Inhibition of RhoA/ROCK signalling pathway activity improves neural damage and cognitive deficits in the fluorosis model.

Excessive fluoride intake poses health risks to humans and animals. Many studies have indicated that fluoride exposure can damage the cytoskeleton and synapses, which has negative effects on the intellectual development of humans and animals. Our previous study suggested that the RhoA/ROCK signalling pathway is activated by NaF exposure in HT-22 cells and plays a vital role in cytoskeletal assembly and synaptogenesis. However, the mechanism underlying RhoA/ROCK-mediated cytoskeletal injury induced by fluoride remains unclear. In this study, Neuro-2A cells and ICR mice were used to investigate the effects of RhoA/ROCK activation inhibition on NaF-induced synaptic dysfunction and cognitive impairment. We detected the expression of GAP, RhoA, ROCK1/2, and (p)-MLC in vivo and in vitro model. The results showed that NaF exposure activated the RhoA/ROCK/MLC signalling pathway. We measured the effects of RhoA/ROCK inhibition on synaptic injury and intellectual impairment induced by NaF exposure. In vitro, Y-27632 suppressed activated RhoA/ROCK, attenuated morphological and ultrastructural damage, and decreased the survival rate and synapse-functional protein expression caused by NaF. In vivo, the results showed that the RhoA/ROCK/MLC pathway was inhibited by fasudil and improved pathological damage in the hippocampus, cognitive impairment, and decreased expression of neurofunctional proteins induced by NaF. Overall, these results suggest that fasudil and Y-27632 can reverse neurotoxicity caused by fluoride exposure. Furthermore, inhibition of RhoA/ROCK may be a future treatment for CNS injury, and more detailed studies on other neurodegenerative disease models are required to confirm its effectiveness.

Hepatic epithelioid angiomyolipoma: magnetic resonance imaging characteristics.

PURPOSE: The aim of the study was to analyze MR imaging features of hepatic epithelioid angiomyolipoma (HEAML). METHODS: This study included 113 patients with 122 pathologically confirmed HEAML who underwent enhanced MRI scanning before partial hepatectomy. MR images were retrospectively reviewed and correlated with pathological findings. RESULTS: The mean age of 113 patients was 48.12 ± 11.77 years old, and the male to female ratio was 1:3.35 with 87 females (76.99%). 107 (94.69%) patients presented as single tumor, and 96 patients (84.96%) were asymptomatic. 122 HEAML lesions were diagnosed pathologically in 113 patients, with the average of 4.47 ± 3.26 cm. 109 lesions (89.34%) and 108 lesions (88.52%) showed regular and well-defined boundary. On T1WI, 121 lesions (99.18%) mainly presented hypointensity. On T2WI, 118 lesions (96.72%) and 109 lesions (89.34%) mainly showed hyperintensity and heterogeneous signals. Most of the lesions (97.46%) showed hyperintensity on DWI. 118 lesions (96.72%) manifested as severe hyperenhancement and 106 lesions (86.89%) showed heterogeneity during the arterial phase. As for the lesion enhancement pattern, 73 lesions (59.84%) presented as persistent enhancement, 37 lesions (30.33%) as wash out, 8 lesions (6.56%) as degressive enhancement, and 4 lesions (3.28%) as poor blood supply. Additionally, 96 lesions (78.69%) with intra-tumor vessels and 85 lesions (69.67%) with outer rim were confirmed during the delayed phase. CONCLUSION: At enhanced MRI, hypointensity on T1WI, hyperintensity and heterogeneous signals on T2WI, hyperintensity on DWI, little or no fat component, heterogenous hyperenhancement, persistent enhancement, intra-tumor vessels, and outer rim would be helpful to diagnose HEAML.

Establishment of a time-resolved immunoassay for acute kidney injury based on the detection of Kim-1.

