Laparoscopic radical resection for gallbladder cancer / 中华普通外科杂志

Objective:To investigate the feasibility and clinical efficacy of laparoscopic radical cholecystectomy(LRC) for gallbladder cancer.Methods:The clinical data of 247 patients with gallbladder cancer who underwent radical resection from Jan 2013 to Dec 2019 at Department of General Surgery, Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine was analyzed retrospectively. After propensity score matching, 54 patients were included in laparoscopic group and 103 in laparotomy group. The clinicopathological characteristics and the short- and long-term outcomes were compared.Results:Compared to the laparotomy group, patients in the laparoscopic group had less intraoperative blood loss [100(50,200)ml vs. 200(100,300) ml, Z=4.105, P<0.001], earlier postoperative oral diet[1.0(1.0,2.0) d vs. 2.0(1.0,4.0) d, Z=4.157, P<0.001]and drainage removal[6.5(4.0,12.5) d vs. 9.0(6.0,16.0) d, Z=2.769, P=0.006], shorter hospital stay[7.0(5.0,9.3) d vs. 9.0(8.0,14.0) d, Z=3.923, P<0.001]. The number of lymph node dissection in laparoscopic group was significantly lesser than that in open group [6(4,9) vs. 8(5,12), Z=2.639, P=0.008]. There were no significant differences between the two groups in postoperative complications, short-term and long-term survival outcomes. Conclusions:Laparoscopic radical surgery for gallbladder cancer is as safe and feasible, and identical survival prognosis as open surgery, and moreover a less traumatic procedure.

Blockade of Wnt/β-catenin signaling pathway by DKK1 inhibits paraquat-induced transition of lung fibroblasts / 中华急诊医学杂志

Objective:To investigate the effects of inhibition of Wnt/ β-catenin signaling pathway on paraquat (PQ)-induced transition of human lung fibroblast cell line MRC-5 and related molecular mechanisms.Methods:The MRC-5 cells were divided into three groups. Control group: without drug treatment; PQ group: the cells were treated by PQ (50 μmol/L) for 72 hours to establish cell transition model; PQ+DKK1 group: the cells were treated with PQ (50 μmol/L) and DKK1 (10 ng/mL) for 72 hours. Then, the cells were collected, and the transition related signatures including α-SMA, Vimentin and Collagen I were detected by immunofluorescence and Western blot (WB); Meanwhile, the expression levels of Wnt pathway-related molecules including β-catenin, Cyclin D1 and WISP1 were determined by WB, immunofluorescence and real-time fluorescence quantitative PCR (RT-PCR) during the transition; In addition, the inhibitor of Wnt/β-catenin pathway Dickkopf-1 (DKK1) was applied to block the signaling. Then the expression changes of β-catenin, cyclin D1 and WISP1 were detected by WB to verify the inhibitory effect, and the transition marker molecules including α-SMA, Vimentin and Collagen I were also determined by WB.Results:After 72 hours, compared with the Control group, the expression levels of α-SMA, Vimentin and Collagen I of MRC-5 cells in PQ group were increased significantly ( P<0.05); The expression levels of β-catenin, Cyclin D1 and WISP1 of MRC-5 cells in PQ group were significantly up-regulated ( P<0.05); DKK1 could inhibit the high expression of α-SMA, Vimentin and Collagen I of MRC-5 cells during PQ-induced transition ( P<0.05). Conclusions:DKK1 could inhibit PQ-induced transition of lung fibroblasts by interference with Wnt/β-catenin signaling, which was expected to further inhibit pulmonary fibrosis caused by PQ.

