationwide, cross-sectional cohort of consecutive participants of family members of ICU patients from 10 provinces randomly selected in mainland China conducted between October 2022 and May 2023. METHODS: The basic information scale, Self-rating depression scale, Self-rating Anxiety Scale, Impact of Event Scale-Revised, Pittsburgh sleep quality index, Perceived Stress Scale, Connor-Davidson resilience scale, Simplified Coping Style Questionnaire were employed to explore mental health status among participants. RESULTS: A total of 463 participants, comprising 156 individuals in Covid-19 family member cohort (infection group) and 307 individuals in control family member cohort (control group), met inclusion criteria. The infection group exhibited significantly higher incidence of composite mental health symptoms compared to control group (P = 0.017). Multivariable logistic regression analysis revealed that being female, engaging in physical/mental labor, residing in rural areas, and having children were identified as risk factors for the development of depression, anxiety, and post-traumatic stress disorder symptoms, while medical history of surgery was protective factor. A predictive model demonstrated a favorable discriminative ability and excellent calibration. CONCLUSION: COVID-19 infection experience regarded as new traumatic stressors worsen mental health status of ICU patients' family members.

Application of lung ultrasound in monitoring bronchopulmonary dysplasia and pulmonary arterial pressure in preterm infants.

OBJECTIVE: The aim of this study was to evaluate the application value of lung ultrasound in monitoring bronchopulmonary dysplasia (BPD) and pulmonary artery pressure in premature infants. PATIENTS AND METHODS: A total of 98 preterm infants diagnosed with BPD in the Fourth Hospital in Shijiazhuang were recruited, and their disease severity was classified as mild (n=32), moderate (n=33), or severe BPD (n=33) based on gestational age and oxygen concentration. Lung ultrasonography of the children was performed. The correlation between lung ventilation scores and disease severity was statistically analyzed, and the discrete optimization results were documented. The pulmonary hypertension indexes of the three groups of children were compared. RESULTS: Aberrant alterations of the pleural line were observed in all included children, and the B-line rose as the disease progressed. The duration of invasive ventilation, medication, and hospital stay increased with disease exacerbation (p<0.05). The three groups significantly differed in terms of ultrasound pulmonary ventilation scores and clinical severity (p<0.05). Only mild BDP was identified by lung ultrasound on the first day of birth (T1), and severe BDP was detectable during the first and second week (T2-T3) as well as the third and fourth week (T4-T5). Severe BPD was associated with significantly higher levels of pulmonary hypertension indices vs. mild and moderate BPD (p<0.05). CONCLUSIONS: Pulmonary ultrasonography demonstrates great potential to predict pulmonary hypertension in children and assesses the disease severity. Pulmonary ultrasound allows for dynamical real-time observation of the pulmonary lesions in children with pulmonary hypertension, thereby revealing the severity of pulmonary hypertension in premature children.

The feasibility of a novel computer-aided classification system for the characterisation and diagnosis of breast masses on ultrasound: a single-centre preliminary test study.

AIM: To introduce a novel computer-aided classification (CAC) system and investigate the feasibility of characterising and diagnosing breast masses on ultrasound (US). MATERIALS AND METHODS: A total of 246 breast masses were included. US features and the final assessment categories of the breast masses were analysed by a radiologist and the CAC system according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon. The CAC system evaluated the BI-RADS assessment from the fusion of multi-view and colour Doppler US images without (SmartBreast) or with combining clinical variables (m-CAC system). The diagnostic performance and agreement of US characteristics between the radiologist and the CAC system were compared. RESULTS: The agreement between the radiologist and the CAC system was substantial for mass shape (κ = 0.673), orientation (κ = 0.682), margin (κ = 0.622), posterior features (κ = 0.629), calcifications in a mass (κ = 0.709) and vascularity (κ = 0.745), fair for echo pattern (κ = 0.379), and moderate for BI-RADS assessment (κ = 0.575). With BI-RADS 4a as the cut-off value, the specificity (52.5% versus 25%, p<0.0001) and accuracy (73.98% versus 62.6%, p=0.0002) of the m-CAC system were improved without significant loss of sensitivity (94.44% versus 98.41%, p=0.1250) compared with the SmartBreast. The m-CAC system showed similar specificity (52.5% versus 45.83%, p=0.2430) and accuracy (73.98% versus 73.58%, p=1.0000) as the radiologist, but a lower sensitivity (94.44% versus 100%, p=0.0156). CONCLUSION: The CAC system showed an acceptable agreement with the radiologist for characterisation of breast lesions. It has the potential to mimic the decision-making behaviour of radiologists for the classification of breast lesions.

