HCC portal hypertension imaging score derived from CT predicts re-bleeding and mortality after acute variceal bleeding.

BACKGROUND/PURPOSE: Risk factors for re-bleeding and death after acute variceal bleeding (AVB) in cirrhotic HCC patients are not fully understood.We aimed to (1) explore how the combination of high-risk esophageal varices, HCC status, and portal vein tumor thrombus (i.e., HCC Portal Hypertension Imaging Score [HCCPHTIS]) helps predict increased risk of variceal re-bleeding and mortality; (2) assess predictability and reproducibility of the identified variceal re-bleeding rules. METHODS: This prospective study included 195 HCC patients with first-time AVB and liver cirrhosis, and conducted multivariable Cox regression analysis and Kaplan-Meier analysis. Receiver operating characteristic curve analysis was calculated to find the optimal sensitivity, specificity, and cutoff values of the variables. The reproducibility of the results obtained was verified in a different but related group of patients. RESULTS: 56 patients (28.7%) had re-bleeding within 6 weeks; HCCPHTIS was an independent risk factor for variceal re-bleeding after AVB (Odd ratio, 2.330; 95% confidence interval: 1.728-3.142, p < 0.001). The positive predictive value of HCCPHTIS cut off value > 3 was 66.2%, sensitivity 83.9%, and specificity 82.3%. HCCPHTIS area under the curve was higher than Child-Pugh score (89% vs. 75%, p < 0.001). 74(37.9%) death occurred within 6 weeks; HCCPHTIS > 4 was associated with increased risk of death within 6 weeks after AVB (p < 0.001). CONCLUSION: HCCPHTIS > 3 is a strong predictor of variceal re-bleeding within the first 6 weeks. However, patients with HCCPHTIS > 4 were at increased risk of death within 6 weeks.

Application of injection autologous tissue homogenate implantation in surgical treatment of secondary hyperparathyroidism / 中国现代医生

Objective To investigate the application value of injectable autogenous tissue homogenate implantation in surgical treatment of secondary hyperparathyroidism(SHPT).Methods A total of 46 patients with SHPT who underwent long-term regular hemodialysis and failed medical treatment in Sichuan Mianyang 404 Hospital from June 2017 to June 2021 were selected.According to random number table method,the patients were divided into homogenate injection group and particle embedding group,with 23 cases in each group.Parathyroidectomy(PTX)plus autogenous forearm injection homogenate implantation was performed in homogenate injection group,and PTX plus autogenous forearm particle implantation was performed in particle embedding group.The changes in blood calcium,blood phosphorus,intact parathyroid hormone(iPTH),and alkaline phosphatase(ALP)of two groups before and after operation,as well as the improvements in vascular calcification,pruritus,bone pain,and sleep disorders after operation were compared.Results One year after surgery,the serum calcium level of two groups were significantly higher than before treatment,and the serum phosphorus,iPTH and ALP levels were significantly lower than before treatment(P<0.05).The serum calcium level in homogenate injection group was significantly higher than that in particle embedding group,and the serum phosphorus,iPTH and ALP levels were significantly lower than those in particle embedding group(P<0.05).The improvement of blood vessel calcification,pruritus,bone pain and sleep disorder in homogenate injection group were better than those in particle embedding group(P<0.05).Conclusion Injectable autologous tissue homogenate implantation for refractory SHPT patients is safe and effective,with high success rate,less trauma,and can improve patient symptoms and quality of life.

The Efficiency Improvement of Multiple Receivers in Wireless Power Transmission by Integrating Metasurfaces.

In this paper, we propose the use of metasurfaces to enhance evanescent wave coupling to improve the wireless power transfer (WPT) efficiency of multiple receivers. A 4 × 4 negative permeability metasurface is designed and placed between the transmitter (Tx) and receiver (Rx) coils for the greatest improvement in transfer efficiency. Through the analysis of the number and position topologies of Rx coils, the efficiency can be greatly improved; the maximum efficiency at longer transmission distances is achieved through the 4 × 4 negative permeability metasurface in the multiple-receiver system. We show with simulation and measurement results that the power transfer efficiency of the system can be improved significantly by integrating metasurfaces. The maximum transfer efficiency is achieved in a multiple-receiver WPT system when the number and topology of Rx coils is case 0 of single transmitter-three receivers (STTR). The results show that the total efficiency of the multiple receivers WPT system can be as high as 97%.

