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OBJECTIVE To explore the protective effect and mechanism of Longshengzhi capsules on cerebral ischemia- reperfusion injury in rats. METHODS The model of middle cerebral artery occlusion （MCAO） was established by using the improved thread occlusion method. The experiment was divided into six groups： sham surgery group （only separating blood vessels without inserting thread plugs， given the same volume of normal saline）， model group （modeling， given the same volume of normal saline）， nimodipine group （positive control， modeling， dose of 20 mg/kg）， and low-dose， medium-dose， and high-dose groups of Longshengzhi capsules （modeling， doses of 0.72， 1.44 and 2.88 g/kg， respectively）， with 10 mice in each group. Each group was given corresponding medication solution/normal saline by gavage， once a day， for 7 consecutive days. One hour after the last administration， the Zea Longa scoring method was used to score the neurological deficits in each group of rats， and the ABC enzyme-linked immunosorbent assay was used to detect the serum levels of tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） in rats； TTC staining was used to observe the volume of cerebral infarction in rats and calculate the cerebral infarction volume ratio. Hematoxylin eosin staining was used to observe the pathological changes in the brain tissue of rats. Immunohistochemical staining was used to detect the positive expression of NLRP3 protein in the brain tissue of rats. Real-time fluorescence quantitative PCR was used to detect mRNA relative expressions of Toll-like receptor 4 （TLR4） and nuclear factor-κB （NF-κB） in the brain tissue of rats. Western blot assay was adopted to detect the relative expressions of TLR4， NLRP3 and phosphorylated NF-κB （p-NF-κB） protein in the brain tissue of rats and its intracellular NF-κB protein. RESULTS Compared with the sham surgery group， the neural dysfunction score， serum levels of TNF-α and IL-6， cerebral infarction volume ratio， relative expression levels of NF-κB and TLR4 mRNA， as well as protein relative expressions of TLR4， NLRP3 and p-NF-κB in the brain tissue， and relative protein expression of intracellular NF-κB were increased significantly in the model group （P＜0.01）； the enlarged gap and significant edema were observed in cortical nerve cells of brain tissue in rats， with a large amount of inflammatory cell infiltration； the positive expression of NLRP3 protein in brain tissue of rats obviously increased. Compared with the model group， the levels of the above indicators in the medium-dose and high-dose groups of Longshengzhi capsules， as well as the Nimodipine group， were reversed to varying degrees， and most differences were statistically significant （P＜0.05 or P＜0.01）； the pathological morphology observation showed a significant improvement， and the positive expression of NLRP3 protein in the brain tissue of rats was obviously reduced. CONCLUSIONS Longshengzhi capsules may inhibit TLR4/NF-κB/NLRP3 signaling pathway and neuroinflammatory response， thereby achieving a protective effect against cerebral ischemia-reperfusion injury in rats.
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BACKGROUND: While statins have been widely used in patients with large-artery atherosclerotic stroke, their effectiveness in patients with cardioembolic large vessel occlusion (CE-LVO) undergoing endovascular treatment (EVT) remains unclear. This study aimed to evaluate whether combining statin therapy with EVT could improve clinical outcomes in patients with acute ischemic stroke caused by CE-LVO in the anterior circulation. METHODS: We performed a retrospective screening on patients with CE-LVO in the anterior circulation who underwent EVT in 27 hospitals across China between 2018 and 2021. The primary outcome measure was functional independence, defined as a 90-day modified Rankin Scale (mRS) score of 0 to 2. Safety outcomes included 90-day mortality and symptomatic intracranial hemorrhage (sICH). RESULTS: A total of 510 patients with CE-LVO in the anterior circulation undergoing EVT were included in this study. Of these, 404 (79.2%) patients received statin treatment (statin group), while 106 (20.8%) did not (non-statin group). Statin treatment was significantly associated with improved functional independence (adjusted OR (aOR) 2.072, 95% CI 1.197 to 3.586, P=0.009). Moreover, statin use was associated with a lower rate of 90-day mortality (aOR 0.343, 95% CI 0.197 to 0.596, P<0.001) and a lower rate of sICH (aOR 0.153, 95% CI 0.072 to 0.325, P<0.001). CONCLUSION: Statin treatment was associated with improved clinical outcomes and reduced risks of mortality and sICH in patients with CE-LVO in the anterior circulation undergoing EVT.