[A study on the diagnostic value of GP73 in liver fibrosis among patients with chronic liver disease].

Objective: This study aimed to evaluate the diagnostic value of serum Golgi protein 73(GP73) alone and GP73 combined with liver stiffness measurement (LSM), aspartate aminotransferase/platelet ratio index (APRI), and 4-factor-based fibrosis index (FIB4) in diagnosing liver fibrosis in patients with chronic liver disease of different etiologies. Methods: A diagnostic test. A total of 68 patients who underwent liver biopsy in the Department of Traditional and Western Medical Hepatology of the Third Hospital of Hebei Medical University from October 2019 to December 2020 were selected to detect serum GP73 levels. iLivTouch was used to assess liver stiffness measurement (LSM). In addition, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), total bilirubin (TBil), direct bilirubin (DBil), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL) levels, and peripheral platelet (PLT) counts were assayed. The correlation between GP73 and the above indexes was assessed, and APRI and FIB-4 were calculated. SPSS 21.0 statistical software was used for statistical analysis. The area under the receiver operating characteristic curve was calculated to evaluate diagnostic efficacy of GP73 in identifying hepatic fibrosis stages. Furthermore, the difference between GP73 and liver stiffness, as well as APRI and FIB4 in diagnosing significant fibrosis was assessed. Results: Based on liver biopsy, 13, 18, 17, and 20 cases were diagnosed as stages S0-1, S2, S3, and S4, respectively. The AUC of GP73 diagnosing hepatic fibrosis stage S≥3 and S=4 were 0.806 and 0.844 at cut-off points of 2.06 and 3.27 µg/L, and the sensitivity and specificity were 93.5%, 61.5%, 90.0%, 70.3%, respectively. In addition, GP73 levels were positively correlated with the degree of liver fibrosis (r=0.547, P<0.001). Conclusions: The efficacy of serum GP73 level in diagnosing the degree of liver fibrosis in patients with chronic liver disease from different causes was significantly higher than that of APRI, FIB4, and LSM. The combination of GP73 and FIB4 can further improve the accuracy of diagnosis of liver fibrosis staging S≥3 and S=4, which is a reliable serological marker for the diagnosis of fibrosis in patients with chronic liver disease.

[Analysis on the status quo of the awareness rate of core knowledge of cancer prevention and treatment and its influencing factors among residents in Liaoning Province in 2021].

Objective: To analyze the status quo of the knowledge and related factors of cancer prevention and treatment among residents in Liaoning Province in 2021. Methods: From August to November 2021, through network sampling method, 17 474 permanent residents aged 15-69 years in Liaoning Province were surveyed. The WeChat public account was used to collect information such as demographic characteristics and core knowledge of cancer prevention and treatment. The Chi-square test was used to compare the difference of the level of the cancer prevention and treatment knowledge among different groups. The multivariate logistic regression model was used to analyze the related factors. Results: Among the 17 474 subjects, 43.1% (7 528) were male and 58.7% (10 262) were urban residents. The overall awareness rate was 72.3%, and the awareness rate of cancer cognition, prevention, early diagnosis and treatment, cancer management and rehabilitation were 71.4%, 67.6%, 72.7%, 83.4% and 63.5%, respectively. The multivariate logistic regression model showed that the residents who were man (OR: 0.850, 95%CI: 0.781-0.925), in rural areas (OR: 0.753, 95%CI: 0.694-0.817), 55-59 years old (OR: 0.851, 95%CI: 0.751-0.963), quitters (OR: 0.721, 95%CI: 0.640-0.813) and smoker (OR: 0.724, 95%CI: 0.654-0.801) had lower awareness rates, while the residents who were 35-54 years old (OR: 1.312, 95%CI: 1.202-1.432), with an educational level of junior high school/senior high school/college degree or above (OR: 1.834-5.130, 95%CI: 1.575-6.047), technical personnel (OR: 1.592, 95%CI: 1.367-1.854), civil servant/institution staff (OR: 1.282, 95%CI: 1.094-1.503), enterprise/business/service staff (OR: 1.218, 95%CI: 1.071-1.385), retired (OR: 1.324, 95%CI: 1.114-1.573) and with family history of cancer (OR: 1.369, 95%CI: 1.266-1.481) had higher awareness rates. Conclusion: The level of the awareness of core knowledge of cancer prevention and treatment among residents in Liaoning Province has met the requirements of the Healthy China Action. Region, gender, education level, age, family history of cancer and smoking are relevant factors.

