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Objective: To investigate the pathological features and the clinicopathological significance of TERT detection in those tumors that were difficult to diagnosis. Methods: A total of 93 cases of fibroepithelial tumors without definite diagnosis were collected from the Affiliated Hospital of Qigndao University between 2013 and 2021. The clinical details such as patients' age and tumor size were collected. All slides were re-reviewed and the pathologic parameters, including stromal cellularity, stromal cell atypia, stromal cell mitoses, and stromal overgrowth were re-interpreted. Sanger sequencing was used to detect TERT promoter status, and immunohistochemistry was performed to detect TERT protein expression. The relationship between TERT promoter mutation as well as protein expression levels and the clinicopathological parameters were also analyzed. Results: The patients' ages ranged from 30 to 71 years (mean of 46 years); the tumor size ranged from 1.2 to 8.0 cm (mean 3.8 cm). These tumors showed the following morphologic features: leafy structures in the background of fibroadenoma, or moderately to severely abundant stromal cells. The interpretations of tumor border status were ambiguous in some cases. The incidence of TERT promoter mutation was high in patients of age≥50 years, tumor size≥4 cm, and stromal overgrowth at ×4 or ×10 objective, and these clinicopathologic features were in favor of diagnosis of phyllodes tumors. TERT protein expression levels was not associated with the above clinicopathologic parameters and its promoter mutation status. Conclusions: The diagnostic difficulty for the breast fibroepithelial tumors is due to the difficulty in recognition of the leafy structures or in those cases with abundant stromal cells. A comprehensive evaluation combined with morphologic characteristics and molecular parameters such as TERT promoter may be helpful for the correct diagnosis and better evaluating recurrence risk.
Subject(s)
Humans , Adult , Middle Aged , Aged , Female , Neoplasms, Fibroepithelial/pathology , Phyllodes Tumor/genetics , Stromal Cells , Fibroadenoma/pathology , Breast Neoplasms/pathology , Mutation , Telomerase/geneticsABSTRACT
BACKGROUNDS@#Hypersensitivity pneumonitis (HP) is an immune-mediated interstitial lung disease (ILD) that develops in response to the inhalation of various antigens. The clinical pathologies are very complex and undetermined. The clinical features and outcomes of HP have not been fully elucidated. The aim of this study was to analyze the incidence, clinical features, and outcomes of HP patients and construct a simple clinical model for diagnosing chronic HP (CHP).@*METHODS@#The cohort study included 101 patients with HP admitted to the Nanjing Drum Tower Hospital from January 2009 to December 2017. The patients were categorized into acute HP (AHP, n = 72) and CHP (n = 29) groups according to the updated international criteria. The clinical, imaging, treatment, and follow-up data were retrospectively reviewed. All patients were followed up until December 31, 2017. Statistical analysis was performed, and a clinical scoring system for CHP was constructed by SPSS 20.0 software.@*RESULTS@#The incidence of HP was 2.4% in ILD inpatients in our center. Patients in the CHP group were older (t = -2.212, P = 0.029), had more smokers (χ = 8.428, P = 0.004), and longer duration of symptoms (t = -4.852, P < 0.001) than those in the AHP group. Weight loss, crackles, digital clubbing, and cyanosis were more common in the CHP group than those in the AHP group (χ = 5.862, P < 0.001; χ = 8.997, P = 0.003; χ = 11.939, P = 0.001; and χ = 4.025, P = 0.045, respectively). On chest high-resolution computed tomography (HRCT), reticular patterns, traction bronchiectasis, and accompanying honeycombing were more common in CHP cases than those in AHP cases (χ = 101.000, P < 0.001; χ = 32.048, P < 0.001; and χ = 36.568, P < 0.001, respectively). The clinical scoring system for CHP was established based on the clinical variables (age [A], duration of symptoms [D], smoking history [S], unidentified exposure [U], and chest HRCT [C]; ADSUC) (area under the curve 0.935, 95% confidence interval: 0.883-0.987, P < 0.001). Eleven patients (15.3%) in the AHP group developed CHP, and unidentified exposure was an independent risk factor for the progression of disease (P = 0.038). The survival of patients with CHP, smoking history, unidentified antigens and fibrosis on Chest HRCT were significantly worse (P = 0.011, P = 0.001, P = 0.005, and P = 0.011, respectively) by Kaplan-Meier analysis. Cox multivariate regression analysis revealed that unidentified exposure and total lung volume (TLC pred%) were independent prognostic predictors for HP patients (P = 0.017 and P = 0.017, respectively).@*CONCLUSIONS@#The clinical features and outcomes of the CHP patients differ from those of the AHP patients. ADSUC is a simple and feasible clinical model for CHP. Unidentified exposure is an independent risk factor for the progression of AHP to CHP. Unidentified exposure and a low baseline TLC pred% are independent predictors for survival in HP patients.