AIM: To establish a highly sensitive time-resolved fluorescence immunoassay (TRFIA) of kidney injury molecule-1 (Kim-1) and evaluate its clinical value in acute kidney injury (AKI). METHODS: The Kim-1-TRFIA was established by the double-antibody sandwich method, and the method was evaluated. The established Kim-1-TRFIA was used to detect the concentration of Kim-1 in the serum of healthy controls and patients with AKI. RESULTS: The optimal coating antibody concentration and optimal Eu3+ -labeled antibody dilution ratio for Kim-1-TRFIA are 1 µg/ml and 1:140, respectively. The linear range is 42.71-4666.69 pg/ml. The intra- and inter-assay coefficients of variation are <10%. The specificity of our Kim-1-TRFIA is acceptable. The recovery is between 95.14% and 102.84%. The concentration of Kim-1 in the serum of patients with AKI is 126.50 ± 67.99 pg/ml, which is significantly higher than that in the serum of healthy controls (49.72 ± 16.40 pg/ml, p < 0.001). Staging patients with AKI by glomerular filtration rate shows that the serum concentration of Kim-1 increases significantly with increasing disease severity (p < 0.05). CONCLUSION: A highly sensitive Kim-1-TRFIA was established. With this immunoassay, a good differential diagnosis can be made, and healthy people and AKI patients can be differentiated by detecting the concentration of Kim-1 in the serum. Moreover, the severity of AKI patients can be determined.

Clinical and pathological predictors of relapse in IgG4-related disease.

OBJECTIVES: In IgG4-related disease, the relationship between pathological findings and relapse has not been well established. This study aimed to identify the clinical and pathological predictors of disease relapse in IgG4-RD. METHODS: Patients with newly diagnosed IgG4-RD (n = 71) were enrolled between January 2011 and April 2020; all cases were pathologically confirmed. The clinical and pathological features were recorded in a database at baseline and each follow-up visit. Patients were followed up at least once a month via outpatient clinic examinations and telephone calls. Univariate and multivariate Cox regression analyses and receiver operating curve (ROC) analysis were used to identify the predictors of disease relapse and to assess their predictive value. RESULTS: Over a median follow-up of 26 (range, 6-123) months, 3/71 (4.2%) patients died. Of the remaining 68 patients, 47 (69.1%) patients had achieved clinical remission and 21 (30.9%) had suffered relapse at the last follow-up. The independent predictors of relapse were IgG4 ≥ 6.5 g/L (HR = 2.84, 95% CI: 1.11-7.23), IgG ≥ 20.8 g/L (HR = 4.11, 95% CI: 1.53-11.06), IgG4-RD responder index (RI) ≥ 9 (HR = 3.82, 95% CI: 1.28-11.37), and severe IgG4+ plasma cell infiltration (HR = 6.32, 95% CI: 1.79-22.41). A prognostic score developed using three of the identified predictors (IgG ≥ 20.8 g/L, IgG4-RD RI ≥ 9, and severe IgG4+ plasma cell infiltration) showed good value for predicting impending relapse (AUC, 0.806). CONCLUSIONS: In patients with IgG4-RD, IgG4 ≥ 6.5 g/L, IgG ≥ 20.8 g/L, IgG4-RD responder index (RI) ≥ 9, and severe IgG4+ plasma cell infiltration are predictors of relapse.

Magnetic resonance imaging characteristics of primary diffuse large B-cell lymphoma of the liver / 中华肝胆外科杂志

Objective:To study the magnetic resonance imaging (MRI) features of primary hepatic diffuse large B-cell lymphoma (PDLBCLL) with the aim to improve the diagnosis of this disease.Methods:The clinical data of 15 patients with PDLBCLL confirmed by biopsy or surgical resection specimens at Zhongshan Hospital of Fudan University and Yiwu Central Hospital from May 2015 to August 2021 were retrospectively analyzed. There were 8 males and 7 females, aged (58.3±12.0) years old. Thirteen patients underwent conventional Gd-DTPA enhanced MR examinations, and 2 patients underwent hepatobiliary specific contrast agent (Gd-EOB-DTPA) enhanced MR examinations. Image analysis included the number, location, size, shape, signal intensity and enhancement features of the lesions. Apparent diffusion coefficient (ADC) values of lesions and surrounding liver parenchyma were measured on the ADC map, and paired sample t-test was used to compare the differences between the two groups. Results:In 15 patients, 10 patients had a single, 4 had multiple lesions. In 1 patient, there was diffuse, mild enhancement in the arterial phase, slow decrease in the early portal venous, late portal venous and equilibrium phases, and ring low signal signals were detected in the hepatobiliary specific phase. The average ADC value of the 15 patients was (0.826±0.379)×10 -3 mm 2/s, and the average ADC value of the adjacent liver parenchyma was (1.311±0.236)×10 -3 mm 2/s. The difference was significant ( P<0.05). Uniform signals were detected in lesions in 3 patients, in the scar tissues of 2 patients, moderate enhancement scan lesions were improved in 10 patients, mild aggrandizement in 5 patients, lesions showing a " floating vessels" sign in 6 patients, lesions showing a typical " target" appearance in 7 patients, abnormal perfusion around the lesion in 7 patients, and compression of bile ducts with perifocal bile duct dilatation in 2 patients. Conclusion:The MRI findings of PDLBCLL showed certain characteristics. The lesion boundary was clear and the signal was uneven. Contrast-enhanced scans showed a lack of blood supply, most of which were accompanied by necrosis, and the " vessel floating sign" and " target sign" were characteristic.