[Efficacy and safety of neoadjuvant toripalimab combined with nimotuzumab and chemotherapy in patients with unresectable stage â £ squamous cell carcinoma of penis].

Objective: To compare the efficacy and safety of neoadjuvant chemotherapy alone or combined with toripalimab and nimotuzumab in patients with unresectable locally advanced or metastatic squamous cell carcinoma of penis. Methods: A total of 33 patients with unresectable squamous cell carcinoma of penis undergoing neoadjuvant chemotherapy alone or combined with toripalimab and nimotuzumab at Sun Yat-sen University Cancer Center from May 2015 to June 2021 were enrolled retrospectively. All the patients were male, with a median age (M(IQR))of 49.0 (13.5) years (range: 30 to 70 years). According to the therapy protocols, patients were divided into the chemotherapy group (16 cases) and the triple combination group (17 cases). Log-rank test was used to compare the progression-free survival and overall survival. χ2 test or Fisher exact method was used to compare the objective response rate, pathological down-stage rate and adverse events between these two groups. Results: The follow-up time was 28.1(19.2) months (range: 1.5 to 33.4 months). Patients of triple combination group were observed significantly longer progression-free survival (30.0 months vs. 8.2 months, χ²=3.998, P=0.046) than those of chemotherapy group. The median overall survival of the triple combination group and chemotherapy group were not reached and 15.2 months (χ²=3.298, P=0.069), respectively. Although there was no significant difference in the subsequent surgical resection rate between these two groups (12/17 vs.11/16, P=1), the objective response rate and the pathological complete response rate in triple combination group were significantly higher than in chemotherapy group (13/17 vs. 6/16, χ²=5.125, P=0.024; 6/7 vs. 0, P=0.001). The main common grade 1 to 2 adverse events in the triple combination group were alopecia (16 cases), anemia (15 cases), and nausea (14 cases). The main common grade 1 to 2 adverse events in the chemotherapy group were anemia (14 cases), alopecia (12 cases), decreased appetite (12 cases), and nausea (11 cases). The incidence of adverse events ≥grade 3 was similar in the triple combination group and chemotherapy group (8/17 vs. 6/16, χ²=0.308, P=0.579). There was no grade 3 adverse event in both groups. Conclusion: Compared with traditional chemotherapy alone, chemotherapy combined with toripalimab and nimotuzumab provides longer progression-free survival and similar toxicity for unresectable stage Ⅳ squamous cell carcinoma of penis.

[Research progress on infiltrating zone and microvascular invasion of hepatic alveolar echinococcosis].

Hepatic alveolar echinococcosis (AE) is a parasitic disease with biological characteristics similar to malignant tumor. It has no obvious clinical symptoms in the early stage. Most patients have complications such as jaundice, ascites and gastrointestinal bleeding when they see a doctor. At this time, the course of disease is at an advanced stage. In addition, the incomplete resection of the AE lesion(s) leads to a high postoperative recurrence rate, which has a serious impact on the physical and mental health of patients. Based on the summary of the latest research at home and abroad and the analysis of blood supply, microvascular invasion and vascular growth factor expression in the "infiltrating zone" adjacent to the lesions of hepatic AE, this article has a deep understanding of the occurrence and development process of hepatic AE, aiming to better guide clinical practice and improve the quality of life of patients.

[Effects of three kinds of proximal pedicled flaps of hand for relaying repair of degloving injuries of fingertips and the soft tissue defects in the donor sites].