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Background@#The prognosis of acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is very poor with a high mortality. The aim of this study was to describe the clinical features and survival of patients with AE-IPF with usual pulmonary fibrosis (UIP) and possible UIP (P-UIP) pattern on chest high resolution computed tomography (HRCT).@*Methods@#This retrospective study included 107 patients with AE-IPF admitted to Nanjing Drum Tower Hospital from January 2010 to December 2016. The subjects were divided into UIP (n = 86) and P-UIP group (n = 21) based on chest HRCT. Continuous variables were analyzed using Student’s t test or Mann-Whitney U test. Categorical variables were analyzed using χ2 test. Log-rank test was used for the survival analysis. Cox proportional models evaluated the risk factors for AE occurrence and survival.@*Results@#The male, older patients, previous N-acetylcysteine use, elevated white blood cell (WBC) counts, and microbiology infection were more common in the UIP group than the P-UIP group (χ2= 13.567, P < 0.001; z = -2.936, P = 0.003; χ2 = 5.901, P = 0.015; t = 2.048, P = 0.043; χ2 = 10.297, P = 0.036, respectively). The percentage of AE with UIP pattern in idiopathic interstitial pneumonia (IIP) was significantly higher than P-UIP pattern (χ2 = 40.011, P < 0.001). Smoking was the risk factor for AE within 6 months after IPF diagnosis in the UIP group. The cumulative proportion survival of 30-days was significantly higher in the UIP group compared with the P-UIP group (χ2 = 5.489, P = 0.019) despite of the similar overall survival in the two groups. Multivariate Cox regression analysis indicated WBC count, partial pressure of oxygen in artery (PaO2)/fractional concentration of inspired oxygen (FiO2), and computed tomography (CT) score were the independent predictors for survival in the UIP group (hazard ratio [HR]: 1.070, 95% confidential interval [CI]: 1.027-1.114, P = 0.001; HR: 0.992, 95% CI: 0.986–0.997, P = 0.002; and HR: 1.649, 95% CI: 1.253–2.171, P < 0.001, respectively).@*Conclusions@#AE occurrence of UIP patients in IIP was significantly more than P-UIP cases. The short-term survival was better in the UIP group despite of the similar overall survival in the two groups. WBC count, PaO2/FiO2, and CT score were the independent predictors for survival in UIP subjects.
