A fast radio burst source at a complex magnetized site in a barred galaxy.

Fast radio bursts (FRBs) are highly dispersed, millisecond-duration radio bursts1-3. Recent observations of a Galactic FRB4-8 suggest that at least some FRBs originate from magnetars, but the origin of cosmological FRBs is still not settled. Here we report the detection of 1,863 bursts in 82 h over 54 days from the repeating source FRB 20201124A (ref. 9). These observations show irregular short-time variation of the Faraday rotation measure (RM), which scrutinizes the density-weighted line-of-sight magnetic field strength, of individual bursts during the first 36 days, followed by a constant RM. We detected circular polarization in more than half of the burst sample, including one burst reaching a high fractional circular polarization of 75%. Oscillations in fractional linear and circular polarizations, as well as polarization angle as a function of wavelength, were detected. All of these features provide evidence for a complicated, dynamically evolving, magnetized immediate environment within about an astronomical unit (AU; Earth-Sun distance) of the source. Our optical observations of its Milky-Way-sized, metal-rich host galaxy10-12 show a barred spiral, with the FRB source residing in a low-stellar-density interarm region at an intermediate galactocentric distance. This environment is inconsistent with a young magnetar engine formed during an extreme explosion of a massive star that resulted in a long gamma-ray burst or superluminous supernova.

Diverse polarization angle swings from a repeating fast radio burst source.

Fast radio bursts (FRBs) are millisecond-duration radio transients1,2 of unknown origin. Two possible mechanisms that could generate extremely coherent emission from FRBs invoke neutron star magnetospheres3-5 or relativistic shocks far from the central energy source6-8. Detailed polarization observations may help us to understand the emission mechanism. However, the available FRB polarization data have been perplexing, because they show a host of polarimetric properties, including either a constant polarization angle during each burst for some repeaters9,10 or variable polarization angles in some other apparently one-off events11,12. Here we report observations of 15 bursts from FRB 180301 and find various polarization angle swings in seven of them. The diversity of the polarization angle features of these bursts is consistent with a magnetospheric origin of the radio emission, and disfavours the radiation models invoking relativistic shocks.

[Expert consensus on the application of critical care ultrasonography in invasive procedures].

The evolution of critical care medicine is inextricably linked to the development of critical care procedures. These procedures not only facilitate diagnosis and treatment of critically ill patients, but also provide valuable insights into disease pathophysiology. While critical care interventions offer undeniable benefits, the potential for iatrogenic complications necessitates careful consideration. The recent surge in critical care ultrasound (US) utilization is a testament to its unique advantages: non-invasiveness, real-time bedside availability, direct visualization of internal structures, elimination of ionizing radiation exposure, repeatability, and relative ease of learning. Recognizing the need to optimize procedures and minimize complications, critical care utrasound study group of Beijing critical care ultrasound research assocition convened a panel of critical care experts to generate this consensus statement. This document serves as a guide for healthcare providers, aiming to ensure patient safety and best practices in critical care.

[Establishment and validation of a preoperative nomogram model for predicting the risk of hepatocellular carcinoma with microvascular invasion].