Efficacy observation of azacitidine alone and combined with CAG regimen in treatment of acute myeloid leukemia and myelodysplastic syndromes / 肿瘤研究与临床

Objective:To compare the efficacy and safety of azacitidine alone or combined with half-course CAG (arorubicin + cytarabine + granulocyte colony stimulating factor) regimen and azacitidine combined with full-course CAG regimen in treatment of patients with acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS).Methods:The clinical data of 51 patients with AML and MDS admitted to Datong Fifth People's Hospital from September 2019 to March 2022 were retrospectively analyzed. Among them, 17 patients received azacitidine alone 7-day regimen, 17 patients received azacitidine combined with half-course CAG regimen and 17 patients received azacitidine combined with full-course CAG regimen. The remission rate, adverse reaction rate and supportive treatment were compared among the three groups.Results:The objective remission rate (ORR) was 58.8% (10/17), 64.7% (11/17) and 70.6% (12/17) in azacitidine alone group, azacitidine combined with half course CAG group, and azacitidine combined with full course CAG group, respectively, and the difference was not statistically significant among the above groups ( P = 0.773). The main adverse reaction after treatment with azacitidine was bone marrow suppression,and 32 patients had grade 3-4 hematological side effects. The average time of agranulocytopenia was (15±5) d, 23 patients had infection and 11 cases had hemorrhage. There were no significant differences of the three groups in the hemorrhage incidence, the infection, incidence, agranulocytosis time, the amount of red blood cell infusion and the amount of platelet infusion (all P > 0.05). Except 1 patient died of acute left ventricular dysfunction after chemotherapy in the first cycle and 1 patient died of cerebral hemorrhage after chemotherapy in the third cycle, all the patients successfully completed the chemotherapy after active symptomatic support treatment and safely passed the bone marrow suppression period. Conclusions:Azacitidine alone, azacitidine combined with half-course CAG, azacitidine combined with full-course CAG regimens in the treatment of AML/MDS all show good curative effects, and their adverse reactions are similar to supportive treatment. Azacitidine combined with full-course CAG regimen has a relatively high effective rate.

Correlation between anhedonia level and cognitive function in patients with first-episode psychosis / 四川精神卫生

ObjectiveTo explore the anhedonia level and its relationship with cognitive function in patients with first-episode psychosis， and to analyze the influencing factors of cognitive function. MethodsA total of 143 first-episode psychiatric patients who met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） in the Affiliated Brain Hospital of Guangzhou Medical University from December 2016 to March 2019 were selected. Positive and Negative Syndrome Scale （PANSS） was used to evaluate the patient’s psychiatric symptoms， in which N2 （emotional withdrawal） and N4 （passive/apathetic social withdrawal） were used to assess the anhedonia level， and patients whose （N2+N4） scores beyond 4 were classified into anhedonia group， and those with （N2+N4） scores less than or equal to 4 were classified into non-anhedonia group. Hamilton Depression Scale-24 item （HAMD-24） was used to measure the depressive symptoms， and the MATRICS Consensus Cognitive Battery （MCCB） was used to detect cognitive function. Then the clinical symptoms and cognitive function of two groups were compared， and the influencing factors of cognitive function were screened by multiple linear regression analysis. ResultsThe negative symptom score， general pathological symptom score and total score of PANSS in anhedonia group were significantly higher than those of non-anhedonia group， with statistical difference （P<0.05）. The score of working memory in adolescent subgroup， the scores of information processing speed， attention/alertness and vocabulary learning in adult subgroup of anhedonia group were lower than those of non-anhedonia group， with statistical difference （P<0.05）. Multiple linear regression analysis showed that the anhedonia score and the duration of untreated psychosis were the influencing factors of working memory in adolescent subgroup （P<0.05）. ConclusionPatients with high levels of anhedonia suffer more severe mental symptoms and cognitive impairment， moreover， anhedonia is one of the influencing factors of working memory in adolescents.