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Backgrounds@#Hypersensitivity pneumonitis (HP) is an immune-mediated interstitial lung disease (ILD) that develops in response to the inhalation of various antigens. The clinical pathologies are very complex and undetermined. The clinical features and outcomes of HP have not been fully elucidated. The aim of this study was to analyze the incidence, clinical features, and outcomes of HP patients and construct a simple clinical model for diagnosing chronic HP (CHP).@*Methods@#The cohort study included 101 patients with HP admitted to the Nanjing Drum Tower Hospital from January 2009 to December 2017. The patients were categorized into acute HP (AHP, n = 72) and CHP (n = 29) groups according to the updated international criteria. The clinical, imaging, treatment, and follow-up data were retrospectively reviewed. All patients were followed up until December 31, 2017. Statistical analysis was performed, and a clinical scoring system for CHP was constructed by SPSS 20.0 software.@*Results@#The incidence of HP was 2.4% in ILD inpatients in our center. Patients in the CHP group were older (t = -2.212, P = 0.029), had more smokers (χ2 = 8.428, P = 0.004), and longer duration of symptoms (t = -4.852, P < 0.001) than those in the AHP group. Weight loss, crackles, digital clubbing, and cyanosis were more common in the CHP group than those in the AHP group (χ2 = 5.862, P < 0.001; χ2 = 8.997, P = 0.003; χ2 = 11.939, P = 0.001; and χ2 = 4.025, P = 0.045, respectively). On chest high-resolution computed tomography (HRCT), reticular patterns, traction bronchiectasis, and accompanying honeycombing were more common in CHP cases than those in AHP cases (χ2 = 101.000, P < 0.001; χ2 = 32.048, P < 0.001; and χ2 = 36.568, P < 0.001, respectively). The clinical scoring system for CHP was established based on the clinical variables (age [A], duration of symptoms [D], smoking history [S], unidentified exposure [U], and chest HRCT [C]; ADSUC) (area under the curve 0.935, 95% confidence interval: 0.883–0.987, P < 0.001). Eleven patients (15.3%) in the AHP group developed CHP, and unidentified exposure was an independent risk factor for the progression of disease (P = 0.038). The survival of patients with CHP, smoking history, unidentified antigens and fibrosis on Chest HRCT were significantly worse (P = 0.011, P = 0.001, P = 0.005, and P = 0.011, respectively) by Kaplan-Meier analysis. Cox multivariate regression analysis revealed that unidentified exposure and total lung volume (TLC pred%) were independent prognostic predictors for HP patients (P = 0.017 and P = 0.017, respectively).@*Conclusions@#The clinical features and outcomes of the CHP patients differ from those of the AHP patients. ADSUC is a simple and feasible clinical model for CHP. Unidentified exposure is an independent risk factor for the progression of AHP to CHP. Unidentified exposure and a low baseline TLC pred% are independent predictors for survival in HP patients.
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BACKGROUND@#The prognosis of acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is very poor with a high mortality. The aim of this study was to describe the clinical features and survival of patients with AE-IPF with usual pulmonary fibrosis (UIP) and possible UIP (P-UIP) pattern on chest high resolution computed tomography (HRCT).@*METHODS@#This retrospective study included 107 patients with AE-IPF admitted to Nanjing Drum Tower Hospital from January 2010 to December 2016. The subjects were divided into UIP (n = 86) and P-UIP group (n = 21) based on chest HRCT. Continuous variables were analyzed using Student's t test or Mann-Whitney U test. Categorical variables were analyzed using χ test. Log-rank test was used for the survival analysis. Cox proportional models evaluated the risk factors for AE occurrence and survival.@*RESULTS@#The male, older patients, previous N-acetylcysteine use, elevated white blood cell (WBC) counts, and microbiology infection were more common in the UIP group than the P-UIP group (χ = 13.567, P < 0.001; z = -2.936, P = 0.003; χ = 5.901, P = 0.015; t = 2.048, P = 0.043; χ = 10.297, P = 0.036, respectively). The percentage of AE with UIP pattern in idiopathic interstitial pneumonia (IIP) was significantly higher than P-UIP pattern (χ = 40.011, P < 0.001). Smoking was the risk factor for AE within 6 months after IPF diagnosis in the UIP group. The cumulative proportion survival of 30-days was significantly higher in the UIP group compared with the P-UIP group (χ = 5.489, P = 0.019) despite of the similar overall survival in the two groups. Multivariate Cox regression analysis indicated WBC count, partial pressure of oxygen in artery (PaO2)/fractional concentration of inspired oxygen (FiO2), and computed tomography (CT) score were the independent predictors for survival in the UIP group (hazard ratio [HR]: 1.070, 95% confidential interval [CI]: 1.027-1.114, P = 0.001; HR: 0.992, 95% CI: 0.986-0.997, P = 0.002; and HR: 1.649, 95% CI: 1.253-2.171, P < 0.001, respectively).@*CONCLUSIONS@#AE occurrence of UIP patients in IIP was significantly more than P-UIP cases. The short-term survival was better in the UIP group despite of the similar overall survival in the two groups. WBC count, PaO2/FiO2, and CT score were the independent predictors for survival in UIP subjects.