Effect of polarized bone marrow-derived macrophage transplantation on the progression of CCl / 临床肝胆病杂志

Objective To investigate the effect of polarized bone marrow-derived macrophage (BMDM) transplantation on the progression of CCl 4 -induced liver fibrosis in rats. Methods Rat BMDMs were isolated and induced to differentiate into M1 phenotype (M1-BMDM) by lipopolysaccharide (5 ng/mL) or M2 phenotype (M2-BMDM) by the supernatant of L929 cells. A rat model of liver fibrosis was established by subcutaneous injection of 30% CCl 4 for 6 weeks, and at week 7, the model rats were randomly divided into model control group (M group), M1-BMDM group, and M2-BMDM group and were given a single injection of normal saline, M1-BMDM, and M2-BMDM, respectively, via the caudal vein, and subcutaneous injection of 30% CCl 4 was given until the end of week 9. Related indices were observed, including liver function, liver histopathology, hydroxyproline (Hyp) content in liver tissue, hepatic stellate cell activation, liver fibrosis, and expression of inflammatory cytokines. The continuous data were expressed as mean±standard deviation; an analysis of variance was used for comparison between multiple groups, and the SNK- q test was used for further comparison between two groups. Results Compared with the M group, both M1-BMDM and M2-BMDM significantly inhibited liver inflammation and liver fibrosis progression and significantly reduced serum alanine aminotransferase and aspartate aminotransferase activities ( P < 0.01) and Hyp content in liver tissue ( P < 0.05). M1-BMDM and M2-BMDM significantly inhibited the activation of hepatic stellate cells and significantly reduced the mRNA expression levels of TGF-β, Col1A1, and Col4 (all P < 0.05). Both M1-BMDM and M2-BMDM significantly increased the expression level of CD163 protein in liver tissue ( P < 0.01), and the M2-BMDM group had a significantly higher level than the M1-BMDM group ( P < 0.05); both M1-BMDM and M2-BMDM significantly reduced the mRNA expression levels of MMP-2 and TIMP-1 in liver tissue ( P < 0.05) and significantly increased the mRNA expression level of MMP-13 ( P < 0.01); in addition, M2-BMDM significantly reduced the expression level of CD68 protein in liver tissue ( P < 0.01). Both M1-BMDM and M2-BMDM significantly increased the mRNA expression levels of IL-6 and IL-10 and the protein expression level of albumin in liver tissue (all P < 0.05), and the above indices in the M2-BMDM group were significantly higher than those in the M1-BMDM group (all P < 0.05). Conclusion Both M1-BMDM and M2-BMDM can effectively inhibit the progression of CCl 4 -induced liver fibrosis in rats, possibly by inhibiting the activation of hepatic stellate cells and promoting the activation of anti-inflammatory macrophages. Moreover, M2-BMDM can also inhibit the activation of pro-inflammatory macrophages and thus has a better comprehensive intervention effect than M1-BMDM.

Role of Wnt signal-mediated crosstalk between hepatic macrophages and hepatic progenitor cells in the development and repair of liver fibrosis / 临床肝胆病杂志

Hepatic macrophages and hepatic progenitor cells play an important role in the development and repair of liver fibrosis. The polarized state of macrophages can affect the differentiation orientation of hepatic progenitor cells, and the Wnt signaling pathway may play a key role in the crosstalk between hepatic macrophages and hepatic progenitor cells. This article overviews the role of macrophages and hepatic progenitor cells and the mechanism of the crosstalk between them in the pathological state of liver fibrosis. It is pointed out that in-depth studies are needed to investigate the genome and phenotype of hepatic macrophages and clarify the mechanism of action of macrophages in regulating the differentiation of hepatic progenitor cells, in order to provide a basis for the treatment of liver fibrosis.

Comparison of Therapeutic Efficacy and Safety of Jianpi Shengxue Tablets and Iron Polysaccharide Complex Capsules in the Treatment of Nondialysis Renal Anemia / 中国药房