Risk factors for acute liver injury in patients after resuscitation from cardiac arrest and their influence on prognosis / 中华急诊医学杂志

Objectives:To investigate the risk factors for acute liver injury (ALI) in patients after resuscitation from cardiac arrest and their influence on prognosis.Methods:The clinical data of patients after cardiopulmonary resuscitation in our department from January 2015 to January 2018 were analyzed. According to whether ALI occurred, the selected patients were divided into the ALI group and non-ALI group. The basic situation of the two groups of patients and the occurrence of shock and cardiac insufficiency after cardiac arrest were investigated. Kaplan-Meier method was used to analyze the effect of ALI on the 1-year survival of patients. The 28-day mortality and neurological recovery were observed in patients in the ALI group. Multivariate logistic regression was used to analyze the risk factors for ALI.Results::There were 54 patients in the ALI group and 158 patients in the non-ALI group. The patients in the ALI group needed a longer time to recover spontaneous circulation [19 (10-27) min, P=0.015], and the overall condition (SOFA score, acidosis, and lactic acid) were more serious. The incidences of shock and heart failure after cardiac arrest in the ALI and non-ALI groups were 74% and 55%, and 89% and 70%, respectively. The 1-year cumulative survival rate of patients in the non-ALI group was significantly higher than that of the ALI group ( P=0.043). The longer the duration of ALI, the higher the incidence of poor prognosis. The time to resume spontaneous circulation ( OR=3.762; 95% CI: 2.347-5.098) and heart failure ( OR=4.272; 95% CI: 2.943-5.932) after cardiac arrest were associated with ALI in patients after cardiopulmonary resuscitation (both P<0.05). Conclusions:The time to resume spontaneous circulation after cardiac arrest and heart failure after cardiopulmonary resuscitation are risk factors for ALI, and the occurrence of ALI increases patient’s mortality.

Effect of bortezomib on the proliferation and apoptosis of acute T lymphocyte leukemia cell line Jurkat and its related mechanism / 中国基层医药

Objective:To explore the effects and mechanisms of bortezomib on the proliferation and apoptosis of acute T lymphocyte leukemia cell line Jurkat.Methods:MTT assay was used to test the influence of bortezomib on the proliferation of Jurkat cells.Flow cytometry was used to detect the influence of bortezomib on apoptosis of Jurkat cells.Real-time quantitative polymerase reaction(RT-PCR) was used to detect the effects of bortezomib on the expression of Bax, Bcl-2 and Cox-2 genes in Jurkat cells.Results:The inhibition rates of 5ng/mL, 10ng/mL, 20ng/mL and 40ng/mL bortezomib on Jurkat cells at 24h were (13.23±0.71)%, (39.53±0.95)%, (53.07±1.12)%, (60.43±0.75)%, respectively, and the inhibition rates at 48h were (25.20±0.96)%, (52.80±1.30)%, (60.67±0.64)%, (75.10±1.35)%, respectively.The inhibitory rates of proliferation of Jurkat cells at 72h were (38.37±0.93)%, (60.94±0.85)%, (73.83±5.08)%, (88.37±1.55)%, respectively.The inhibitory rates of proliferation of Jurkat cells increased with the increase of drug concentration and the prolongation of action time, and the differences were statistically significant( F=1 602.202, 1 085.089, 181.034, all P<0.05). Bortezomib (5ng/mL, 10ng/mL, 20ng/mL and 40ng/mL) treatment for 24h, 48h and 72h, the apoptosis rate of Jurkat cells increased with the increase of drug concentration and the prolongation of action time, the differences were statistically significant( F=1 288.571, 223.378, 251.175, all P<0.05). The expression of Bax mRNA in Jurkat cells increased with the increase of drug concentration and time( F=258.446, 518.929, 276.764, all P<0.05). The Bcl-2 mRNA and Cox-2 mRNA expression levels decreased with the increase of drug concentration and the prolongation of action time( FBcl-2 mRNA=236.848, 264.849, 343.968, FCox-2 mRNA=679.404, 1288.681, 1541.850, all P<0.05). Conclusion:Bortezomib can inhibit the proliferation and induce apoptosis of Jurkat cells.Bortezomib can increase the expression of Bax mRNA and decrease the expression of Bcl-2 and Cox-2 mRNA, which may be the molecular mechanism of bortezomib to promote apoptosis.