Objective: To establish and validate a nomogram model for predicting the risk of microvascular invasion(MVI) in hepatocellular carcinoma. Methods: The clinical data of 210 patients with hepatocellular carcinoma who underwent hepatectomy at Department of Hepatobiliary and Pancreatic Surgery,the Affiliated Hospital of Qingdao University from January 2013 to October 2021 were retrospectively analyzed. There were 169 males and 41 females, aged(M(IQR)) 57(12)years(range:30 to 80 years). The patients were divided into model group(the first 170 cases) and validation group(the last 40 cases) according to visit time. Based on the clinical data of the model group,rank-sum test and multivariate Logistic regression analysis were used to screen out the independent related factors of MVI. R software was used to establish a nomogram model to predict the preoperative MVI risk of hepatocellular carcinoma,and the validation group data were used for external validation. Results: Based on the modeling group data,the receiver operating characteristic curve was used to determine that cut-off value of DeRitis ratio,γ-glutamyltransferase(GGT) concentration,the inverse number of activated peripheral blood T cell ratio (-aPBTLR) and the maximum tumor diameter for predicting MVI, which was 0.95((area under curve, AUC)=0.634, 95%CI: 0.549 to 0.719), 38.2 U/L(AUC=0.604, 95%CI: 0.518 to 0.689),-6.05%(AUC=0.660, 95%CI: 0.578 to 0.742),4 cm(AUC=0.618, 95%CI: 0.533 to 0.703), respectively. Univariate and multivariate Logistic regression analysis showed that DeRitis≥0.95,GGT concentration ≥38.2 U/L,-aPBTLR>-6.05% and the maximum tumor diameter ≥4 cm were independent related factors for MVI in hepatocellular carcinoma patients(all P<0.05). The nomogram prediction model based on the above four factors established by R software has good prediction efficiency. The C-index was 0.758 and 0.751 in the model group and the validation group,respectively. Decision curve analysis and clinical impact curve showed that the nomogram model had good clinical benefits. Conclusions: DeRitis ratio,serum GGT concentration,-aPBTLR and the maximum tumor diameter are valuable factors for preoperative prediction of hepatocellular carcinoma with MVI. A relatively reliable nomogram prediction model could be established on them.

[Impact of COVID-19 on primary percutaneous coronary intervention in patients with acute ST segment elevation myocardial infarction in Beijing].

Objective: To investigate the impact of COVID-19 on treatment of patients with acute ST segment elevation myocardial infarction(STEMI) undergoing primary percutaneous coronary intervention(PPCI). Methods: This was a multicenter retrospective study. STEMI patients undergoing PPCI from January 1, 2019 to December 31, 2021 were selected, based on the data of Xinnaolvsetongdao App. Clinical data and treatment time indicators, including symptom to first medical contact (S-FMC), symptom to door (StoD), first medical contact to ECG (FMC-ECG), first medical contact to guide wire (FMC-W), door to balloon (DtoB) and total ischemic time in 2019, 2020 and 2021 were compared. STEMI patients aged<60 years were sub-grouped as the young and middle-aged group, and STEMI patients aged≥60 years were sub-grouped as the elderly group. Results: A total of 7 435 (3 305 in 2019, 1 796 in 2020 and 2 334 in 2021) STEMI patients aged (59.6±12.6) years undergoing PPCI were included in this analysis. There were 5 990 males. For STEMI patients with PPCI in 2019, 2020 and 2021, FMC-ECG was 3 (1, 5) min, 3(1, 7) min and 4 (1, 7) min. FMC-W was 73 (56, 87) min, 78 (62, 95) min and 77 (62, 87) min. DtoB was 73 (56, 85) min, 78 (62, 95) min and 77 (62, 86) min. Total ischemic time was 189 (130, 273) min, 196 (138, 295) min and 209 (143, 276) min. FMC-ECG, FMC-W, DtoB and total ischemic time were longer in 2020 and 2021 than in 2019 (all P<0.05). The proportions of patients with FMC-ECG≤10 min (88.4% (1 588/1 796) vs. 92.7% (3 064/3 305), P<0.05), FMC-W≤120 min (87.9% (1 579/1796) vs. 91.7% (3 030/3 305), P<0.05) and DtoB≤90 min (72.3% (1 298/1 796) vs. 80.8% (2 672/3 305), P<0.05) were lower in 2020 than in 2019, whereas no differences were observed in the proportions of patients with FMC-ECG≤10 min (91.3% (2 131/2 334) vs. 92.7% (3 064/3 305), P=0.054), FMC-W≤120 min (92.0% (2 148/2 334) vs. 91.7% (3 030/3 305), P=0.635) and DtoB≤90 min (80.0% (1 867/2 334) vs. 80.8% (2 672/3 305), P=0.424) in 2021 compared with 2019. In the subgroup analysis, the proportions of patients with FMC-ECG≤10 min, FMC-W≤120 min and DtoB≤90 min were lower in the elderly group than in young and middle-aged group in 2019 (all P<0.05). The proportions of patients with FMC-W≤120 min and DtoB≤90 min were lower in the elderly group than in young and middle-aged group in 2021(all P<0.05). No differences were observed in the proportions of patients with FMC-ECG≤10 min, FMC-W≤120 min and DtoB≤90 min between the two group in 2020 (all P>0.05). Conclusions: Affected by the COVID-19, there is a reduction in the number of PPCI cases and treatment delays in STEMI patients, especially in the elderly. After adjusting the treatment strategy and widely applying the Xinnaolvsetongdao APP, the above indicators are significantly improved in 2021 as compared with 2020.