Application of near-infrared spectroscopy technology in the complex fermentation system to achieve high-efficiency production.

The fermentation process is dynamically changing, and the metabolic status can be grasped through real-time monitoring of environmental parameters. In this study, a real-time and on-line monitoring experiment platform for substrates and products detection was developed based on non-contact type near-infrared (NIR) spectroscopy technology. The prediction models for monitoring the fermentation process of lactic acid, sophorolipids (SLs) and sodium gluconate (SG) were established based on partial least-squares regression and internal cross-validation methods. Through fermentation verification, the accuracy and precision of the NIR model for the complex fermentation environments, different rheological properties (uniform system and multi-phase inhomogeneous system) and different parameter types (substrate, product and nutrients) have good applicability, and R2 was greater than 0.98, exhibiting a good linear relationship. The root mean square error of prediction shows that the model has high credibility. Through the control of appropriate glucose concentration in SG fermentation as well as glucose and oil concentrations SLs fermentation by NIR model, the titers of SG and SLs were increased to 11.8% and 26.8%, respectively. Although high cost of NIR spectrometer is a key issue for its wide application in an industrial scale. This work provides a basis for the application of NIR spectroscopy in complex fermentation systems.

A clinical analysis of 19 patients with hepatic pseudolymphoma / 中华肝胆外科杂志

Objective To study the clinical features of hepatic pseudolymphoma.Methods A retrospective study was conducted on 19 patients with hepatic pseudolymphoma who were diagnosed and treated at Zhongshan Hospital in Shanghai from June 2013 to December 2017.Eighteen patients were females and one was a male.The mean age was (55±9) years,range 36 to 68 years.This study mainly analyzed the imaging features,treatment and postoperative results.Results All patients were diagnosed accidentally,and 78.9％ patients did not exhibit any evidence of hepatic B viral infection.A monofocal lesion was found in 14 patients and multifocal lesions in 5 patients.Surgical treatment was performed in all the patients.The lesion size was (1.1±0.4) cm (range 0.5～2.4 cm).Ultrasound revealed hypo-or slightly hypo-echogenicity.On MRI,diffusion weighted imaging showed slight hyperintensity or hyperintensity,all lesions manifested as homogeneous and slightly hyperintensity on T2WI and hypointensity on T1WI.Dynamic enhancement pattern,wash in and wash out,degressive and persistent enhancement were observed in 16(55.2％),12(41.4％),and 1 (3.4％) patients,respectively.More than 70％ of lesions were diagnosed as malignant tumors on preoperative imaging.During a follow-up of 6 ～ 44 months (median:19 months),no patient developed metastasis or recurrence.Conclusions Hepatic pseudolymphoma commonly occurred in women with a small sized lesion.Due to the lack of specific clinical manifestations and imaging findings,preoperative diagnosis was difficult.Surgical resection is still the most optimal treatment.The patients usually have favorable prognosis.

Association between tea drinking and stroke in adults in Zhejiang province: a prospective study / 中华流行病学杂志