Objective: To investigate the effects of the dorsal branch of digital artery pedicled flap combined with V-Y advancement flap for repair of degloving injury of fingertip and reverse dorsal metacarpal recurrent artery pedicled island flap for relaying repair of the soft tissue defects in the donor sites of the proximal dorsum. Methods: A total of 21 patients with degloving injuries of fingertips at the 2nd to 5th fingers were hospitalized in the Department of Hand Surgery of the Second Hospital of Tangshan from June 2016 to January 2019, including 14 males and 7 females aged 24-60 years. The retrospective clinical follow-up study was conducted. The areas of wounds after debridement ranged from 2.0 cm×1.5 cm to 3.5 cm×2.2 cm. The dorsal branch of digital artery pedicled flaps with dorsal branch of the proper digital nerve and dorsal digital nerve were designed in the proximal dorsum of the affected fingers to repair dorsal wounds in the distal dorsum of the affected fingers, and the sizes of the flaps ranged from 1.6 cm×1.5 cm to 2.6 cm×2.4 cm. The V-Y advancement flaps in the palmar side of the affected fingers were designed to repair palmar wounds in the distal segment of the affected fingers, and the sizes of the flaps ranged from 0.8 cm×0.6 cm to 2.0 cm×1.5 cm. The reverse dorsal metacarpal recurrent artery pedicled island flaps were used to repair the soft tissue defects in the donor sites of proximal dorsum, the sizes of the flaps ranged from 1.8 cm×1.7 cm to 2.8 cm×2.6 cm, and the donor sites of the flaps in back of hand were sutured directly. The survivals after the operation and the blood supply and appearance during follow-up of the three flaps were observed. At the final follow-up, the static two-point discrimination distance of the three flaps was measured, the satisfaction degree of patients for the appearance of hand was evaluated based on Michigan Hand Function Questionnaire, and the total active range of motion of the injured finger joints was assessed by the trial standard for the evaluation of the functions of the upper limbs of the Hand Surgery Society of the Chinese Medical Association. Results: All the flaps survived after operation. Tension blisters appeared on the surface of one dorsal branch of digital artery pedicled flap, and the wound healed after removing the stitch at the pedicle and changing dressings. During follow-up of 6-20 months, with an average of 12 months, the three kinds of flaps had good appearance, soft texture, and similar color with surrounding tissue, and with only linear scars in donor sites of the dorsal hand. At the final follow-up, the static two-point discrimination distances of V-Y advancement flaps, dorsal branch of digital artery pedicled flaps, and reverse dorsal metacarpal recurrent artery pedicled island flaps were 4-7 mm, 5-10 mm, and 8-15 mm, respectively. Sixteen patients were strongly satisfied with the appearance of hand, and the remaining five patients were satisfied with the appearance of hand. The total active range of motion of the injured finger joints was evaluated as excellent in 17 cases, good in 4 cases. Conclusions: The operation is simple and reliable for dorsal branch of digital artery pedicled flap combined with V-Y advancement flap to repair the degloving injury of fingertip, and reverse dorsal metacarpal recurrent artery pedicled island flaps to repair the soft tissue defects in the donor sites of the proximal dorsum, and the appearance and function of the affected fingers recover well, with minimal injury.

Dexmedetomidine promotes the recovery of renal function and reduces the inflammatory level in renal ischemia-reperfusion injury rats through PI3K/Akt/HIF-1α signaling pathway.

OBJECTIVE: To evaluate the protective effect of dexmedetomidine (Dex) against renal ischemia-reperfusion injury (RIRI) in rats through the phosphatidylinositol 3-hydroxy kinase (PI3K)/protein kinase B (Akt)/hypoxia-inducible factor-1α (HIF-1α) signaling pathway. MATERIALS AND METHODS: (1) A Sprague- Dawley rat model of RIRI was established. Thirty rats were divided into Sham group, injury (RIRI) group, and Dex treatment (RIRI + Dex) group. Serum was collected to detect renal function-related indexes, and the levels of serum inflammatory factors were examined via enzyme-linked immunosorbent assay (ELISA). (2) The kidney tissues were separated, and the degree of tissue damage was determined using immunohistochemical staining. (3) Ribonucleic acids (RNAs) were extracted from tissues, and the mRNA levels of inflammatory factors were measured using quantitative reverse transcription-polymerase chain reaction (qRT-PCR). (4) The protein expressions of Akt, phosphorylated (p)-Akt, PI3K, p-PI3K, and HIF-1α were detected via Western blotting. RESULTS: Compared with those in RIRI group, the levels of blood urea nitrogen and creatinine declined (p<0.05), the synthesized mRNAs of inflammatory factors in the kidney tissues were reduced (p<0.05), the secreted serum inflammatory factors was also reduced (p<0.05), and the phosphorylation levels of Akt and PI3K and the HIF-1α level rose (p<0.05) in RIRI + Dex group. CONCLUSIONS: Dex promotes the recovery of renal function and reduces the inflammatory level in RIRI rats through the PI3K/Akt/HIF-1α signaling pathway.

[Cost-effectiveness of primary prophylaxis with PEG-rhG-CSF in early-stage breast cancer patients receiving chemotherapy in China].