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Objective:To investigate the diagnostic value of X-ray mammography, ultrasound and MRI in breast cancer with silicone implants.Methods:The clinical and imaging data of 20 patients with breast cancer in women with silicone implants in the First Affiliated Hospital of Zhengzhou University from March 2014 to October 2021 were analyzed retrospectively. The mammography, ultrasound and MRI findings were analyzed, and the differences in detection rate, diagnostic accuracy and omission diagnostic rate of breast cancer in women with implants were compared among the three imaging methods.Results:Compared with mammography, both ultrasound and MRI were able to display the prosthesis and breast lesions completely. There were significant differences in detection rate, diagnostic accuracy and omission diagnostic rate among mammography, ultrasound and MRI. And the detection rate and diagnostic accuracy of MRI in breast cancer in women with implants were higher than those of mammography, and the omission diagnostic rate was lower.Conclusions:Ultrasound and MRI are superior to mammography in evaluating breast cancer after silicone prosthesis implantation, and MRI has more advantages in guiding clinical diagnosis and treatment.
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Objective:To investigate the effect of Sirtuin 1 (SIRT1) on subarachnoid hemorrhage (SAH) and its possible mechanism.Methods:A mouse model of SAH was constructed by internal carotid artery puncture. The protein and mRNA expression levels of SIRT1 at 0, 3, 6, 12, 24, 48, and 72 h were detected by Western Blot and qRT-PCR. A Western Blot assay was used to examine SIRT1 and the expression levels of endoplasmic reticulum stress-related markers GRP78, p-PERK/PERK, p-eIF2α/eIF2α, and CHOP after administration of a SIRT1 inhibitor or SIRT1 si-RNA. At 24 h after SAH, subarachnoid hemorrhage volume, neurological function score, brain water content, and blood-brain barrier integrity were measured.Results:The highest expression of SIRT1 protein and mRNA was observed at 24 h compared with other time points, and the differences were statistically significant (all P < 0.001). Inhibition of SIRT1 expression leads to increased expression of endoplasmic reticulum stress-related proteins GRP78, p-PERK/PERK, p-eIF2α/eIF2α, and CHOP, exacerbating hemorrhage and brain water content, disrupting blood-brain barrier integrity, and significantly reducing neurological function scores. Conclusions:Inhibition of SIRT1 expression significantly increased the endoplasmic reticulum response to excitation and exacerbated early brain injury after SAH.
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Objective:To investigate the effect of galectin-3 (gal-3) on microglia polarization after subarachnoid hemorrhage (SAH).Methods:C57BL/6 male adult mice were used to induce SAH or sham operation models. Gal-3 siRNA or negative control siRNA was injected into the lateral ventricle 48 h before the model was induced. After 24 h of model preparation, the SAH score, neurological function score, brain water content, and Evans blue exudate were measured. Western blot analysis was used to detect the expressions of M1 phenotypic markers (inducible nitric oxide synthase [iNOS], CD11b, tumor necrosis factor [TNF]-α) and M2 phenotype markers (CD206, YM1/2, arginase-1 [Arg1]).Results:After using Gal-3 siRNA to inhibit Gal-3, the neurological function score significantly increased, while the SAH score, brain water content, and Evans blue exudate significantly decreased ( P<0.001). Western blot analysis showed that the expressions of M1 phenotypic markers (iNOS, CD11b and TNF-α) in microglia were significantly decreased after Gal-3 inhibition, while the expressions of M2 phenotypic markers (CD206, YM1/2 and Arg1) were significantly increased ( P<0.001). Conclusion:Inhibition of Gal-3 expression can alleviate the early brain injury after SAH, and its mechanism may be associated with regulating the polarization of microglia from M1 to M2 phenotype.