Objective To prospectively explore the association between tea drinking and incidence of stroke of adults of Zhejiang province.Methods After excluding participants with heart disease,stroke,cancer and diabetes at baseline study,53 916 participants aged 30-79 years in the China Kadoorie Biobank (CKB) study from Tongxiang were included for final analysis.Cox regression model was used to estimate the hazard ratio (HR) for the association of tea drinking with incident stroke.Results The main type of drinking tea was black tea (79.78％),followed by green tea (20.08％).Of the 53 916 participants,the proportion of participants who drank tea at least once per week was 31.27％.The corresponding proportions for men and women were 60.24％ and 10.30％,respectively.Among 391 512 person-years of the follow-up program (median 7.26 years),a total of 1 487 men and 1 769 women were diagnosed with stroke.After adjusting for socio-demographic status,lifestyle,BMI,waist circumference,and systolic blood pressure,HR for incident stroke decreased with the increase of daily average tea consumption amount (P=0.000 6).Compared with participants who did not drink tea weekly,the HRs for incident stroke in those consuming tea 0.1-,3.0-and ≥5.0 g/d were 0.93 (95％ CI:0.85-1.00),0.88 (95％ CI:0.77-0.99) and 0.79 (95％ CI:0.69-0.89),respectively.The HRs for incident stroke in smokers and non-smokers who consumed tea ≥5.0 g/d were 0.71 (95％CI:0.59-0.86) and 0.97 (95％CI:0.77-1.21),respectively,compared with current smokers and non-smokers who did not drink tea weekly (P=0.040 0).The corresponding HRs for alcohol drinkers and non-drinkers were 0.96 (95％CI:0.76-1.22) and 0.70 (95％CI:0.58-0.84),respectively (P=0.040 0).The corresponding HRs for central obese persons and non-central obese persons were 0.60 (95％ C1:0.44-0.81) and 0.86 (95％ CI:0.73-1.01),respectively (P=0.040 0).Conclusion Tea drinking had an effect on reducing the possibility of incident stroke,especially among those who were current smokers,non-alcohol drinkers and central obese.

Prospective study on the effect of BMI and waist circumference on diabetes of adults in Zhejiang province / 中华流行病学杂志

Objective To explore the effect of BMI and waist circumference on diabetes of adults.Methods After excluding participants with heart disease,stroke,cancer and diabetes at baseline study,53 916 people aged 30-79 in the China Kadoorie Biobank (CKB) study from Tongxiang city of Zhejiang province were recruited.Cox regression model was used to estimate the hazards ratios (HR) for the associations of baseline BMI and waist circumference with incident diabetes.Results Among 391 512 person-years of the follow-up program between 2004 and 2013 (median 7.26 years),a total of 944 men and 1 643 women were diagnosed as having diabetes.Compared to those with normal weight,after adjusting for known or potential factors,HR of both overweight and obesity in men for incident diabetes appeared as 2.72 (95％CI:2.47-2.99) and 6.27 (95％CI:5.33-7.36),respectively.The corresponding figures in women were 2.19 (95％CI:2.04-2.36)and 3.78 (95％CI:3.36-4.26).Compared to those with normal waist circumference,after adjusting for known or potential factors,HR of Ⅰ grade and Ⅱ grade in men for diabetes were 2.56 (95％ CI:2.22-2.95) and 4.66 (95％CI:4.14-5.24),respectively.The corresponding figures in women were 1.99 (95％CI:1.80-2.21) and 3.16 (95％CI:2.90-3.44),respectively.Conclusions Overweight,obesity and central obesity were all associated with the increased incident of diabetes.Strategies on diabetes prevention should include not only losing weight,but reducing waist circumference as well.

Association between tea drinking and stroke in adults in Zhejiang province: a prospective study / 中华流行病学杂志

Objective To prospectively explore the association between tea drinking and incidence of stroke of adults of Zhejiang province.Methods After excluding participants with heart disease,stroke,cancer and diabetes at baseline study,53 916 participants aged 30-79 years in the China Kadoorie Biobank (CKB) study from Tongxiang were included for final analysis.Cox regression model was used to estimate the hazard ratio (HR) for the association of tea drinking with incident stroke.Results The main type of drinking tea was black tea (79.78％),followed by green tea (20.08％).Of the 53 916 participants,the proportion of participants who drank tea at least once per week was 31.27％.The corresponding proportions for men and women were 60.24％ and 10.30％,respectively.Among 391 512 person-years of the follow-up program (median 7.26 years),a total of 1 487 men and 1 769 women were diagnosed with stroke.After adjusting for socio-demographic status,lifestyle,BMI,waist circumference,and systolic blood pressure,HR for incident stroke decreased with the increase of daily average tea consumption amount (P=0.000 6).Compared with participants who did not drink tea weekly,the HRs for incident stroke in those consuming tea 0.1-,3.0-and ≥5.0 g/d were 0.93 (95％ CI:0.85-1.00),0.88 (95％ CI:0.77-0.99) and 0.79 (95％ CI:0.69-0.89),respectively.The HRs for incident stroke in smokers and non-smokers who consumed tea ≥5.0 g/d were 0.71 (95％CI:0.59-0.86) and 0.97 (95％CI:0.77-1.21),respectively,compared with current smokers and non-smokers who did not drink tea weekly (P=0.040 0).The corresponding HRs for alcohol drinkers and non-drinkers were 0.96 (95％CI:0.76-1.22) and 0.70 (95％CI:0.58-0.84),respectively (P=0.040 0).The corresponding HRs for central obese persons and non-central obese persons were 0.60 (95％ C1:0.44-0.81) and 0.86 (95％ CI:0.73-1.01),respectively (P=0.040 0).Conclusion Tea drinking had an effect on reducing the possibility of incident stroke,especially among those who were current smokers,non-alcohol drinkers and central obese.