Optimization of extraction technology for Gegen-Shujin granules with orthogonal test / 国际中医中药杂志

Objective@#To optimize the extraction technology for Gegen-Shujin granules.@*Methods@#With yield of volatile oil as index, single factor tests were used to investigate effects of water, soaking time and distillation time on extraction technology of volatile oil. The water amount, extraction time and numbers of extraction as factors, the contents of puerarin and total solid as indexes, orthogonal test was employed to optimize the extraction technology of Gegen-Shujin granules.@*Results@#The optimical extraction technology conditions were as follows: Cinnamomi Ramulus, cinnamomi ramulus, notopterygium, turmeric were extracted to get volatile oil with eight-folds amount water of herbs for 6 hours; while the other herbs were boiled with ten-folds amount water of herbs and extrancted for two times, 1.5 hours each time.@*Conclusions@#This extraction process is reasonable and practical, and can guarantee the quality of preparation.

Correlation between cognitive function and oxidative stress in different disease states of bipolar disorder typeⅠ / 中国神经精神疾病杂志

Objective To explore the relationship between cognitive function and oxidative stress biochemical markers in patients with bipolar disorder. Methods One hundred forty-six patients who met the DSM-Ⅳ bipolar disorder diagnostic criteria including 83 patients with stable phase,42 patients with manic episodes and 21 patients with depression and 115 normal controls were recruited. Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to assess cognitive function. Biochemical indicators were measured including superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), catalase (CAT), malonaldehyde (MDA), total antioxidant capacity (T-AOC) and nitric oxide (NO). Results The immediate memory, speech function, attention, time-delay memory, and total score of patients in biphasic stable phase, manic phase, and depression were lower than those in the control group (P<0.01). The visual breadth scores of patients in manic and depression were lower than those in the control group (P<0.01), and the attention scores and total scores were lower than those in the stable group (P<0.01). The delayed memory score of patients with depression was lower than that of stable group (P=0.04). The MDA level of patients with manic episode and depression was higher than that of stable group (P<0.01); the level of NO in manic, depression and control group was higher than that in stable group, and CAT level was low in the stable phase group (P<0.05). In the stable phase group, the visual breadth (r=-0.50, P=0.04), attention (r=-0.67, P<0.01), delayed memory (r=-0.61, P=0.01) were correlated with GSH-PX respectively; time-delay memory was negatively correlated with T-AOC (r=-0.54, P=0.03). The speech function of the biphasic mania phase group was negatively correlated with SOD (r=-0.46, P=0.01). The immediate memory of the biphasic depression group was positively correlated with NO (r=0.61, P=0.02); delayed memory was positively correlated with CAT (r=0.67, P=0.01); speech function (r=-0.76, P<0.01) and cognitive total score (r=-0.59, P=0.03) were negatively correlated with GSH-PX. Conclusion Patients with bipolar disorder have varying degrees of cognitive decline and oxidative stress changes, and some antioxidant enzyme systems are associated with cognitive function.

Correlation between heme oxygenase-1 gene rs2071746 polymorphism and long-term outcome in patients with ischemic stroke / 国际脑血管病杂志

Objective To investigate the association between heme oxygenase-1 (HO-1) gene rs2071746 polymorphism and long-term clinical outcome in patients with ischemic stroke.Methods Between July 2015 and June 2017,consecutive patients with acute ischemic stroke admitted to the Department of Neurology,the Third Affiliated Hospital of Soochow University were enrolled prospectively.TOAST classification was performed for all patients.Genotyping of the HO-1 gene rs2071746 polymorphism was performed using a modified multiplex ligase detection reaction technique.The patients were followed up.The primary endpoint events included ischemic stroke,vascular death,and myocardial infarction.Multivariate Cox proportional hazard regression model was used to analyze the independent influencing factors for primary endpoint events.Results A total of 1 698 patients with successful genotyping and follow-up information were enrolled.Genotyping showed that the frequency of rs2071746 A allelewas 44.91％.They were followed up for 15.21 ± 7.39 months,and 168 patients (9.89％) had primary endpoint events.The incidence of primary endpoint events in A allele carriers was significantly lower than that in non-A allele carriers (8.80％ vs.12.40％;P =0.018).Multivariate Cox proportional risk regression model showed that after adjusting for age,gender,hypertension,diabetes mellitus,smoking,alcohol consumption,and genotype,A allele was an independent protective factor for primary endpoint events in patients with acute ischemic stroke (hazard risk [HR] 0.693,95％ confidence interval [CI]0.506-0.949;P=0.022).Subgroup analysis showed that carrying the A allele was an independent protective factor for primary endpoint events in patients with large atherosclerotic stroke (HR 0.651,95％ CI 0.425-0.997;P=0.048),while rs2071746 polymorphism was not associated with long-term outcome in other etiological subtypes.Conclusion The HO-1 gene rs2071746 A allele may be a protective factor for the long-term outcome in patients with acute ischemic stroke and large atherosclerotic stroke.