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Objective To observe the changes of preoperative and postoperative retinal circulation time in partretinal laser photocoagulation (PRP) in patients with diabetic retinopathy (DR).Methods Together 16 patients (16 eyes) were collected as the subjects in this study,who was diagnosed as severe non-proliferative and proliferative DR by fundus fluorescein angiography (FFA) examination and had PRP indications for undergoing pan-retinal laser photocoagulation.Then retinal arterial and venous cir culation time in all patients was recorded using FFA before and 1 to 3 months after treatment.Meanwhile,it was necessary to observe the following variables,including the developing duration and complete filling time of the four branches of the retinal artery,as well as the duration of the laminar flow and complete filling time of the four branches of the venous artery,followed by calculating mean transition time of retinal artery,retinal capillary,retinal vein,retinal arteriovenous flow for comparison and analysis of changes in transit time of retina in different time-periods before and after treatment.Results The mean transition time of the retinal capillary in patient was (1.58 ± 0.99) s before treatment and (2.19 + 1.23)s after treatment,and the difference was statistically significant(P =0.011),but there was no significant difference in the mean transition time of the retinal artery,retinal vein and arteriovenous flow (all P ＞ 0.05).Conclusion The transit time of the retinal capillary at 1 to 3 months after PRP is significantly longer than that before treatment.
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Objective:A meta-analysis was use to systematically assess the diagnostic value of Septin-9 in Colorectal cancer. Methods:Literature fulfilling the criteria was searched in PubMed, Foreign Medical Journals Platform, Ovid, CNKI, CBM, WanFang and VIP Databases from inception to Jan. 2017. Literatures were strictly screened according to the inclusion and exclusion cri-teria. Study quality was assessed in terms of the Quality Assessment of Diagnostic Accuracy Studies ( QUADAS) checklist. A bivariate Meta-analysis model was employed to assess the pooled accuracy,and study heterogeneity was evaluated via Cochran-Q and I2 tests;subgroup analysis and sensitivity analysis were conducted to deeply trace the sources of heterogeneity;publication bias was judged by Deek′s funnel plot. Results:A total of 11 studies were included. Analysis of methylated Septin-9 achieved a pooled sensitivity of 0. 70 (95%CI:0. 67-0. 72),specificity of 0. 91 (95%CI:0. 90-0. 92),and DOR of 28. 76(95%CI:17. 70-46. 75),corresponding to an AUC of 0. 9221. Heterogeneity test suggested that there was obvious heterogeneity from non-threshold effect. Sensitivity analysis identified one outlier study. Subgroup analysis results showed that the AUC of 1/3 positive to 2/3 positive group was 0. 9397 versus 0. 8265,and the AUC of the Asian population group to the Caucasian population group was 0. 9368 versus 0. 9210. Funnel plot ( Deek′s) revealed no publication bias. Conclusion:Our data indicate that circulating methylated Septin-9 seemed to harbor a relatively high accuracy in conforming colorectal cancer,and might be popularized as a routine biomarker for colorectal cancer detection.