Prospective study on the effect of BMI and waist circumference on diabetes of adults in Zhejiang province / 中华流行病学杂志

Objective To explore the effect of BMI and waist circumference on diabetes of adults.Methods After excluding participants with heart disease,stroke,cancer and diabetes at baseline study,53 916 people aged 30-79 in the China Kadoorie Biobank (CKB) study from Tongxiang city of Zhejiang province were recruited.Cox regression model was used to estimate the hazards ratios (HR) for the associations of baseline BMI and waist circumference with incident diabetes.Results Among 391 512 person-years of the follow-up program between 2004 and 2013 (median 7.26 years),a total of 944 men and 1 643 women were diagnosed as having diabetes.Compared to those with normal weight,after adjusting for known or potential factors,HR of both overweight and obesity in men for incident diabetes appeared as 2.72 (95％CI:2.47-2.99) and 6.27 (95％CI:5.33-7.36),respectively.The corresponding figures in women were 2.19 (95％CI:2.04-2.36)and 3.78 (95％CI:3.36-4.26).Compared to those with normal waist circumference,after adjusting for known or potential factors,HR of Ⅰ grade and Ⅱ grade in men for diabetes were 2.56 (95％ CI:2.22-2.95) and 4.66 (95％CI:4.14-5.24),respectively.The corresponding figures in women were 1.99 (95％CI:1.80-2.21) and 3.16 (95％CI:2.90-3.44),respectively.Conclusions Overweight,obesity and central obesity were all associated with the increased incident of diabetes.Strategies on diabetes prevention should include not only losing weight,but reducing waist circumference as well.

Risk factors of intrahepatic recurrence after resection for Barcelona Clinic Liver Cancer stage 0 hepatocellular carcinoma / 中华肝胆外科杂志

Objective To investigate the risk factors of intrahepatic recurrence after resection for Barcelona Clinic Liver Cancer (BCLC) stage 0 hepatocellular carcinoma (HCC).Methods 58 patients with pathologically confirmed BCLC stage 0 HCC treated with liver resection at the Zhongshan Hospital,Fudan University from January to December 2011 were included in this study.The male/female ratio was 50/8.The age ranged from 31 to 72 years.The clinical,pathological and MR imaging features of these patients were analyzed.The recurrence-free survival rates between patients with HCC ≤ 1.5 cm (n=27) and ＞ 1.5 cm (n=31) were compared.The risk factors of intrahepatic recurrence for HCCs were compared using the Cox regression analysis.Results Intrahepatic recurrence was identified in 25 patients,and the median recurrence time was 33 months.The 3-and 5-year cumulative recurrence-free survival rates were 73.0％ (95％CI:60.7％～85.3％) and 52.3％ (95％CI:37.2％～67.4％).No significant differences were found in the recurrence-free survival rates between tumors ≤ 1.5 cm and ＞ 1.5 cm (P＞0.05).Multivariate analyses demonstrated that serum alpha-fetoprotein level ＞20 g/L (HR 3.773,95％CI:1.628～8.745;P＜0.05) and irregular tumor shape (HR 4.584,95％CI:1.485～ 14.155;P＜0.05) were independent risk factors of intrahepatic recurrence.Conclusions Elevated serum alpha-fetoprotein level and irregular tumor shape were associated with an increased risk of intrahepatic recurrence for BCLC stage 0 HCC patients after resection.They could be used as early prognostic indicators in clinical practice.