Optimization of extraction technology for Gegen-Shujin granules with orthogonal test / 国际中医中药杂志

Objective To optimize the extraction technology for Gegen-Shujin granules. Methods With yield of volatile oil as index, single factor tests were used to investigate effects of water, soaking time and distillation time on extraction technology of volatile oil. The water amount, extraction time and numbers of extraction as factors, the contents of puerarin and total solid as indexes, orthogonal test was employed to optimize the extraction technology of Gegen-Shujin granules. Results The optimical extraction technology conditions were as follows: Cinnamomi Ramulus, cinnamomi ramulus, notopterygium, turmeric were extracted to get volatile oil with eight-folds amount water of herbs for 6 hours; while the other herbs were boiled with ten-folds amount water of herbs and extrancted for two times, 1.5 hours each time. Conclusions This extraction process is reasonable and practical, and can guarantee the quality of preparation.

Heritability of cognitive functions in nuclear families with bipolar I disorder / 中国神经精神疾病杂志

Objective To examine the heritability of neurocognitive functions in bipolar I disorder(BD-I)families and BD-associated cognitive endophenotypes. Methods Seventy-nine nuclear families consisting of euthymic BD-I probands and their healthy parents were recruited. Cognitive functions including attention, working memory, processing speed and executive function were evaluated by 7 classic neurocognitive tests, and the heritability of neuroconitive functions in these families was estimated using parent-offspring regression indexes of quantitative traits.Furthermore,the heritable cognitions were compared between 79 BD probands and 140 normal controls. Results After adjusted by age and education,mistake numbers of Trail Making Test A(TMT-A),total score and completed mission numbers of Tower of Hanoi (TOH) were significantly heritable (P<0.05). The comparison of these heritable cognitions between patients and normal controls showed that TOH total score and TOH completed mission numbers were significantly impaired in the patient group (P<0.05). Conclusion Processing speed and executive function are probably heritable in BD nuclear families. Executive function impairments may be disease-related which could be candidate endophenotypes for bipolar disorder.

The role of connective tissue growth factor in pulmonary fibrosis induced by paraquat / 中华急诊医学杂志

Objective To examine the role of connective tissue growth factor (CTGF) in a rat model of paraquat (PQ)-induced pulmonary fibrosis. Methods In the laboratory of Medical School of Nanjing University, 48 adult male Sprague-Dawley (SD) rats were randomly(random number) divided into two groups. The experimental group received a single intraperitoneal injection of PQ (30 mg/kg), while the control group received an equivalent volume of sterile saline. The rats were then sacrificed and the left lungs were collected on 7th, 14th and 28th day, respectively. HE staining, Masson staining and hydroxyproline content analysis were used to determine the quantity of collagen, and the fibrosis process and severity were evaluated. Western blotting and immunohistochemical staining was used to detect the expression of CTGF. MRC-5 human lung fibroblasts were exposed to different concentrations of PQ (50-500 μmol/L) for 3 days. The proliferation, migration and differentiation of MRC-5 cells were investigated by CCK8, Transwell and Western blotting after exposing with various concentrations of CTGF (50-200 ng/mL). Data was analyzed with SPSS18.0. Results At 2 weeks after PQ administration, lung tissue sections exhibited a marked thickening of the alveolar walls with an accumulation of interstitial cells witha fibroblastic appearance. Masson staining revealed a patchy distribution of collagen deposition, indicating pulmonary fibrogenesis. Western-blott and immunohistochemical staining demonstrated that CTGF expression was significantly upregulated in the PQ-treated group (P<0.01). Similarly, CTGF expression in PQ-treated MRC-5 cells was increased in a dose-dependent manner (P<0.01). In addition, CTGF promoted the proliferation and migration of MRC-5 cells (P<0.01), and induced the differentiation of fibroblasts into myofibroblasts. Conclusions These findings demonstrate that PQ can increase CTGF expression, which may be important in PQ-induced pulmonary fibrogenesis. Therefore, this growth factor can be considered as a potential pharmacological target.