Objective: To evaluate the cost effectiveness of primary prophylaxis (PP) with pegylated recombinant human granulocyte colony stimulating factor (PEG-rhG-CSF), PP with recombinant human granulocyte colony stimulating factor (rhG-CSF) and no prophylaxis in women with early-stage breast cancer in China. Methods: Two phase Markov models were constructed for a hypothetical cohort of patients aged 45 with stage Ⅱ breast cancer. The first phase modelled costs and outcomes of 4 cycles docetaxel combined with cyclophosphamide [TC×4, febrile neutropenia (FN) risk>20%] chemotherapy, which assumptions based on literature reviews, including FN rates [base-case (deterministic sensitivity analysis range), 0.29 (0.24-0.35)] and related events [FN case-fatality, 3.4 (2.7-4.1)]. Second phase modelled the long term survival which was link with the relative dose intensity (RDI) [mortality hazard ratio (HR) of RDI < 85% vs ≥85%, 1.45 (1.00-2.32)]. Clinical effectiveness, therapeutic costs, and economic utilities were estimated from peer-reviewed publications and expert opinions in case of unavailability of published evidences. Results: Compared to rhG-CSF PP and no prophylaxis, the cost of PEG-rhG-CSF PP increased to 5 208.19 RMB and 5 222.73 RMB, respectively. The quality-adjusted life-years (QALYs) enhanced to 0.066 and 0.297, respectively. Accordingly, the incremental cost effectiveness ratios (ICERs) are 79 146.3 RMB and 17 558.77 RMB per QALY, which were both below the willingness to pay (WTP) threshold of three times GDP per capita (18, 000 RMB) recommended by the WHO. Sensitivity analysis suggested that the more clinically effective the primary prophylaxis with PEG-rhG-CSF is, the more cost-effective primary prophylaxis with PEG-rhG-CSF will be. And the lower the mortality HR of RDI<85% vs ≥85% is, the more cost-effective primary prophylaxis with PEG-rhG-CSF will be. Conclusion: Although the cost of PP PEG-rhG-CSF is higher, considering the additional benefits, the administrating of PP PEG-rhG-CSF is likely to be a cost-effective alternative to PP rhG-CSF and no prophylaxis in patients with early stage breast cancer whose FN risks are more than 20% in China.

Efficacy of supplemented Er-xian decoction combined with acupoint application for poor ovarian response.

This study aims to observe the efficacy of supplemented Er-xian decoction combined with acupoint application in treating poor ovarian response (POR). This study was a randomized controlled trial. A total of 80 patients, who were treated in the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from January 2016 to December 2017, were divided into two groups by tables of random numbers: experimental group (n = 40), and control group (n = 40). In the experimental group, patients orally received supplemented Er-xian decoction with acupoint application. In the control group, a Kuntai capsule was administered according to the course of treatment. The therapeutic effects in the two groups were observed and compared. In the experimental group, the total effective rate was 90%, the cure rate was 15% (six patients), the markedly effective rate was 35% (14 patients), the effective rate was 40% (16 patients), and the ineffective rate was 10% (four patients). In the control group, the total effective rate was 50%, the cure rate was 5% (two patients), the markedly effective rate was 15% (six patients), the effective rate was 30% (12 patients), and the ineffective rate was 50% (20 patients). The differences were statistically significant (P > 0.05). Definite efficacy was observed when a poor ovarian response was treated by supplemented Er-xian decoction combined with acupoint application. Improvements in perimenopausal symptoms, menstruation conditions, hormone levels, inhibin B (INHB), and antral follicle count (AFC) were markedly better in the experimental group than in the control group. In addition, the treatment was safe and had few side effects.

Correlation between the hemoporfin-mediated photodynamic treatment response and the dermoscopy vascular pattern in patients with a port-wine stain: a prospective study.

BACKGROUND: Vascular targeted photodynamic therapy (PDT) is a novel and promising therapy for the treatment of port-wine stains (PWS). There has been little prior exploration to our knowledge of how the dermatological vascular pattern may predict the response to PDT. OBJECTIVES: To analyse whether the vascular pattern classifications of PWS by dermoscopy can predict the efficacy of PDT. METHODS: This prospective cohort study included 163 patients with a clinical diagnosis of PWS who were treated twice with hemoporfin-mediated photodynamic therapy (HMME-PDT) at two-month intervals and followed up for 6 months. The vascular manifestations of dermoscopy with PWS were independently classified into 8 categories by 3 dermatologists. Images of the lesions were taken using VISIA, and the vascular patterns were imaged by dermoscopy by the same investigator. Images were captured before and after each treatment. The efficacy was evaluated with pre- and post-treatment VISIA images, and correlations between efficacy and vascular patterns were analysed by four dermatologists in a blinded and independent manner, between 10 January 2019 and 11 December 2019. RESULTS: In the dermoscopy images for the whole cohort, dotted and globular vessels (15.3%), short clubbed vessels (18.4%) and curved vessels (12.9%) were highly associated with cure and beneficial treatment effects. Pale halos surrounding brown dots (8.0%) and arborizing vessels (9.8%) were mainly correlated with skin lesion alleviation. Mixed vessels (12.9%), a grey-whitish veil (11.7%) and reticular patterns (11.0%) were mainly associated with no effect. The differences between each subgroup were statistically significant (P = 0.000). CONCLUSIONS: There is a clear correlation between the efficacy of PDT and the dermoscopy pattern in patients with PWS. Dermoscopy may therefore provide very useful clinical information prior to treatment in these cases. In addition, the vascular manifestations of PWS determined by dermoscopy help to predict response to PDT and manage patient expectations.