Diagnostic value of contrast-enhanced ultrasound for dysplastic nodule with a focus of hepatocellular carcinoma / 中华超声影像学杂志

Objective To investigate the imaging features of dysplastic nodules with a focus of hepatocellular carcinoma ( DN-HCC ) on contrast-enhanced ultrasound ( CEUS ) and to improve the diagnostic accuracy . Methods The clinical data of 60 patients and CEUS imaging of 62 hepatic nodules [DN-HCCs , n =54 ;dysplastic nodules (DN) , n =8] pathologically proved were reviewed retrospectively . According to Contrast Enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) , the lesions were categorized . Results Significantly different CEUS patterns between DN-HCCs and DNs were observed ( P < 0 .05) . During the arterial phase ,54 DN-HCC lesions showed various enhancement patterns [ hypervascular ,59 .3％ ( 32/54 ) ;nodule-in-nodule ,9 .3％ ( 5/54 ) ;isovascular ,13 .0％ ( 7/54 ) and hypovascular ,18 .5％ (10/54)] . Of the 54 DN-HCC lesions ,44 .4％ (24/54) showed washout during the late phase .Of the 8 DN lesions ,62 .5％ (5/8) showed iso-enhancement during the arterial phase ,25％ (2/8) showed hypo-enhancement ,and 12 .5％ (1/8) showed hyper-enhancement . No DN lesion showed washout during the late phase .According to CEUS LI-RADS (LR) algorithm ,27 .8％ (15/54) DN-HCCs were LR-5 ,46 .3％ (25/54) DN-HCCs were LR-4 ,25 .9％ (14/54) DN-HCCs and 100％ (8/8) DNs were LR-3 . Regarding hyper-enhancement ( including local hyper-enhancement ) during the arterial phase or hypo-enhancement (including local hypo-enhancement) during the late phase as the diagnostic standard of DN-HCC , the diagnostic sensitivity , specificity and accuracy value were 83 .3％ , 87 .5％ and 83 .9％ , respectively . Conclusions The imaging features of hyper-enhancement during the arterial phase or hypo-enhancement during the late phase on CEUS are useful to diagnose DN-HCCs .

Establishment of a new method based on nucleic acid functionalized GO for the rapid detection of Salmonella typhimurium carrying SSeC gene / 中华微生物学和免疫学杂志

Objective To establish a simple, efficient and low-cost method for the detection of Salmonella typhimurium carrying SSeC gene. Methods In this study, a nano-biosensor ( FAM-P/GO) was successfully established based on the noncovalent assembly of carboxy-fluorescein ( FAM)-labeled probe and graphene oxide ( GO) . The target gene at different concentrations and SSeC gene-harbored bacterium sam-ples were detected by the FAM-P/GO nano-biosensor to evaluate its sensitivity. The specificity of the estab-lished nano-biosensor was evaluated by using DNAs with mismatched base pairs and single-stranded DNAs ( ssDNAs) extracted from various species. Results The established strategy for SSeC gene detection showed a good linear range of 0. 05-1. 0 μmol/L (R2=0. 992 1) with a lower limit of 0. 05 μmol/L. Moreover, the lower detection limit for target bacterium samples was 103 CFU/ml and the fluorescence intensity increased linearly with the concentration from 103 CFU/ml to 108 CFU/ml. The signal-to-noise ( S/N) of the experi-mental group was much greater than that of the control group, which indicated that the establish method was highly specific. Conclusion The FAM-P/GO nano-biosensor was successfully established in this study, which provided a new and possible way for the rapid detection of Salmonella typhimurium harboring SSeC gene.

Related factors of infection after laparoscopic hysterectomy / 中华内分泌外科杂志

Objective To explore and analyze the related factors of nosocomial infection in patients after total laparoscopic hysterectomy.Methods A total of 231 patients undergoing total laparoscopic hysterectomy were enrolled in this study and their data were retrospectively analyzed.The related factors such as uterus size,operation duration,intraoperative blood loss,type of disease,drainage tube,hospital duration before surgery,and history of pelvic surgery were analyzed.Results Among the 231 cases undergoing total laparoscopic hysterectomy,23 cases had infection and the infection rate was 9.96％.Univariate analysis showed uterus size,operation duration,intraoperative blood loss,hospital duration before surgery,and history of pelvic surgery had influence on postoperative infection and the difference had statistical significance (P＜0.05),while the difference of age and drainage tube had no statistical significance on postoperative infection (P＞0.05).Conclusion The incidence of infection after laparoscopic hysterectomy is related to uterus size,operation duration,intaoperative blood loss,hospital duration before surgery,and history of pelvic surgery.