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Objective:To explore the thickness and property of different plaques in neck computed tomography angiography(CTA) for the patients with carotid artery stenosis, and analyze the correlation between them and cerebral infarction or transient ischemic attack(TIA).Methods: 160 patients with carotid artery stenosis were divided into observation group (103cases) and control group (57cases) according to whether they had occurred cerebrovascular events. Through CTA for neck of patients to measure the thickness of different plaques and CT value in mild plaque in the image, and analyze the characteristic of these plaques and the correlation between them and cerebral infarction or TIA.Results: The thickness of mild plaque of observation group was significantly thicker than that of control group while the situation of thickness of hard plague was just statistically adverse. The results of analysis of regression indicated that there was a certain correlation between thickness of mild plaque and cerebral infarction or TIA event (r=0.926,P<0.05). Conclusion: There was a certain correlation between thickness of mild plaque in neck CTA and cerebral infarction or TIA event in patients with carotid artery stenosis. In clinical practice, the occurrence of cerebral infarction or TIA event can be forecasted through measure thickness of mild plaque of carotid artery, so as to achieve the aims of prevention and treatment for them.
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Objective To investigate the protective effects of Cerebroprotein Hydrolysate for injection (I) on vascular dementia (VaD) in rats.Method The permanent bilateral common carotid artery ligation method was used to prepare a VaD rat model.Suture of rats was performed after separation of the common carotid artery in Sham group.The model rats were randomly divided into model group,Cerebroprotein Hydrolysate Injection (Cerebrolysin,10 mg/kg,positive drug group),Cerebroprotein Hydrolysate for injection (I) high,medium and low dose (20,10 and 5 mg/kg) groups.Rats were treated with relative drug by tail iv injection once daily for two weeks,and rats in Sham group were given equal volume of saline.The learning and memory abilities were evaluated by Y maze and step-through tests.Besides,the levels of insulin-like growth factor-I (IGF-1) in VaD rat serum were determined by ELISA method.Results Compared with model group,Cerebroprotein Hydrolysate for injection (I) significantly increased the correct number in Y maze test,reduced the step-through latency time,and elevated serum IGF-1 level in VaD rats.The protective effects of Cerebroprotein Hydrolysate for injection (I) in VaD rats were equivalent to the same dose of Cerebrolysin.Conclusion Cerebroprotein Hydrolysate for injection (I) could significantly improve the learning and memory abilities of VaD rats,presumably through a mechanism of elevating IGF-1 level,which promotes the repairment and growth of neurons.
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Objective To observe the changes of preoperative and postoperative retinal circulation time in partretinal laser photocoagulation (PRP) in patients with diabetic retinopathy (DR).Methods Together 16 patients (16 eyes) were collected as the subjects in this study,who was diagnosed as severe non-proliferative and proliferative DR by fundus fluorescein angiography (FFA) examination and had PRP indications for undergoing pan-retinal laser photocoagulation.Then retinal arterial and venous cir culation time in all patients was recorded using FFA before and 1 to 3 months after treatment.Meanwhile,it was necessary to observe the following variables,including the developing duration and complete filling time of the four branches of the retinal artery,as well as the duration of the laminar flow and complete filling time of the four branches of the venous artery,followed by calculating mean transition time of retinal artery,retinal capillary,retinal vein,retinal arteriovenous flow for comparison and analysis of changes in transit time of retina in different time-periods before and after treatment.Results The mean transition time of the retinal capillary in patient was (1.58 ± 0.99) s before treatment and (2.19 + 1.23)s after treatment,and the difference was statistically significant(P =0.011),but there was no significant difference in the mean transition time of the retinal artery,retinal vein and arteriovenous flow (all P ＞ 0.05).Conclusion The transit time of the retinal capillary at 1 to 3 months after PRP is significantly longer than that before treatment.