The diagnostic accuracy of dermoscopy and reflectance confocal microscopy for amelanotic/hypomelanotic melanoma: a systematic review and meta-analysis.

BACKGROUND: Dermoscopy and reflectance confocal microscopy (RCM) are noninvasive techniques for the diagnosis of skin lesions. Their accuracy for amelanotic/hypomelanotic melanoma (AHM) has not been systematically studied. OBJECTIVES: We aimed to investigate systematically the accuracy of dermoscopy and RCM and to compare the accuracy between them for diagnosing AHM. METHODS: We searched the PubMed, Web of Science, Embase and Cochrane Library databases for eligible studies about dermoscopy, RCM and AHM from inception to 31 June 2019. The quality of the studies was assessed with the Quality Assessment of Diagnostic Accuracy Studies tool. The pooled results were calculated using a random effects model in Stata 14, Meta-DiSc, RevMan 5·3 and SAS 9·4. We also explored the sources of heterogeneity by sensitivity analysis. RESULTS: Seven studies with a total of 1111 lesions were included. The pooled sensitivity and specificity of dermoscopy for the diagnosis of AHM were 61% [95% confidence interval (CI) 0·37-0·81] and 90% (95% CI 0·74-0·97), respectively. The corresponding respective values of RCM for the diagnosis of AHM were 67% (95% CI 0·51-0·81) and 89% (95% CI 0·86-0·92). In three studies including the performance of both RCM and dermoscopy, the relative diagnostic odds ratio of RCM over dermoscopy was 4·69 (95% CI 0·81-27·3) (P = 0·068). CONCLUSIONS: Our study demonstrates that both dermoscopy and RCM offer good diagnostic accuracy with high specificity and moderate sensitivity in the diagnosis of AHM. RCM is more accurate than dermoscopy in diagnosing AHM but the comparison needs to be confirmed. What's already known about this topic? Amelanotic/hypomelanotic melanoma (AHM) is the most lethal skin cancer. The diagnosis of AHM is a great challenge because of its nonspecific clinical manifestation. Early diagnosis can improve the prognosis. Dermoscopy and reflectance confocal microscopy (RCM) have high diagnostic accuracy for pigmented melanoma. What does this study add? Both dermoscopy and RCM offer good diagnostic accuracy with high specificity and moderate sensitivity for AHM. RCM might be more accurate than dermoscopy for diagnosis of AHM. More research on the diagnostic accuracy of dermoscopy and RCM for AHM is required in support of these findings.

[Effects of remifentanil gradual withdrawal on remifentanil induced postoperative hyperalgesia].

Objective: To explore the effects of remifentanil gradual withdrawal on remifentanil induced postoperative hyperalgesia. Methods: Ninety patients from January to June 2018 undergoing elective laparoscopic hysterectomy under general anaesthesia at Ningbo NO.2 hospital, ASA Ⅰ or Ⅱ grade, aged 20-60, were enrolled in this study and randomly assigned to 3 groups (n=30): Group L (low dose remifentanil), Group H (high dose remifentanil) and Group G (high dose remifentanil with gradual withdrawal). Mechanical pain thresholds (MPT), visual analogue scale (VAS) and additional analgesics were recorded at 6 and 24 hours after the operation. Results: There was no significant difference among the VAS and additional analgesics in three groups at 6 and 24 hours after operation (P>0.05). There was no significant difference among the MPT in three groups before operation (P>0.05). The MPT of group L, group H and group G were (49.8±12.2), (35.5±13.0) and (48.6±11.4) g at 6 hours after surgery, and (51.4±14.3), (36.9±11.1) and (48.8±11.5) g at 24 hours after surgery, respectively, with statistically significant differences (F=12.6, 11.668, both P<0.01). The MPT of group H at 6 h and 24 h after surgery was lower than that of group L (all P<0.01), while the MPT of group G at 6 h and 24 h after surgery was significantly higher than that of group H (all P<0.01). No correlation was observed between MPT and VAS scores or additional analgesics at 6 and 24 hours postoperatively (P>0.05). Conclusion: Remifentanil gradual withdrawal significantly alleviated intraoperative administration of remifentanil induced postoperative hyperalgesia in laparoscopic hysterectomy patients.