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【Objective】 To explore the value of thrombelastogram(TEG) on monitoring the coagulation function and guiding blood transfusion in admitted patients in early stage of severe trauma. 【Methods】 A total of 96 patients in early stage of severe trauma were selected from Ezhou Central Hospital, and were divided into two groups using a random number table method, with 48 patients in each group. The control group was guided by four routine coagulation tests for blood transfusion, while the observation group was guided by TEG.The detection rate of trauma-induced coagulopathy, detection duration, blood infusion volume within 24 hours of admission, coagulation index levels at different time points after blood transfusion, length of hospital stay, ICU stay, and mortality rate between the two groups were compared. 【Results】 The detection rate of trauma-induced coagulopathy was 72.9% in the control group and 93.8% in the observation group(P<0.05). The transfusion volume of fresh frozen plasma (U) and red blood cell (U) in the observation group within 24 hours of admission were significantly lower than those in the control group, which were (35.13±4.75) vs (45.17±6.54), (5.19±1.41) vs (7.08±1.32) (P<0.05); the tranfusion volume of cryoprecipitate (U) and the rate of platelet transfusion in the observation group were significantly higher than those in the control group, which were (36.78±2.49) vs (24.84±3.92), 79.2% vs 22.9%(P<0.05). The APTT(s), PT(s), TT(s), R(min), and K(min) in the observation group 8 hours after blood transfusion were significantly lower than those in the control group, which were (58.16±10.39) vs (70.83±14.99), (15.44±3.22) vs (17.32±2.89), (21.39±4.51) vs (25.18±4.73), (13.03±3.29) vs (14.95±4.57), and (8.07±3.65) vs (10.54±5.14) (P<0.05), while FIB(g/L), MA(mm), α(°), and Plt (×109/L) were higher than those in the control group, which were (2.02±0.46) vs (1.09±0.27), (35.56±11.88) vs (29.57±9.25), (40.07±13.34) vs (27.23±10.87), and (135.87±59.13) vs (108.17±52.08) (P<0.05). 【Conclusion】 TEG can help monitoring the coagulation function in patients in early stage of severe trauma and guide the blood transfusion.
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Objective@#We primarily aimed to investigate the attention network function among parents of children with autism spectrum disorder (ASD) using the Attention Network Test (ANT). The secondary objective was to observe whether the three attention networks of all participants were related to each other. @*Methods@#We included 28 parents of children with ASD and 28 well-matched parents of typically developing children. All participants underwent the neuropsychological assessment and ANT test. The three distinct attention networks, including alerting, orienting, and executive control, were also measured. @*Results@#Compared with controls, parents of children with ASD showed less-efficient alerting and executive control network (all p<0.05), but not orienting network (p=0.74). No significant correlation was found between the alerting, orienting, and executive control network for either group. @*Conclusion@#Our findings showed that parents of children with ASD had deficits in alerting and executive control attention functions. The deficits are indications of a broad autism phenotype.
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Objective:To analyze the significance and factors influencing of CT scan under the modified Valsalva maneuver. Methods:Clinical data of 52 patients with hypopharyngeal carcinoma diagnosed from August 2021 to December 2022 were collected, all patients had calm breathing CT scan and modified Valsalva maneuver CT scan. Compare the exposure effect of the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall, and glottis with each CT scanning method. The effects of age, neck circumference, neck length, BMI, tumor site, and T stage on the exposure effect were analyzed. Results:In 52 patients, 50 patients（96.15%） completed CT scan at once time. The exposure effect of the CT scan under modified Valsalva maneuver in the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall was significantly better than CT scan under calm breathing（Z=-4.002, -8.026, -8.349, -7.781, -8.608, all P<0.01）, while CT scan under modified Valsalva maneuver was significantly worse in glottis than CT scan under calm breathing（Z=-3.625, P<0.01）. In the modified Valsalva CT scan, age had no obvious effect on the exposure effect. The exposure effect was better with long neck length, smaller neck circumference, smaller BMI and smaller T stage. The exposure of postcricoid carcinoma was better than pyriform sinus carcinoma and posterior hypopharyngeal wall carcinoma. But differences were not all statistically significant. Conclusion:The anatomical structure of the hypopharynx was clearly under CT scan with modified Valsalva maneuver, which clinical application is simple, but the effect of glottis was worse. The influence of age, neck circumference, neck length, BMI, and tumor T stage on the exposure effect still needs further investigation.