Advance in Studies on Anti-inflammatory Mechanism of Flavonoids / 中国药师

Flavonoids are the secondary metabolites of plants , which are found in many plants .Flavonoids have extensive phar-macological actions , such as anti-inflammation, anti-tumor, anti-bacteria and anti-virus, scavenging free radicals , osteoporosis preven-tion and cardiovascular protection .Based on the analysis of relative literatures published at home and abroad in recent years , the mech-anisms of anti-inflammatory effects of flavonoids were reviewed , including arachidonic acid metabolism pathway , cytokine and its recep-tor, cell second messenger, active oxygen, nitrogen monoxide, platelet activating factor and its receptor , nuclear factor, intercellular adhesion molecule and so on .The review aimed to provide theoretical basis for the further development and research .

Association between sleep duration and stroke in adults / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the association between sleep duration and stroke in adults.</p><p><b>METHODS</b>Baseline data of 57 704 subjects who were aged 30-79 years and enrolled into China Kadoorie Biobank (CKB) study from Tongxiang county, Zhejiang province were analyzed. Multiple logistic regression analysis was conducted to investigate the putative association between sleep duration and stroke after adjusting for potential confounders.</p><p><b>RESULTS</b>The mean age of the subjects was (53.15 ± 10.20) years in males and (51.72 ± .69) years in females, respectively. There were 14.43% of males and 15.30% of females reporting sleep durations ≤ 6 hours per day and 5.39% of males and 5.95% of females reporting long duration of sleep (≥ 10 hours per day). The prevalence of stroke was 0.92% in males compared with 0.44% in females. The prevalence of stroke showed a U-shaped distribution with sleep duration. Compared with 7 hours sleep duration per day, long sleep duration (≥ 10 hours per day) was associated with stroke. The odds ratios (OR) were 2.11 (95%CI: 1.32-3.37) for males and 2.13 (95%CI: 1.24-3.65) for females after adjusting for age, socioeconomic status, health behaviors and health status. No statistical significant association was found between short sleep duration and stroke. Meanwhile, frequent sleep snoring was found to be associated with stroke in females (OR=1.63, 95% CI: 1.11-2.40).</p><p><b>CONCLUSION</b>Longer sleep duration was found to be associated with higher risk of stroke in both males and females. Frequent sleep snoring would increase the risk of stroke in females.</p>

Value of MR susceptibility weighted imaging for characterization of small hepatocellular carcinoma in cirrhotic livers / 中华放射学杂志

Objective To investigate the value of susceptibility?weighted imaging (SWI) for characterization of small hepatocellular carcinoma (sHCC) in cirrhotic livers. Methods Two hundred seventy?two patients suspiciousof HCC underwent conventional MR imaging and susceptibility?weighted imaging (SWI). Two hundred and five patients were excluded due to either size larger than 3.0 cm, no cirrhosis or HCC. Finally, a total of 84 hepatocellular nodules in 67 patients were included in this prospective study. There were 22 DNs in 12 cases, 8 DNs with HCC foci in 7 cases, and 54 overt HCCs in 48 cases. Two abdominal radiologists independently evaluated signal intensity and enhancing pattern using conventional MRI set and conventional MRI combining with SWI set. A five?point scale was performed to evaluate diagnostic confidence of HCC. Kappa analysis was performed to assess interobserver agreement of the two sets by two readers.The diagnostic performance and confidence level were compared for each image set,ROC was used to evaluate the diagnostic efficiency.Results Good interobserver agreement was identified with a Kappa value of 0.923 for conventional MRI set and 0.865 for conventional MRI combining with SWI set, respectively. The diagnostic sensitivity, specificity, accuracy, and area under the alternative?free response ROC (Az) were 80.6% and 80.6%, 81.8% and 77.3%, 81.0% and 79.8%, 0.804 and 0.782 using conventional MRI set, and 93.5%and 85.5%, 90.9%and 86.4%, 92.9%and 85.7%, 0.898 and 0.859 using conventional MRI combining with SWI set for reader 1 and reader 2, respectively.The diagnostic confidence level of conventional MRI combining with SWI set for diagnosis of HCC with less than 2 cm in size(n=36) was significantly higher than that of conventional MRI (reader 1, 3.86±0.47 vs 3.40±0.91;reader 2, 3.85±0.57 vs 3.41±0.92;t values were 3.733 and 2.468, P were 0.001 and 0.018).Conclusion SWI can provide additional valuable information and improve diagnostic performance for characterization of sHCC in cirrhotic livers.