Effect of xuebijing on caspase-3 and inflammatory factors expression in acute respiratory distress syndrome rat model with paraquat poisoning / 中华急诊医学杂志

Objective To study the effect of xuebijing on the expression of Caspase-3 in lung tissues and inflammatory factors in serum in acute respiratory distress syndrome rat model with paraquat poisoning. Methods Selecting 50 healthy rats and dividing into 5 groups randomly, Control group, Paraquat group, Low-dose xuebijing group(LD), Middle-dose xuebijing group(MD), High-dose xuebijing group(HD). Using 25 mg/kg paraquat solution to establish the animal model. 14 μmol/kg, 28 μmol/kg, 56μmol/kg xuebijing solution were injected into the abdominal cavity in LD, MD and HD group respectively, and the same dose of normal saline was injected into Control and Paraquat group. The expression levels of TNF-α and IL-6 in plasma were detected by ELISA after 24 hours, Immunohistochemistry was used to detect the expression levels of caspase-3 in the right lung tissue, and TUNEL method was used to detect apoptosis in the right lung tissue. Results The expression levels of TNF-α and IL-6 in plasma were significantly increased after paraquat poisoning, and expression of Caspase-3 protein was also significantly increased in lung tissue(P<0.01). After different dose of xuebijing treatment, the levels of TNF-α and IL-6 in plasma and the protein expression of Caspase-3 in lung tissue were much lower than those in Paraquat group, but still higher than those in Control group(P<0.05), the apoptosis levels in MD and HD groupwere much lower than those in Paraquat group(P<0.05). Conclusions Xuebijing can significantly reduce the level of inflammatory factors in plasma, suppress the Caspase-3 protein expression and apoptosis in lung tissue in acute respiratory distress syndrome rat model with paraquat poisoning.

Treatment of chronic prostatitis/chronic pelvic pain syndrome by noninvasive prostatectomy combined with western medicine / 中国生化药物杂志

Objective The non intrusive ultrasound combined with western medicine in the treatment of chronic prostatitis prostate/research and analysis of the effect of chronic pelvic pain syndrome.Methods96 cases of chronic prostatitis patients who were treated in our hospital from September 2016 to were randomly divided into the observation group, the control group 1 and the control group2.The observation group was treated with western medicine in the treatment of non intrusive prostate ultrasound;1 patients in the control group were given a single non intrusive prostate ultrasound treatment;control group 2 given a single treatment with Chinese and Western medicine.The clinical symptoms and NIH-CPSI scores were evaluated before and after treatment in each group.ResultsComparison between groups of patients before treatment NIH-CPSI score, no significant difference;after treatment, the NIH-CPSI score has decreased, there are obvious differences (P<0.05);the patients in the observation group were decreased significantly, the total score before treatment (26.21±2.20), the total score after treatment (11.77±1.90), there are obvious the difference (P<0.05).The treatment groups were compared with the efficiency, the total efficiency of observation group was 93.75%, the control group of 1 patients with the total effective rate was 75%, the control group of 2 patients with the total effective rate was 68.75%, there was significant difference in the treatment effect, with statistical significance (P<0.05).ConclusionNon intrusive ultrasound combined with western medicine in the treatment of prostate in compared with non intrusive ultrasound therapy and Western medicine alone in the treatment of prostate, has more significant treatment effect, should strengthen the clinical application and promotion.