[Meta-analysis of the influence of prophylactic central lymph node dissection on the prognosis of patients with thyroid micropapillary carcinoma].

Objective: To evaluate the efficacy and safety of prophylactic central neck dissection (pCND) in papillary thyroid microcarcinoma (PTMC). Method: The PubMed, EMbase, Web of Knowledge, CBM, Wanfang, and CNKI databases were searched, and controlled trials and cohort studies of central lymph node dissection for cervical cancer in PTMC surgery were collected. The search time was from the establishment of the library to September 2018. Meta-analysis was performed on 4 articles that met the inclusion criteria to calculate the relative risk. Result: A total of 1 169 cases were included in 4 retrospective cohort studies. In addition to conventional thyroidectomy, pCND reduced the risk of local recurrence and did not increase the recurrent laryngeal nerve (RLN) injury (temporary or permanent), the incidence of permanent hypocalcemia. Postoperative temporary hypocalcemia is more common after surgery with pCND.Conclusion: Prophylactic central lymph node dissection reduces local recurrence rates without increasing long-term complications compared with thyroid and tumor resection alone.

Expression and prognostic significance of long noncoding RNA AK001796 in esophageal squamous cell carcinoma.

OBJECTIVE: Previous study has reported that long noncoding RNA AK001796 (AK001796) functions as a tumor promoter in esophageal squamous cell carcinoma (ESCC). However, its clinical in ESCC patients remains largely unclear. The purpose of the present study was to evaluate the prognostic value of AK001796 in ESCC patients. PATIENTS AND METHODS: The expression levels of AK001796 in ESCC tissues and matched normal tissues were detected by RT-PCR. Association between AK001796 levels and clinicopathological factors was also analyzed by chi-square test. Overall survival (OS) and disease-free survival (DFS) were analyzed using the Kaplan-Meier method and log-rank test. The predictors for OS and DFS were assessed by univariate analysis and multivariate analysis using Cox's proportional hazards model. RESULTS: We found that AK001796 was elevated in human ESCC samples compared with the adjacent normal tissues (p<0.01), and the high level of AK001796 expression was significantly correlated with lymph node metastasis (p=0.032) and advanced UICC stage (p=0.016). Interestingly, Kaplan-Meier analysis indicated that patients with high AK001796 expression had a significantly lower OS (p=0.010) and DFS (p=0.001). Moreover, we showed that AK001796 was an independent poor prognostic factor for OS and DFS in ESCC patients through univariate and multivariate analysis. CONCLUSIONS: Our data provide important evidence that AK001796 may be a useful biomarker of advanced progression and poor prognosis of ESCC.

[Analysis on the trend of innovation and development in the field of ophthalmology].

Objective: To systematically analyze the innovation and development trend in the field of ophthalmology. Methods: The latest ophthalmology funding program from the National Eye Institute and National Natural Science Foundation of China, and funding project for 2012 to 2016 from the National Institutes of Health, National Natural Science Foundation of China and National key research and development plan of China was collected. Using the comparative analysis method, the major ophthalmology funding areas at home and abroad were analyzed. Papers published in 2012 to 2016 in the field of ophthalmology were collected from the Web of Science Core Collection, among which ESI highly cited papers and hot papers were particularly selected. Using bibliometric methods, the time trend of the number of papers and the citation frequency were analyzed. Using the co-occurrence cluster analysis method, the continued focuses and emerging concerns of ophthalmology papers was analyzed. Results: The funding plan of the National Eye Institute mainly covers nine major diseases in ophthalmology. NSFC focuses on retinal damage and repair mechanisms. The National Key Research and Development Program of China focuses on research on high-end ophthalmic implants. NIH continues to focus on the molecular mechanisms of blinding eye disease such as diabetic retinopathy, age-related macular degeneration, glaucoma, corneal disease and cataracts, basic research in genetics, and advanced diagnostic techniques such as imaging. Latest areas of interest involve gene editing techniques and the application of stem cell technology in ophthalmology. In China, research and application of stem cells in ophthalmic diseases, intraocular sustained-release drug carrier, and precision medicine research in ophthalmology are emerging areas of funding. In 2012 to 2016, research topics of 168 papers collected by ESI focused on macular degeneration, retinal diseases, glaucoma and other eye diseases. How to quickly promote new drugs and new technological achievements to the clinical application is a problem in the field of ophthalmology. How to change the ophthalmology clinic model, so as to provide patients with convenient and quality service, has become a research topic that needs to be given attention to. Conclusions: Based on the multidimensional analysis of innovation and development in the field of ophthalmology, cross application and integration of ophthalmology and high - tech fields such as advanced imaging technology, stem cell technology, gene editing technology, molecular targeting, and artificial intelligence will provide a strong basis for the enhancement of China's ophthalmology research innovation and international competitiveness. Research efforts for ophthalmic transformation should be strengthened, in order to realize the clinical application of the achievements as soon as possible. (Chin J Ophthalmol, 2018, 54: 452-463).