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Objective:A meta-analysis was use to systematically assess the diagnostic value of Septin-9 in Colorectal cancer. Methods:Literature fulfilling the criteria was searched in PubMed, Foreign Medical Journals Platform, Ovid, CNKI, CBM, WanFang and VIP Databases from inception to Jan. 2017. Literatures were strictly screened according to the inclusion and exclusion cri-teria. Study quality was assessed in terms of the Quality Assessment of Diagnostic Accuracy Studies ( QUADAS) checklist. A bivariate Meta-analysis model was employed to assess the pooled accuracy,and study heterogeneity was evaluated via Cochran-Q and I2 tests;subgroup analysis and sensitivity analysis were conducted to deeply trace the sources of heterogeneity;publication bias was judged by Deek′s funnel plot. Results:A total of 11 studies were included. Analysis of methylated Septin-9 achieved a pooled sensitivity of 0. 70 (95%CI:0. 67-0. 72),specificity of 0. 91 (95%CI:0. 90-0. 92),and DOR of 28. 76(95%CI:17. 70-46. 75),corresponding to an AUC of 0. 9221. Heterogeneity test suggested that there was obvious heterogeneity from non-threshold effect. Sensitivity analysis identified one outlier study. Subgroup analysis results showed that the AUC of 1/3 positive to 2/3 positive group was 0. 9397 versus 0. 8265,and the AUC of the Asian population group to the Caucasian population group was 0. 9368 versus 0. 9210. Funnel plot ( Deek′s) revealed no publication bias. Conclusion:Our data indicate that circulating methylated Septin-9 seemed to harbor a relatively high accuracy in conforming colorectal cancer,and might be popularized as a routine biomarker for colorectal cancer detection.
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Objective To investigate the neuroprotective mechanisms of Cerebroprotein Hydrolysate for Injection (Ⅰ) on vascular dementia in rats.Method The rat vascular dementia model was prepared using an improved two-vessel occlusion method,and the common carotid artery was only isolated but not blocked in sham group.Rats were randomly divided into sham group,model group,Cerebroprotein Hydrolysate for Injection (Ⅰ) groups with low,medium and high dose (5,10,20 mg/kg) and Cerebroprotein Hydrolysate Injection group (Cerebrolysin,Positive drug,10 mg/kg).The drug was administered by iv injection of rat tail vein once a day for two weeks,while the same volume of saline was administered in sham and model group.At the end of administration,the plasma was collected through abdominal aorta to separate serum,and rat cortex was isolated to prepare homogenate.The levels of nerve growth factor (NGF) and insulin-like growth factor 2 (IGF-2) in serum and level of gamma-aminobutyric acid (GABA) in cortex were detected by ELISA.Level of glutamate (Glu) in cortex of VaD rats was detected by colorimetry.Results Compared with model group,levels of NGF and IGF-2 in the serum of VaD rats and level of GABA in cortex were significantly increased,while level of Glu in cortex was significantly decreased after administration of Cerebroprotein Hydrolysate for Injection (Ⅰ).The increased IGF-2 and GABA levels by Cerebroprotein Hydrolysate for Injection (Ⅰ) were significantly higher than that of Cerebrolysin at same dose.Conclusion The mechanisms underlying the increased leaming and memory ability of VaD rats by Cerebroprotein Hydrolysate for Injection (Ⅰ),are possibly related to the increased levels of NGF and IGF-2 in body and a regulation of the balance between excitatory and inhibitory amino acid neurotransmitters.
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Objective:To explore the thickness and property of different plaques in neck computed tomography angiography(CTA) for the patients with carotid artery stenosis, and analyze the correlation between them and cerebral infarction or transient ischemic attack(TIA).Methods: 160 patients with carotid artery stenosis were divided into observation group (103cases) and control group (57cases) according to whether they had occurred cerebrovascular events. Through CTA for neck of patients to measure the thickness of different plaques and CT value in mild plaque in the image, and analyze the characteristic of these plaques and the correlation between them and cerebral infarction or TIA.Results: The thickness of mild plaque of observation group was significantly thicker than that of control group while the situation of thickness of hard plague was just statistically adverse. The results of analysis of regression indicated that there was a certain correlation between thickness of mild plaque and cerebral infarction or TIA event (r=0.926,P<0.05). Conclusion: There was a certain correlation between thickness of mild plaque in neck CTA and cerebral infarction or TIA event in patients with carotid artery stenosis. In clinical practice, the occurrence of cerebral infarction or TIA event can be forecasted through measure thickness of mild plaque of carotid artery, so as to achieve the aims of prevention and treatment for them.