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Humanos , Hipofaringe/diagnóstico por imagem , Manobra de Valsalva , Neoplasias Hipofaríngeas/cirurgia , Tomografia Computadorizada por Raios X , CarcinomaRESUMO
BackgroundSubstance use has become a critical health concern during the COVID-19 pandemic, and emerging attention has been paid to people with the persistent symptoms of COVID-19 (COVID-19 long haulers) due to their high vulnerability. However, scant research has investigated their substance use and relevant psychosocial factors. The current study was to (1) examine substance use behaviors (i.e., legal drug use, illicit drug use, and non-medical use of prescription drugs); and (2) assessed their associations with psychiatric symptoms (i.e., depression, anxiety, and post-traumatic stress disorder) and psychosocial factors (i.e., personal mastery and social support) among COVID-19 long haulers. MethodsIn January - March 2022, 460 COVID-19 long haulers (50% female), with an average age of 32, completed online surveys regarding their demographics, substance use, psychiatric symptoms, and psychosocial factors. ResultsIn the past three months, the most commonly used or non-medically used substances were tobacco (82%) for legal drugs, cocaine (53%) for illicit drugs, and prescription opioids (67%) for prescription drugs. Structural equation modeling suggested that psychiatric symptoms were positively associated with substance use behaviors ({beta}s = .38 to .68, ps < .001), while psychosocial factors were negatively associated with substance use behaviors ({beta}s = -.61 to -.43, ps < .001). ConclusionSubstance use is common in COVID-19 long haulers and psychiatric symptoms are the risk factors. Personal mastery and social support appear to offer protection offsetting the psychiatric influences. Substance use prevention and mental health services for COVID-19 long haulers should attend to personal mastery and social support.
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Direct human physical contact accelerates COVID-19 transmission. Smartphone mobility data has been an emerging data source to reveal fine-grained human mobility, which can be used to estimate the intensity of physical contact surrounding different locations. Our study applied smartphone mobility data to simulate the second wave spreading of COVID-19 in January 2021 in three major metropolitan statistical areas (Columbia, Greenville, and Charleston) in South Carolina, United States. Based on the simulation, the number of historical county-level COVID-19 cases was allocated to neighborhoods (Census blockgroups) and points of interest (POIs), and the transmission rate of each allocated place was estimated. The result reveals that the COVID-19 infections during the study period mainly occurred in neighborhoods (86%), and the number is approximately proportional to the neighborhoods population. Restaurants and elementary and secondary schools contributed more COVID-19 infections than other POI categories. The simulation results for the coastal tourism Charleston area show high transmission rates in POIs related to travel and leisure activities. The results suggest that the neighborhood-level infectious controlling measures are critical in reducing COVID-19 infections. We also found that the households of lower socioeconomic status may be an umbrella against infection due to fewer visits to places such as malls and restaurants associated with their low financial status. Control measures should be tailored to different geographic locations since transmission rates and infection counts of POI categories vary among metropolitan areas.
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Concentrated disadvantaged areas have been disproportionately affected by COVID-19 outbreak in the United States (US). Meanwhile, highly connected areas may contribute to higher human movement, leading to higher COVID-19 cases and deaths. This study examined whether place connectivity moderated the association between concentrated disadvantage and COVID-19 fatality. Using COVID-19 fatality over four time periods, we performed mixed-effect negative binomial regressions to examine the association between concentrated disadvantage, Twitter-based place connectivity, and county-level COVID-19 fatality, considering potential state-level variations. Results revealed that concentrated disadvantage was significantly associated with an increased COVID-19 fatality. More importantly, moderation analysis suggested that place connectivity significantly exacerbated the harmful effect of concentrated disadvantage on COVID-19 fatality, and this significant moderation effect increased over time. In response to COVID-19 and other future infectious disease outbreaks, policymakers are encouraged to focus on the disadvantaged areas that are highly connected to provide additional pharmacological and non-pharmacological intervention policies.
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BackgroundHigh uptake of COVID-19 vaccine is one of the most promising measures to control the pandemic. However, some African American (AA) communities exhibit vaccination hesitancy due to mis-or dis-information. It is important to understand the challenges in accessing reliable COVID-19 vaccine information and to develop feasible health communication interventions based on voices from AA communities. MethodsWe conducted two focus group discussions (FGDs) among 18 community leaders recruited from three counties in South Carolina on October 8 and October 29, 2021. The FGDs were conducted online via Zoom meetings. The FGD data were managed and thematically analyzed using QSR NVivo 12 software. ResultsParticipants (73% female and 61% between the ages of 18 and 30) worked primarily in colleges (55.5%), churches (39%), and health agencies (5.5%). We found that challenges of accessing reliable COVID-19 vaccine information in AA communities primarily included structural barriers, information barriers, and lack of trust. Community leaders recommended recruiting trusted messengers, using homecoming events, football games, and other social events to reach target populations and conducting health communication campaigns through open dialogue among stakeholders. ConclusionHealth communication interventions on COVID-19 vaccine uptake should be grounded in ongoing community engagement, trust-building activities, and transparent communication about vaccine development. Tailoring health communication interventions to different groups may help reduce misinformation spread and thus promote vaccination in AA communities in the Southern States.