[Characteristics of ERG, Fli-1, CD34, CD31 and Fâ §RAg expression in hepatic malignant vascular tumors].

Objective: To investigate the expression of ERG, Fli-1, CD34, CD31 and factor Ⅷ-related antigen(FⅧRAg) in hepatic malignant vascular tumors. Methods: A retrospective analysis was conducted on 63 cases of primary hepatic malignant vascular tumors and 31 cases of hepatic other malignant spindle cell tumors collected during January 1986 to January 2014. EnVision method was used to detect the expression of ERG, Fli-1, CD34, CD31, FⅧRAg. Results: Sixty-three cases of malignant vascular tumors, including 24 cases of angiosarcoma, 38 cases of epithelioid hemangioendothelioma and 1 case of hepatic Kaposi's sarcoma. All of the cases were positive for ERG(100.0%, 63/63). Positive rate of Fli-1, CD34, CD31, FⅧRAg was 96.8% (61/63), 87.3% (55/63), 81.0% (51/63) and 41.3% (26/63), respectively. In other hepatic malignant spindle cell tumors, the positive rate of ERG, Fli-1, CD34, CD31 and FⅧRAg was 3.2% (1/31), 19.4% (6/31), 19.4% (6/31), 9.7%(3/31) and 3.2%(1/31), respectively.The sensitivity of ERG, Fli-1, CD34, CD31, FⅧRAg was 100.0%, 96.8%, 87.3%, 81.0% and 41.3%, respectively.The specificity was 96.8%, 80.6%, 80.6%, 90.3% and 96.8%, respectively. Conclusion: ERG is a more sensitive and specific diagnostic marker for hepatic malignant vascular tumors in comparison to Fli-1, CD34, CD31 and FⅧRAg.

Transient receptor potential melastatin 4 cation channel in pediatric heart block.

OBJECTIVE: Progressive cardiac conduction disease (PCCD) is a common pediatric heart conduction disorder. It is an autosomal inheritance of rare mutations, which leads to familial cases of PCCD. In these cases, the His-Purkinje system's conductive capacity is progressively deranged, involving either right or left bundle branch block. Also, QRS complexes display widening is an important characteristic that culminates in complete AV block, syncope, and sudden death. Mutations in TRPM4 gene that encodes for transient receptor potential melastatin 4 have recently been reported to cause familial cases of PCCD and heart block. TRPM4 conducts a Ca2+-activated non-selective monovalent cationic current leading to a negative plasma membrane potential. TRPM4 channels let Na+ ion influx, causing membrane depolarization, whereas, at positive membrane potentials, TRPM4 channels repolarize the membrane by facilitating K+ ion efflux from the cell. TRPM4 protein contains many regulatory motifs that confer voltage dependence, ATP/ADP sensitivity, and Ca2+ responsiveness. Mutational studies revealed the significance of the two-calmodulin binding sites at the N-terminus of for Ca2+ dependent activation of this channel. Mutations that reduce deSUMOylation increase the steady-state levels of active TRPM4 channels on the membrane without alteration of its sensitivity to Ca2+ or ATP or its voltage dependence of activation. Increased TRPM4 function interferes with cardiac conduction and eventually contributes to heart block. Both gain and loss of function mutations of TRPM4 are implicated in the cardiac block. Currently, the major therapeutic management of cardiac block due to TRPM4 mutations is implantation of a pacemaker to reinstate normal current propagation through AV node.