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Objective To explore a new mode for self-printing by a doctor station.Methods A self-printing program was developed with Delphi 6.0,which obtained the information on the hospitalized and discharged patients from oracle database of HIS first,then inquired the examination results and printing identification in SQL database of LIS and printed the laboratory report finally.Results The new mode saved the workload for laboratory report printing and distribution,shortened the time consumed for pasting the report,reduced the ratio for missed and false pasting,avoided the pathogen transmission due to the report and increased the report quality.Conclusion The new mode realizes data sharing and raises working efficiency,and thus is worthy promoting practically.
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Objective To design an outpatient appointment system based on ASP.NET which gains advantages over the existing system in database stability,functional module integrity and interface friendliness.Methods The ASP.NET-based system was developed with Microsoft Visual Studio 2010 as the platform,Microsoft SQL Server 2005 to create data and kinds of components to establish database and application interface.Results The system enhanced hospital registration and patient satisfaction.Conclusion The system is worthy promoting for outpatient appointment in the hospital.
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Objective@#To study the long-term prognosis of the convalescent patients with hepatitis B virus (HBV) associated acute-on-chronic liver failure (HBV-ACLF).@*Methods@#A 72-month follow-up study of HBV-ACLF recovery patients recruited between January 2005 and December 2009 was performed in our hospital. According to the results of imaging examination at the first visit, the enrolled patients were divided into two groups, the liver cirrhosis ACLF (Lc-ACLF) group and chronic hepatitis B related ACLF (CHB-ACLF) group. In both groups, the occurrence of cirrhosis, decompensated cirrhosis or ACLF and hepatocellular carcinoma (HCC) were observed.@*Results@#The media time of cirrhosis formation, decompensated cirrhosis and HCC occurrence in CHB-ACLF group were 12.5, 23 and 43 months, respectively. However, the median time of LC-ACLF patients developing to decompensated cirrhosis and HCC were 7 and 14 months, which was significantly shorter than that in CHB-ACLF group (P=0.009, 0.040, with statistical significance). Furthermore, the blood chemical parameters including serum albumin (ALB), cholinesterase (CHE) and total cholesterol (TC), triglyceride (TG), as well as platelet count (PLT), the anti-viral treatment compliance and the virus mutation were significantly related to the clinical endpoint events, respectively (P<0.05). Moreover, results from the logistic regression model demonstrated that the patient age, with or without liver cirrhosis, HBV mutation and the anti-viral treatment compliance were the independent risk factors for the long-term prognosis of patients with hepatitis B associated liver failure (OR=1.035, 0.510, 2.462, respectively. P< 0.05). The cumulative risk of Lc-ACLF patients progressed to decompensate cirrhosis, acute-on-chronic liver failure or HCC was significantly higher than that of CHB-ACLF patients (χ2=21.603, 4.423, P=0.000, 0.035, respectively).@*Conclusions@#Considering the importance of patients with or without liver cirrhosis, HBV mutation and the anti-viral treatment compliance in the long-term prognosis of HBV-ACLF patients, it is necessary and important to monitor the virus mutation and anti-viral treatment compliance of HBV- ACLF patients during antiviral therapy and those processes would benefit the improvement of long term prognosis of the patients with ACLF.
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Aim To explore the role of endoplasmic reticulum stress(ERS)signaling pathway in high fat-induced cell apoptosis in human umbilical vein endo-thelial cells(HUVECs). Methods HUVECs were ex-posed to different concentrations of palmitic acid(0. 1, 0. 2,0. 4,0. 8 mmol·L - 1 )for 24 h and different time points of 0. 4 mmol·L - 1 palmitic acid(0,12, 24,48 h). Cell viability was measured by cell count-ing kit(CCK-8),and the protein expressions of ERS signaling pathway protein such as GRP78,CHOP, PERK,IRE1,ATF6 were determined by Western blot. The level of intracellular apoptosis was detected by immunofluorescence. Results HUVECs exposed to palmitic acid at 0. 4 mmol·L - 1 for 24 h showed a de-crease in their viability and an increase in the expres-sion of ERS signaling pathway proteins (GRP78, CHOP,PERK,IRE1,ATF6)(P < 0. 05);cell ap-optotic levels significantly increased(P < 0. 05). The intracellular apoptosis levels in the vascular endothelial cells of ERS signaling pathway inhibitor 4-phenylbutyr-ic acid (4-PBA,10 mmol · L - 1 )were significantly lower than those of the PA group(P < 0. 05). Conclu-sion Activated ERS signaling pathway might play an important role in the treatment of high fat-induced cell apoptosis in vascular endothelial cells.