OBJECTIVE:To compare the clinical efficacy and safety of Jianpi shengxue tablets and Iron polysaccharide complex capsules in the treatment of nondialysis renal anemia. METHODS:A total of 60 nondialysis renal anemia patients in our hospital during Mar. 2016 to Mar. 2017 were divided into control group(30 cases)and observation group(30 cases)with random allocation concealment method according to random number and admission order. Both groups received routine treatment as rhEPO injection,Folic acid tablets,Vitamin B12 tablets. Based on it,control group was given Iron polysaccharide complex capsules 0.15 g orally,once a day;observation group was given Jianpi shengxue tablets 1.8 g orally,3 times a day. Both groups were treated for 12 weeks. Clinical efficacies were compared between 2 groups. The levels of Hb,RBC,HCT and Ret％ were observed before treatment and 2,4,8,12 weeks after treatment;the levels of SI,SF and TS were also observed before treatment and 8,12 weeks after treatment. The occurrence of ADR was recorded. RESULTS:Both groups completed the treatment. The total effective rate of observation group(86.67％)was significantly higher than control group(63.33％),with statistical significance(P<0.05). Before treatment,there was no statistical significance in the levels of Hb,RBC,HCT,Ret％,SI,SF or TS between 2 groups (P<0.05). After treatment,the levels of above indexes in 2 groups were significantly higher than before treatment,and observation group was significantly higher than control group(except for Ret％ at 8th week),with statistical significance(P<0.05). The case number of black stool and rust colored stool in observation group were significantly lower than control group,while the incidence of black-dyed teeth in observation group was significantly higher than control group, with statistical significance (P<0.05). CONCLUSIONS:Therapeutic efficacy of Jianpi shengxue tablets are significantly better than Polysaccharide iron complex capsules in the treatment of nondialysis renal anemia,and can significantly improve iron reserve and anaemia. But Jianpi shengxue tablets causes high incidence of black-dyed teeth.

Discussion on Design and Implementation Ideas of Laboratory Information Management System in TCM Research Laboratories / 中国中医药信息杂志

Laboratory Information Management System (LIMS) is an information management tool that combines modern management concepts with database-centric computer technology. At present, LIMS has been widely used in a number of laboratories at home and abroad. Exploring LIMS in the TCM research laboratory design ideas can help the TCM research laboratory informatization and modernization. Therefore, this article from the analysis on the characteristics of TCM research laboratories, put forward to the design idea of TCM research laboratories LIMS of setting research business processes and experimental business processes as the main body, with two kinds of business process interactions as a supplement; expounded the significance of implementation of TCM research laboratories LIMS to enhance the level of laboratory management, data reliability and work efficiency;discussed the problems that should be paid attention to in the implementation process.

[Effect of Shirexiao waist hot-compress on the expressions of Th17/Treg-specific factors in the mouse model of experimental autoimmune prostatitis with damp heat syndrome].

OBJECTIVE: To investigate the effect of waist hot-compress with the Shirexiao (SRX) pad on the expressions of Th17/Treg-specific factors in the prostatic tissue of the mouse model of experimental autoimmune prostatitis (EAP) with damp heat syndrome, and explore its possible action mechanisms. METHODS: Twenty healthy male mice were included as normal controls and another 100 chosen for establishing the model of EAP with damp heat syndrome by subcutaneous injection of purified prostate protein solution from the Wistar rat and Freund's complete adjuvant using the TCM method. The model mice were randomly divided into five groups: model control, matrix, and low-, medium- and high-dose SRX. After chemical removal of the hair at lumbar vertebrae 1－3, the animals of the low-, medium- and high-dose SRX groups were treated with the SRX pad heated to 45℃ and externally applied to the non-hair area, qd, bid, and tid, respectively, 10 minutes each time, those of the matrix group with the vaseline pad, and those of the normal and model control groups with the saline pad. After 4 weeks of continuous treatment, all the mice were sacrificed for determination of the protein and mRNA expressions of RORγt and Foxp3 in the prostate tissue by Western blot and quantitative real-time PCR. RESULTS: The symptoms, signs and pathological changes of the EAP model mice were similar to the manifestations of chronic prostatitis. After intervention, the protein and mRNA expressions of Foxp3 were significantly down-regulated while those of RORγt markedly up-regulated in the EAP model group as compared with the normal control (P <0.05). In comparison with the model controls, the protein and mRNA expressions of RORγt were remarkably decreased in the medium- and high-dose SRX groups (P <0.05), that of the Foxp3 protein was markedly increased in the high-dose group (P <0.05), while that of Foxp3 mRNA exhibited no statistically significant difference in the low-, medium- or high-dose groups (P >0.05). CONCLUSIONS: The Shirexiao waist hot-compress therapy plays a positive role in the treatment of autoimmune prostatitis with damp heat syndrome by reducing the expression of RORγt, inhibiting the differentiation of Th17 and thus checking the differentiation imbalance of Th17/Treg.