Analysis of clinical characteristics and prognosis of 63 cases of pancreatic neuroendo-crine tumor / 中国肿瘤临床

Objective: To investigate the clinical characteristics, diagnosis, treatment, and prognostic factors of pancreatic neuroendocrine neoplasms (PNENs). Methods: From August 2004 to August 2016, the clinical data of 63 patients with PNENs in the Sir Run Run Shaw Hospital, an affiliate of the Zhejiang University School of Medicine, were retrospectively analyzed. The data included age, gender, function, tumor location, tumor size, pathological characteristics, lymph nodes, metastasis, and treatment. Association of these factors with PNEN prognosis was proven by univariate analysis and multivariate analysis. Results: In our study, the patients' overall survival time was between 5 and 127 months; the median time was about 46.6 months. Moreover, the survival rates in three years and five years are 88.8％ and 84.1％ respectively. Univariate analysis showed that factors such as lymph node metastasis, liver metastasis, vascular invasion, TNM staging and pathological grading, and radical operation were associated with prognosis (P<0.05). We did not prove any of the factors to be an independent factor associated with poor short-term outcome by multivariate analysis. Conclusion: PNENs are rare low-grade malignant tumors with heterogeneity, which is why they can be erroneously diagnosed. AJCC TNM staging in 2017 and the WHO pathological classification in 2010 can actively guide the prognosis evaluation. The lymph node metastasis, liver metastasis,and vascular invasion affected the prognosis of PNENs. Patients with radical operation had improved prognosis.

Forensic Validation of the GoldeneyeTM DNA ID 25A Kit / 法医学杂志

Objective To test and estim ate the forensic application of G oldeneyeTM DNA ID 25A K it. Methods The kit was validated by a series of tests for accuracy, sensitivity, consistency, peak height balance, stability, and m ixed sam ples through m easured blood sam ples and other sam ples in routine casework. Results The peak height balance of the different loci was ≥42% . The genotyping results of the positive control DNA was accurate. The com plete STR genotyping result could be obtained from 0.125 ng positive control DNA . Conclusion G oldeneyeTM DNA ID 25A K it is suitable for crim inal cases and DNA database in forensic practice.

A comparison of three different staging systems of hilar cholangiocarcinoma / 中华普通外科杂志

Objective To compare the value among three hilar cholangiocarcinoma (HCC) staging systems,Bismuth-Corlette classification,TNM staging system and MSKCC classification,in predicting the resection rate and prognosis of HCC patients.Methods The clinical and histopathological data of 154 HCC cases were analyzed retrospectively.Three different staging methods were performed respectively to analyze the correlations with respectability and survival.Chi-square test and Kaplan-Meier analysis were applied to find clinical and histopathological factors related to prognosis.Results There was no significant difference in resectability between Bismuth-Corlette classification or TNM stage Ⅰ,Ⅱ,Ⅲ and Ⅳ.The resection rates of MSKCC T1,T2 and T3 were 68.6％,44.8％,19.2％respectively (x2 =20.03,P =0.000).With higher T stage,resection rate obviously declined.The survival predicted by TNM staging and MSKCC classification was better than Bismuth-Corlette classification.Tumor differentiation,LN involvement,distant metastasis,margin status,TNM stage and MSKCC classification were significantly correlated with survival.Conclusions The MSKCC classification predicted resectability better than Bismuth-Corlette classification and TNM staging system,while both MSKCC classification and TNM staging system predicted survival better than Bismuth-Corlette classification.Clinical and histopathological factors such as tumor differentiation,LN involvement,metastasis,margin status,TNM staging,MSKCC classification were correlated with survival.