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Patellofemoral arthritis is a clinical common type of knee osteoarthritis distinguished by its pain and anatomical position. The stability of patella is crucial to the stability of the patellofemoral joint and is related to the occurrence and development of osteoarthritis. Patella stability depends on the structural geometry of patellofemoral condyle, the static mechanics of the surrounding joint capsule, tendon, fascia, ligament and patellar ligament and the dynamic mechanics of the quadriceps. Therefore, manipulation therapy should be based on the considerations on the stability of the patella as well as TCM theory. Starting from maintaining the balance of the dynamic and static mechanical system and focusing on the restoration of the stability of patella, the ultimate goal of the treatment is to restore the stability of patellofemoral joint. The main aspects of manipulation treatment strategy include the balancing of dynamic and static mechanical system, the idea of holism treatment, differentiation treatment based on tendons injury identification, fundamental principle of softening tendons, cooperation between doctors and patients, and combination of therapy and convalesce.
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Aim To explore the role of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase in high fat-induced oxidative stress injury in human umbilical vein endothelial cells (HUVECs).Methods HUVECs were exposed to different concentrations of palmitic acid(0.1,0.2,0.4,0.8 mmol · L-1) for 24 h and different time points of 0.4 mmol · L-1 palmitic acid(0,12,24,48 h).Cell viability was measured by Cell Counting Kit 8,and the protein expression of NADPH oxidase subunits such as p22phox,p47phox,p67phox and gp91phox were determined by Western blot.The expression of reactive oxygen species (ROS) in HUVECs was detected by immunofluorescence.Results Cell proliferation rate of HUVECs stimulated by 0.4 mmol · L-1 palmitic acid for 24 h and 48 h was significantly reduced.In the next experiment,model group was accordingly set as HUVECs stimulated by 0.4 mmol · L-1 palmitic acid for 24 h.The expression of NADPH oxidase subunits such as p22phox,p47phox,p67phox and gp91phox significantly increased at 24 h and 48 h after 0.4 mmol· L-1 palmitic acid stimulation (P ＜ 0.05),and the difference.between the 24 h group and the 48 h group was not significant (P ＞ 0.05).The expression of ROS in HUVECs significantly increased at 24 h and 48 h after O.4 mmol · L-1 palmitic acid stimulation (P ＜ 0.05),and the difference between 24 h group and 48 h group was not significant (P ＜ 0.05).Compared with the model group (0.4 mmol · L-1 palmitic acid stimulation for 24 h),the NADPH oxidase inhibitor diphenyliodonium (DPI,10 μmol · L-1) pretreatment could significantly decrease the expression of ROS in vascular endothelial cells (P ＜ 0.05).Conclusion Activated NADPH oxidase might play an important role in treatment of high fat-induced oxidative stress injury in vascular endothelial cells.
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Acute myocardial ischemia is the most common cause of sudden cardiac death.The diagnosis of early myocardial ischemia is a hot point in forensic medicine,which is also an early and important part for a prevention against myocardial infarction.This paper conducts a comprehensive discussion of the structure,function,clinical value and forensic medicine application prospect of ischemia modified albumin (IMA) and heart-type fatty acid binding protein (H-FABP),aiming to determine whether the two proteins can be used as biochemical detection indicators of early myocardial ischemia for the diagnosis of sudden cardiac death in forensic medicine.