[Application value of metagenomic next-generation sequencing for infectious pathogens in patients receiving allogeneic hematopoietic stem cell transplantation].

Objective: To investigate the application value of Metagenomic Next-Generation sequencing (mNGS) in infectious patients after allogeneic hematopoietic stem cell transplantation(allo-HSCT). Methods: Patients suspected with local or systemic infections were retrospectively included after allo-HSCT in our department from April 2019 to November 2020. Pathogenic microorganisms were tested by mNGS in samples from peripheral blood, cerebrospinal fluid, alveolar lavage Liquid, abscess, etc. Other diagnostic methods such as bacterial/fungal culture, viral PCR detection were simultaneously explored comparing with mNGS results. Results: A total of 112 samples in 83 patients were detected by mNGS, and 34 pathogenic microorganisms were determined. Among these positive samples, 11 strains of bacteria (17 times) with the most common Escherichia coli (4/17) were reported. There were 7 strains of fungi (10 times) detected with primary Candida albicans (7/29). Although arvovirus 30.2% (39/129) were predominantly detected, its diagnostic relevance with infections was not definite. Other pathogenic viruses including cytomegalovirus (CMV) 25.6% (33/129) and Epstein Barr virus (EBV) 14.0% (18/129)were of significance. Comparing with golden diagnostic criteria, the sensitivity of mNGS was 86.5%, and specificity was 45.0%. Regarding single pathogen infection, the consistency of mNGS and conventional methods was 82.9% (29/35), while it was 16/17 in combination infections. Conclusion: mNGS could be a potential method to determine pathogens in patients suspected with infections after allo-HSCT.

[Percutaneous biliary stent combined with brachytherapy for malignant obstructive jaundice: a multicenter retrospective controlled study].

Objective: To investigate the efficacy, safety and prognostic factors of percutaneous biliary stent combined with iodine-125 seed chain brachytherapy (radiotherapy) in the treatment of malignant obstructive jaundice. Methods: Data of 107 cases with malignant obstructive jaundice treated with percutaneous biliary stent implantation from January 2017 to December 2020 were retrospectively analyzed. Among them, 58 cases received biliary stent combined with iodne-125 seed chain brachytherapy (study group), and 49 cases received biliary stent implantation (control group). The changes of bilirubin, stent patency time, complications, overall survival (OS) and prognostic factors were analyzed in both groups. Results: The incidence of complications in the study group and the control group were 17.2% and 18.3% respectively, and the difference was not statistically significant (P=0.974). Serum total bilirubin levels were decreased significantly in both groups at one month after surgery (P<0.001). Postoperative stent patency time was significantly better in the study group (10.0±1.6 months) (95% CI: 8.2～12.5) than that in the control group (5.2±0.4 months) (95% CI: 4.1～6.0, P<0.001). The median OS was longer in the study group (11.2±1.8 months) (95% CI: 9.2～12.8) than that in the control group (8.0±1.1 months) (95% CI: 8.0～12.8, P<0.001). Multivariate analysis result showed that stent combined with brachytherapy (HR=0.08, 95% CI:0.04～0.15, P<0.001) and receiving further anti-tumor therapy after surgery (HR=0.27, 95% CI:0.15~0.49, P<0.001) were independent risk factors affecting the patency of biliary stents. Preoperative percutaneous transhepatic biliary drainage (HR=0.46, 95%CI:0.28～0.74, P=0.002), stent combined with brachytherapy (HR=0.23, 95%CI:0.14～0.39, P<0.001) and receiving further anti-tumor therapy after surgery (HR=0.37, 95%CI:0.22～0.61, P<0.001) were independent risk factors affecting OS. Conclusion: Percutaneous biliary stent combined with brachytherapy is safe and effective in the treatment of malignant obstructive jaundice, which can significantly prolong the patency time of biliary stent and the survival time of patients.