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Vaccination remains the most promising mitigation strategy for the COVID-19 pandemic. However, existing literature shows significant disparities in vaccination uptake in the United States. Using publicly available national-level data, we aimed to explore if county-level social capital can further explain disparities in vaccination uptake rate adjusting for demographic and social determinants of health (SDOH) variables; and if association between social capital and vaccination uptake may vary by urbanization level. Bivariate analyses and hierarchical multivariable quasi-binomial regression analysis were conducted, then the regression analysis was stratified by urban-rural status. The current study suggests that social capital contributes significantly to the disparities of vaccination uptake in the US. The results of stratification analysis show common predictors of vaccine uptake but also suggest various patterns based on urbanization level regarding the associations of COVID-19 vaccination uptake with SDOH and social capital factors. The study provides a new perspective to address disparities in vaccination uptake through fostering social capital within communities, which may inform tailored public health intervention efforts in enhancing social capital and promoting vaccination uptake.
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IntroductionPersistent COVID-19 symptoms (long COVID) may bring numerous challenges to long haulers social lives. Women may have to endure more profound impacts given their social roles and existing structural inequality. This study aims to explore the impacts of long COVID on various aspects of social life among female long haulers. MethodsWe conducted 15 semi-structured interviews with female long haulers in the United States purposely recruited from Facebook groups, Slack groups, and organization websites. The interviews were audio recorded after appropriate consent and transcribed verbatim. Inductive approach was applied in thematic analysis, which consists of six stages: becoming familiar with data, developing initial codes, extracting themes, refining themes, labeling themes, and reporting. The MAXQDA software was used in data analysis. ResultsPersistent COVID-19 symptoms negatively affected female long haulers social lives in many aspects including physical function, financial security, social relationship, conflict of social roles, and social stigma. Physical limitations changed their body image. Social isolation and work-family conflicts caused huge stress. They experienced internalization of stigma and job insecurities. Shifting to new methods of communication, especially social media may buffer the negative effects of social isolation because of long COVID. ConclusionExisting policies and intervention programs need to be adapted to address the challenges and barriers that long haulers face in returning to normal social life, especially for females. Tailored social life-related recommendations and social support are needed for female long haulers.
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Objective:To investigate the diagnostic value of three-dimensional amide proton transfer-weighted imaging (APTWI) and its combination with diffusion weighted imaging (DWI) for differentiating breast benign from malignant lesions.Methods:This was a prospective study. From July to December 2020, 226 patients with breast lesions confirmed by surgery or puncture pathology in the First Affiliated Hospital of Zhengzhou University were collected. All patients underwent MR T 1-weighted imaging, T 2-weighted imaging, DWI, APTWI, and dynamic contrast-enhanced MRI, and the apparent diffusion coefficient (ADC) value and the magnetization transfer ratio asymmetry at an offset of 3.5 ppm [MTRasym(3.5 ppm)] were obtained from DWI and APTWI respectively. Mann-Whitney U test was used for the comparison of DWI and APTWI parameters between breast benign and malignant lesions. Receiver operating characteristic (ROC) curve was used to evaluate the differences of diagnostic efficacy between DWI, APTWI, and their combination. Results:There were 226 patients with 226 breast lesions, including 124 malignant and 102 benign lesions. The ADC values of patients with malignant breast lesions [1.03 (0.93, 1.13)×10 -3 mm 2/s] and MTRasym (3.5 ppm) [1.95% (1.10%, 2.88%)] were lower than those of benign breast lesions [1.38 (1.11, 1.55)×10 -3 mm 2/s, 3.30% (2.20%, 4.20%), respectively], and the differences were statistically significant ( Z=-8.19, -6.51, P<0.05). The area under the ROC curves (AUC) of DWI, APTWI, and its combination in the differential diagnosis of benign and malignant breast lesions were 0.817, 0.752, and 0.868, respectively. The AUC of the combination of DWI and APTWI was higher than that of DWI and APTWI ( Z=4.00, 2.93, P<0.05), and there was no significant difference in the AUC between DWI and APTWI diagnoses ( Z=1.58, P>0.05). Taking 1.25×10 -3 mm 2/s as the optimal cut-off value for ADC values, the sensitivity, specificity, and accuracy in differentiating benign from malignant breast lesions were 94.4% (117/124), 62.7% (64/102), and 80.1% (181/226), respectively; Taking 2.70% as the optimal cut-off value for MTRasym (3.5 ppm), the sensitivity, specificity, and accuracy in differentiating benign from malignant breast lesions were 73.4% (91/124), 64.7% (66/102), and 69.5% (157/226), respectively, and the sensitivity, specificity, and accuracy of DWI combined with APTWI in differentiating benign from malignant breast lesions were 82.3% (102/124), 79.4% (81/102), and 81.0% (183/226), respectively. Conclusion:APTWI can be used for the differential diagnosis of benign and malignant breast lesions, and the combination of APTWI and DWI can obtain the better diagnostic performance than the single method.