Comparison of MRI findings of small hepatocellular carcinoma and small intrahepatic mass-forming cholangiocarcinoma / 中华放射学杂志

Objective To compare the MR features of small hepatocellular carcinoma (sHCC) and small intrahepatic mass-forming cholangiocarcinoma (sIMCC) (≤ 3 cm) and improve the accuracy in diagnosis.Methods Imaging studies of 318 patients with 351 sHCCs and 42 patients with 47 sIMCCs were retrospectively reviewed.Signal intensity on T2WI and on each phase of dynamic enhanced imaging,enhancement patterns,and accompanying findings of the two groups were compared by qualitative and quantitative studies.The qualitative imaging features of tumors were compared by the x2 test and the Fisher exact test,and the statistically significant variables obtained from univariate analysis were used to conduct multivariate stepwise logistic regression analysis.Enhancement pattern between sHCCs with elevated AFP and normal AFP were assessed by thex2 test.Results Multivariate analysis indicated that signal features of enhancement pattern and the accompanying findings of tumor capsule and hepatic capsule retraction were key predictors in differentiating sHCC from sIMCC:Wash-out pattern (276/351) with enhanced tumor capsule (275/351) highly indicated sHCC,while progressive enhancement pattern (27/47) with hepatic capsule retraction (8/47) indicated the diagnosis of sIMCC (P ＜ 0.01).Compared with sHCC with normal AFP,atypical patterns as progressive (n =4) and stable enhancement (n =32) were more commonIy seen in lesions with elevated AFP,dynamic enhancement pattern was different between the two subgroups (x2 =8.241,P ＜ 0.05).Conclusions Enhancement patterns and the accompanying tumor capsule and hepatic capsule retraction were the most important predictors in differentiating sHCC from sIMCC.In addition,enhancement pattern was relatively more typical in sHCCs with normal AFP which provided valuable information in diagnosis for clinicians.

Dysplastic nodule of liver versus early hepatocellular carcinoma: a clinicopathologic and prognostic study / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinical features, pathologic findings and prognosis of patients with dysplastic nodules of liver (DN) and early hepatocellular carcinomas (eHCC).</p><p><b>METHODS</b>One hundred and forty-five archival cases previously diagnosed as DN or eHCC or well-differentiated HCC during the period from 2000 to 2009 were retrieved and reevaluated with the new diagnostic criteria by two experienced pathologists, according to International Consensus Group for Hepatocellular Neoplasia (ICGHN) 2008. Immunohistochemical study (EnVision method) for CD34, HSP70, glutamine synthetase, glypican 3 and Ki-67 was carried out. The original diagnosis and diagnosis after review were compared and correlated with the survival data of the patients, with statistical analysis.</p><p><b>RESULTS</b>With the new criteria, 16 cases were diagnosed as low-grade DN, 50 cases as high-grade DN, 72 cases as DN with microinvasion, 7 cases as advanced HCC. Slide review showed no diagnostic discrepancy in 112 cases (77.2%). Amongst the 33 (22.8%) underdiagnosed cases, there were 7 cases of advanced HCC initially diagnosed as DN or DN with microinvasion and 26 cases of eHCC initially diagnosed as high-grade DN. Kaplan-Meier analysis showed that the diagnosis of high-grade DN or early HCC carried no statistically significant difference in overall survival (P = 0.778, 0.677) or disease-free survival (P = 0.949, 0.700) in all patients and in patients with no history of HCC. The co-existence of advanced HCC in patients with DN or eHCC significantly correlated with overall survival (P = 0.004) but not with disease-free survival (P = 0.079).</p><p><b>CONCLUSIONS</b>The new diagnostic criteria by ICGHN 2008 are useful in delineating high-grade DN and eHCC. The overall survival and disease-free survival of patients with eHCC or high-grade DN undergoing hepatectomy show no statistically significant difference. Patients with DN or eHCC have better prognosis than patients with advanced HCC, though there is still a high risk of tumor recurrence.</p>