[Status of HVPG clinical application in China in 2021].

Objective: The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China. Methods: This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems. Results: According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%). Conclusion: Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Application Prospects and Prospect of Metabolomics in the Identification of Sudden Cardiac Death.

ABSTRACT: In cases of sudden death, the prevention of sudden cardiac death and the analysis of the cause of death after sudden cardiac death have always been a difficult problem. Therefore, clinical research and forensic pathological identification of sudden cardiac death are of great significance. In recent years, metabolomics has gradually developed into a popular field of life science research. The detection of "metabolic fingerprints" of biological fluids can provide an important basis for early diagnosis of diseases and the discovery of potential biomarkers. This article reviews the current research status of sudden cardiac death and the research on metabolomics of cardiovascular diseases that is closely related to sudden cardiac death and analyzes the application prospects of metabolomics in the identification of the cause of sudden cardiac death.

Correlation between the Polymorphism of Coagulation-Related Genes and Lower Extremity Deep Venous Thrombosis.

ABSTRACT: Objective To investigate the correlation between the polymorphism of 4 coagulation-related genes, rs1799963 （coagulation factor V gene Leiden）, rs6025 （prothrombin gene G20210A）, rs1042579 （thrombomodulin protein gene c.1418C>T） and rs1801131 （methylenetetrahydroflate reductase gene） and lower extremity deep venous thrombosis （LEDVT）. Methods The 4 genotypes mentioned above of 150 LEDVT patients and 153 healthy controls were detected by the kompetitive allele specific polymerase chain reaction （KASP）, then related blood biochemical indicators were collected, binary Logistic regression was established to screen the independent risk factors of LEDVT, and the correlation between polymorphism of 4 coagulation-related genes and LEDVT and its indicators under different genetic modes after adjusting confounding factors were analyzed. Results Five variables, D-dimer, fibrinogen degradation product, homocysteine, sex and age might be the risk factors of LEDVT. These variables were put into 4 genetic inheritance models, and adjusted in binary Logistic regression. The results suggested that the mutations of rs1042579 were correlated with LEDVT under dominant inheritance mode. Conclusion The gene polymorphism of rs1799963, rs6025 and rs1801131 has no significant correlation with the formation of LEDVT. The gene polymorphism of rs1042579 plays a role under dominant inheritance mode, and might be an independent risk factor for formation of LEDVT.

[Operative efficacy of 13 malignant uterine tumors after Cf-252 intracavitary irradiation].

Objective: To investigate the surgical therapeutic efficacy of uterine tumors patients underwent Cf-252 neutron intra-cavity and external radiotherapy, and evaluate the application value of Cf-252 neutron radiotherapy. Methods: Thirteen cases of uterine tumor with local suspicious lesions or poor prognostic factors after CF-252 neutron intracavity and external radiotherapy were treated with surgery. Among them, 12 cases underwent extrafascial hysterectomy, 1 case underwent extensive hysterectomy and lymphadenectomy. The postoperative pathology and follow-up results were used to evaluate the efficacy. Results: Nine cases showed severe response to radiotherapy in postoperative cervical pathological tissues without residual tumor, and survived for more than 3-14 years, the median survival time was 8 years. All of 4 cases with residual tumor died within 1 year. Delayed healing of vaginal wounds occurred in 3 of the 12 cases. Conclusions: Cf-252 is a good brachytherapy source. The cervical tissue shows severe response to radiotherapy and prolonged healing time of vaginal wound is observed in some cases after CF-252 radiotherapy. To those uterine tumor patients with local suspicious lesions or poor prognostic factors after CF-252 neutron intracavity and external radiotherapy, extrafascial hysterectomy is a safe and feasible treatment method.