[Study on depression in 212 patients with viral hepatitis].

OBJECTIVE: To investigate the symptoms on depression in patients with viral hepatitis. METHODS: A cross-sectional study was conducted among the patients with viral hepatitis in infectious diseases Hospital of Taiyuan. The questionnaire included a Eysenck Personality Questionnaire, self-rating depression scale (SDS), and a self-designed one related to information regarding general conditions of the disease and social support. RESULTS: (1) Depression symptom prevalence rate among chronic viral hepatitis patients was 54.7% (116/212). (2) Factors as age, occupation, education, confirmed time, number of recurrence and anti-virus treatment, self-confidence on recovery, satisfaction on the surrounding environment etc. that might be associated with depression. (3) The severity of depression was significantly negative correlation with social support scores, objective support scores, subjective support scores (r = -0.262, P = 0.000; r = -0.228, P = 0.001; r = -0.270, P = 0.000). (4) There was positive correlation noticed between severity of the depressive disorder and Eysenck Personality two dimensions scores, while the scores of introversion and extroversion scores were negatively correlated (r = -0.330, P = 0.000) but positively correlated to the emotional stability scores (r = 0.309, P = 0.000). CONCLUSION: (1) Patients with hepatitis showed symptoms of depression to a certain degree. (2) Factors as age, occupation, education, economic situation, confirmed time of diagnosis, number of recurrence and anti-virus treatments, confidence on recovery, satisfaction on the surrounding environment might be associated with symptoms of depression. (3) There was positive correlation between severity of depressive and Eysenck Personality two dimensions scores but the scores of introversion and extroversion scores were negatively correlated.

Studies on sexual dysfunction in male patients with chronic renal insufficiency / 中华男科学杂志

<p><b>OBJECTIVES</b>To investigate the prevalence, main manifestation and related factors of sexual dysfunction in male patients with chronic renal insufficiency (CRI).</p><p><b>METHODS</b>A cross-section study was conducted by six hospitals in Sichuan Province. The prevalence and severity of sexual dysfunction were assessed by SCASF microsoft among patients with chronic renal disease. Logistic regression was used to examine and test the association between sexual dysfunction and other medical conditions.</p><p><b>RESULTS</b>The prevalence of sexual dysfunction was wider in patients with CRI than in those without. The main manifestations in male patients were decreased libido, erectile dysfunction and premature ejaculation. Stratified analysis in uremia showed that the prevalence and severity of sexual dysfunction were similar between patients on haemodialysis(HD) and those on peritoneal dialysis(PD). The patients receiving no replacement treatment suffered more decreased libido and performance anxiety than dialyzed patients (HD and PD) and transplantation patients(Tx). The patients receiving no replacement treatment and dialysis suffered more erectile dysfunction than Tx men. A multivariable analysis demonstrated that the duration, creatinine clearance(Ccr), parathyroid hormone (PTH), albumin(Alb) were not associated with sexual dysfunction. The use of beta-blocker, anemia and depression were risky factors for decreased libido, and increasing age was a risky factor for erectile dysfunction. The use of angiotensin-converting-enzyme inhibitor(ACEI)/angiotention receptor antagonist (ARB) and recombinant human erythropoietin(r-HuEpo) were protective factors for erectile dysfunction.</p><p><b>CONCLUSIONS</b>The main manifestations of sexual dysfunction in male patients with CRI are decreased libido, erectile dysfunction and premature ejaculation. The replacement therapy, especially transplantation, can decrease the prevalence or severity of sexual dysfunction. The genesis of sexual dysfunction is multifactorial, including age, physiological factors, psychological factors and medical conditions.</p>

Role of Wnt signal-mediated crosstalk between hepatic macrophages and hepatic progenitor cells in the development and repair of liver fibrosis / 临床肝胆病杂志

Hepatic macrophages and hepatic progenitor cells play an important role in the development and repair of liver fibrosis. The polarized state of macrophages can affect the differentiation orientation of hepatic progenitor cells, and the Wnt signaling pathway may play a key role in the crosstalk between hepatic macrophages and hepatic progenitor cells. This article overviews the role of macrophages and hepatic progenitor cells and the mechanism of the crosstalk between them in the pathological state of liver fibrosis. It is pointed out that in-depth studies are needed to investigate the genome and phenotype of hepatic macrophages and clarify the mechanism of action of macrophages in regulating the differentiation of hepatic progenitor cells, in order to provide a basis for the treatment of liver fibrosis.