The cognitive impairments of euthymic patients with early-onset or late-onset bipolar Ⅰ disorder / 中国神经精神疾病杂志

Objective To explore the characteristics of cognitive impairments in euthymic patients with early-on?set or late-onset bipolar I disorder (BD-I). Methods Ninety-four with onset age less than 21 (early onset group), 41 eu?thymic patients with onset age above 35 (late onset group) and 135 normal controls with matched education and age were enrolled. Seven classical neuropsychological tests were used to assess attention, processing speed, working memory and executive functions. Results The early-onset group was significantly worse than its corresponding normal controls in 14 indexes of all tests, including digital symbol, digital span, visual graphic reproduction (c1 and c2), time of TMT-A and TMT-B, verbal fluency, number of sorting, error and preserved error in WCST, as well as total score, completed missions, planning time and executing time in TOH (P<0.05). Moreover the effect size of difference were more than 0.4 in verbal fluency, time of TMT-A and TMT-B, and executing time in TOH. Compared with its matched control group, the late-on?set group was significantly impaired in 9 indexes, including digital span, visual graphic reproduction (c1,c2 and total), time of TMT-A, number of error and preserved error in WCST, as well as total score and completed missions in TOH (P<0.05), merely two indexes of TOH with effect size more than 0.4, while the late-onset group was no significantly impaired in digital symbol, TMT-B and verbal fluency. Conclusions There are significant cognitive impairments in euthymic BD-I patients with no matter early-onset or late-onset. But it seems that the cognitive impairments in early-onset bipo?lar disorder are more extensive and serious.

Surgical Treatment of Obstructive Jaundice Caused by Bile Duct Strictures after Hepatic Transcatheter Arterial Chemoembolization / 华中科技大学学报(医学版)

Objective To examine the surgical treatments for obstructive jaundice caused by bile duct strictures after hepat-ic transcatheter arterial chemoembolization(TACE).Methods Clinical data were retrospectively analyzed of 9 patients who de-veloped bile duct strictures among 229 patients after TACE between June 1994 and March 2011 in People’s Hospital of Zhe-jiang Provincial and the Second Affiliated Hospital of Zhejiang University.There were 6 cases of primary liver cancer,and 3 ca-ses of metastatic liver cancer.Obstructive jaundice occurred 5 to 16 months after TACE treatment.The median time was 8 months.Results All the nine patients with bile duct strictures suffered different degrees of obstructive j aundice,which was cured after surgical operations or PTC + stenting in 7 patients and significantly relieved by percutaneous transhepatic cholangic drainage(PTCD)in 2 ones.Two patients with obstructive j aundice after TACE for primary liver cancer were followed up for 3 years,and no recurrence of hepatic carcinoma and bile duct obstruction was found.The other 7 patients were followed up for 3 to 13 months,and they all died of deterioration of primary disease.Conclusion Patients with obstructive jaundice caused by bile duct strictures after TACE benefit from surgical operations or intervention treatment.Different surgical strategies are selected based on the characteristics of primary disease,the site and extent of bile duct stricture.

Association study of LIS1 and TSNAX genes with bipolar disorder in Chinese Han population / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the association of neural development-related genes LIS1and TSNAX with bipolar disorder in a Chinese Han population.</p><p><b>METHODS</b>Three hundred and eight five patients (including 188 males and 197 females) from Guangzhou Brain Hospital with bipolar disorder meeting the Diagnostic and Statistic Manual of Bipolar Disorder (BDI) (Fourth Edition) criteria and 475 healthy controls from the local community were recruited. Ten single nucleotide polymorphisms (SNPs) of the LIS1 and TSNAX genes were genotyped by GoldenGate genotyping assay on an Illumina Beadstation 500 machine. Association analyses of SNPs and haplotypes were performed with Plink 1.07 software.</p><p><b>RESULTS</b>Analysis of the total sample has failed to find any association of SNP or haplotype of the two genes with BDI (P> 0.05). When patients were divided into subgroups with or without psychotic symptom, no significant association of the two genes was found with psychotic BDI or non-psychotic BDI (P> 0.05). No significant association was found between any SNP and haplotype of two genes and female BDI or male BDI, nor were significant association found between age of onset and LIS1 and TSNAX gene polymorphisms.</p><p><b>CONCLUSION</b>Our results indicated that LIS1 and TSNAX genes are not associated with susceptibility to bipolar I disorder in Chinese Han population.</p>