[A Qualitative Proteome-Wide Lysine Succinylation Profiling of Tea Revealed its Involvement in Primary Metabolism].

Lysine succinylation of proteins has potential impacts on protein structure and function, which occurs on post-translation level. However, the information about the succinylation of proteins in tea plants is limited. In the present study, the significant signal of succinylation in tea plants was found by western blot. Subsequently, we performed a qualitative analysis to globally identify the lysine succinylation of proteins using high accuracy nano LC-MS/MS combined with affinity purification. As a result, a total of 142 lysine succinylation sites were identified on 86 proteins in tea leaves. The identified succinylated proteins were involved in various biological processes and a large proportion of the succinylation sites were presented on proteins in the primary metabolism, including glyoxylate and dicarboxylate metabolism, TCA cycle and glycine, serine and threonine metabolism. Moreover, 10 new succinylation sites were detected on histones in tea leaves. The results suggest that succinylated proteins in tea plants might play critical regulatory roles in biological processes, especially in the primary metabolism. This study not only comprehensively analyzed the lysine succinylome in tea plants, but also provided valuable information for further investigating the functions of lysine succinylation in tea plants.

[Clinical value of early bedside ultrasound measurement of quadriceps femoris in diagnosis of ICU-acquired weakness].

Objective: To explore the correlation between quadriceps thickness (thickness of rectus femoris and vastus intermedius), cross-sectional area (cross-sectional area of the rectus femoris) and the strength score of the Medical Research Council (MRC) in critically ill patients, and to explore the changes in the length of hospital stay in the intensive care unit (ICU), and to determine the diagnostic value of muscle changes in the ICU-acquired weakness (ICU-AW). Methods: Patients admitted to the Department of Critical Care Medicine from March to October in 2019 who were expected to stay for more than five days were enrolled in this study. The cross-sectional area of the rectus femoris, the thickness of the rectus femoris, the thickness of the vastus intermedius on the first day of the ICU (D(1)), day 3 (D(3)), and day 5 (D(5)), day 7 (D(7)), out of ICU (D(ICU)), and the MRC muscle strength scores on the day of out of ICU prospectively were collected in all the patients, and the correlation and the regularity of quadriceps changes were analyzed. MRC>48 points on the day of dismiss of ICU were used as the standard for the diagnosis of ICU-AW, and the relationship between muscle changes of the quadriceps and ICU-AW was analyzed. The t test or the Mann-Whitney U test was used for data analysis. Results: A total of 45 patients were included, including 25 males and 20 females, aged (58±10) years. The rectus femoris cross-sectional area, rectus femoris thickness, and vastus intermedius thickness decreased with the length of ICU hospital stay. The cross-sectional area, thickness of the rectus femoris muscle, and the vastus intermedius thickness were positively correlated with the MRC score (r=0.452, 0.411, 0.402, all P<0.05), and the changes were all negatively correlated with the MRC score (r=-0.682, -0.740, -0.734, all P<0.05). On the 3rd day after ICU admission, the best cutoff value of rectus muscle cross-sectional area atrophy rate for discrimination of ICU-AW was 6.0%, with a sensitivity of 66.7% and a specificity of 77.8%; on the 5th day, the best cutoff value of rectus femoris thickness atrophy rate was 14.5%, with a sensitivity of 77.8% and a specificity of 66.7%; on the 7th day, the best cutoff value of vastus intermedius thickness atrophy rate was 19.9%, with a sensitivity of 70.6% and a specificity of 87.5%. Conclusion: Bedside ultrasound measurement of the quadriceps femoris cross-sectional area and thickness has certain diagnostic value for ICU-AW, and can identify patients with ICU-AW early.

[Elevated blood pressure in childhood or adolescence and early cardiovascular damage].

With the increase of overweight and obesity, elevated blood pressure (BP) in children and adolescents has been an important public health issue globally. Many studies have assessed the association between elevated BP and early cardiovascular damage in children and adolescents. A majority of these studies have highlighted the effects of elevated BP on cardiovascular damage, but with partly inconsistent findings. The studies of biological mechanisms played important roles in illuminating the potential mechanisms of cardiovascular damage caused by elevated BP. In addition, studies on the interventions, including losing weight and lowing BP were beneficial to reduce the occurrence of or reverse early cardiovascular damage. In this review, we reviewed articles on the association between elevated BP and early cardiovascular damage (including structural and functional damage of cardiac and vessels) in children and adolescents, underlying biological mechanisms, and the effectiveness of interventions to provide a reference for the prevention and intervention of early cardiovascular damage caused by elevated BP in children and adolescents and then reduce the occurrence of cardiovascular disease in adulthood.

[Association between elevated blood pressure and high carotid intima-media thickness in children according to different blood pressure references].

Objective: To analyze the association between elevated blood pressure (BP) and carotid intima-media thickness (cIMT) in children according to four BP references. Methods: Study population came from"Huantai Childhood Cardiovascular Health Cohort Study"in Huantai County, Zibo City, Shandong Province. A convenient cluster sampling method was used to conduct a cross-sectional survey on 1 515 children from November 2017 to January 2018 in a primary school. A total of 1 431 children aged 6-11 years old with complete data were included in this study. Data on demographic characteristics, BP and cIMT were collected through questionnaire survey, physical examination and ultrasound examination. High cIMT was defined as the level of cIMT ≥ age-and sex-specific 90th percentile of this study population. Based on the Chinese Guideline reference, the Health Industry reference, the International reference and the U.S. reference, all participants were divided into three subgroups: the normal BP, high normal BP and, elevated BP. The multivariate logistic regression models were used to examine the association between BP status and high cIMT in children. Results: The age of children was (8.9±1.5) years, and boys accounted for 53.4% (n=682). The multivariate logistic regression models showed that after adjusting for relevant confounding factors, the risk of high cIMT in elevated BP group was increased compared with the normal BP group according to the four references (all P values<0.05) Conclusion: Elevated BP according to the four BP references is associated with high cIMT in children.

[Design of huantai childhood cardiovascular health cohort study].

Cardiovascular disease (CVD) has been an important public health issue in China. Recently, the prevalence of obesity, elevated blood pressure, hyperglycemia, dyslipidemia, and unhealthy lifestyles was high in Chinese children and adolescents, which might increase the risk of short-term target organ damage and adult CVD. Therefore, we selected one primary school in Huantai County, Zibo City between November 2017 and January 2018 to establish the Huantai Childhood Cardiovascular Health Cohort Study. The aim of this project was to investigate the effects of childhood exposures on short-term target organ damage and adult CVD, and to provide evidence to curb the epidemic of CVD in China from the source. A total of 1 515 children aged 6-11 years old were included at the baseline. In this paper, we will introduce the overall design of the survey, including participants, methods, quality control, basic characteristics of the participants, study limitations, and future directions, which might provide some useful implications for similar researches in the future.

[Role of hepatic venous pressure gradient in the overall management process of portal hypertension].

Portal hypertension is a common complication of many chronic liver diseases and an important factor affecting the clinical prognosis of patients. Portal hypertension can bring a series of serious complications such as esophagogastric varices, gastrointestinal bleeding, ascites, spontaneous peritonitis, renal insufficiency, hypersplenism, and hepatopulmonary syndrome. Hepatic venous pressure gradient is the best clinical indicator that indirectly reflects the portal venous pressure. Currently, it is the gold standard test for diagnosing clinically significant portal hypertension. In addition, the hepatic venous pressure gradient has important application value in predicting the degree of liver cirrhosis, the risk and prognosis of portal hypertension variceal bleeding, ascites production, portal hypertension drugs reduction, and antiviral drugs efficacy. At the same time, individualized treatment based on portal pressure gradient has important theoretical and clinical significance, and provides new clinical ideas in the overall management of patients with portal hypertension.

[Analysis of influencing factors of shunt dysfunction after transjugular intrahepatic portosystemic shunt in liver cirrhosis accompanied with portal vein thrombosis].

Objective: To investigate the efficacy of shunt after transjugular intrahepatic portosystemic shunt (TIPS) in liver cirrhosis accompanied with portal vein thrombosis (PVT). Methods: Forty-four cases with liver cirrhosis accompanied with PVT who underwent TIPS treatment from January 2015 to May 2018 were retrospectively analyzed. Clinical baseline data of the patients were collected. Portal vein pressure gradient (PVPG) before and after the surgery was recorded. Shunt patency was observed at 3, 6, 12, 18 and 24 months after the surgery. The influencing factors were determined by univariate and multivariate analysis. Results: Transjugular intrahepatic portosystemic shunt was successfully established in all 44 cases. The postoperative PVPG was lower than preoperative (P < 0.01). The shunt patency rate after TIPS in PVT was 18.2% (n = 8). The cumulative shunt patency rates at 3, 6, 12, 18, and 24 months after surgery were 95.5%, 90.7%, 90.7%, 86.8% and 74.4%, respectively. Univariate analysis showed that diabetes history, platelet level and prothrombin time-international normalized ratio were associated with postoperative shunt dysfunction. Multivariate analysis showed that diabetes history (P = 0.007, OR = 28.606) was an independent risk factor for postoperative shunt dysfunction. Conclusion: TIPS is a safe and feasible procedure, which can effectively reduce the portal pressure in liver cirrhosis accompanied with PVT. Diabetic patients have a higher risk of postoperative shunt dysfunction. Therefore, clinical intervention should be strengthened for high-risk patients.

Expression of Autophagy-Associated Protein in Rat Muscle Tissues after Antemortem and Postmortem Injury.

ABSTRACT: Objective To study the expression of the three autophagy-associated proteins, BECN1, LC3 and p62, after the injury of the skeletal muscle of rats and to explore its application in differentiation between antemortem and postmortem injury. Methods The 72 healthy Sprague-Dawley rats were randomly divided into the undamaged control group, the antemortem injury group （0.5 h, 1 h, 2 h, 4 h, 8 h, 16 h and 24 h） and postmortem injury group （0.5 h, 1 h, 2 h and 4 h）. A model of the injured right hind limb of rats was constructed. The expressions of the autophagy-associated proteins, BECN1, LC3-2/LC3-1 and p62, in the control group, the antemortem injury group and postmortem injury group were detected by Western blotting method. The data were respectively centralized and standardized and the orthogonal partial least square-discrimination analysis （OPLS-DA） identification model of antemortem and postmortem injury groups was constructed. Results The expression of BECN1, p62 protein and LC3-2/LC3-1 after the injury of the skeletal muscle of the rats showed different degrees of changes, but the differences among the 3 groups had no statistical significance. Antemortem and postmortem injury groups can be distinguished by centralizing and standardizing the expression levels of autophagy protein BECN1 and the ratio of LC3-2/LC3-1. The principal components extracted from OPLS-DA model of antemortem injury and postmortem injury had a relatively good interpretation of the model （Rx2=0.563, Ry2=0.439）, but it were less predictive （Q2=0.366）. Conclusion The expression of BECN1 and the ratio of LC3-2/LC3-1 in injured local tissue of the rat skeletal muscle can be used for the differentiation of antemortem injury group and postmortem injury group.