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Objective:To explore the effect of the 3D printed model assisted network teaching of neurosurgery.Methods:Seventy-six probation students were divided into: 3D printed model assisted online course teaching group (test group) and traditional teaching group (control group). After 1-month online teaching, quantitative assessment and satisfaction survey were carried out. SPSS 17.0 was used for statistical analysis of variance.Results:The department graduation test (theory and operation) scores of students in the test group were (86.7±7.4) points, which was significantly higher than those in the control group (78.2±8.2) points ( t=5.56, P<0.01). The teaching satisfaction survey showed that the test group had significantly higher scores in self-evaluation of spatial imagination ( t=3.81, P<0.01), deepening understanding of neuroanatomy ( t=5.29, P<0.01), and increasing interest in clinical learning ( t=5.12, P<0.01) than those of the control group. Conclusion:Compared with the conventional online teaching methods, 3D printed model assisted online teaching helps to improve teaching quality and students' satisfaction.
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Objective:To investigate the clinical value of computer tomography (CT)-based three-section formula in identification of Siewert types of adenocarcinoma of esophagogastric junction (AEG).Methods:The retrospective and descriptive study was conducted. The clinicopatho-logical data of 62 AEG patients who were admitted to two medical centers, including 33 patients from Peking University Cancer Hospital and 29 patients from the First Affiliated Hospital of Amy Medical University, between January 2019 and January 2021 were collected. There were 53 males and 9 females, aged (66±9)years. All patients underwent CT examination to obtain the coronal and axial images and determine the upper and lower edges of the tumor and the esophagogastric junction, which were imported into the formula for Siewert classification. Observation indicators: (1) results of CT examination and pathological examination; (2) consistence of judgements for CT examination between doctors; (3) consistence of judgements between CT examination and patholo-gical examination. Results of pathological examination came from intraoperative surgical observa-tion and postoperative histopathological examination. Measurement data with normal distribution were represented as Mean± SD, and count data were described as absolute numbers or percentages. The consistency coefficient Kappa ( κ) was used to evaluate the consistency of diagnosis between resear-chers. The κ≥0.75 was regarded as excellent consistency, 0.40< κ<0.75 as good consistency, κ ≤0.40 as poor consistency. Wilcoxon rank sum test was used to evaluate the statistical difference between results of the CT-based three-section formula method and the pathological examination. Taking the results of histopathological examination as standard, the sensitivity, specifi-city, accuracy and 95% confidence interval of the CT-based three-section formula method were calculated. Results:(1) Results of CT examination and pathological examination: all the 62 patients underwent CT examination successfully to obtain the coronal and axial images and determine the upper and lower edges of the tumor and the esophagogastric junction, which were used for Siewert classifica-tion. There were 3 cases with AEG of Siewert type Ⅰ, 47 cases with AEG of Siewert type Ⅱ and 12 cases with AEG of Siewert type Ⅲ according to doctor's judgement from the Peking University Cancer Hospital, and there were 3 cases with AEG of Siewert type Ⅰ, 49 cases with AEG of Siewert type Ⅱ and 10 cases with AEG of Siewert type Ⅲ according to doctor's judgement from the First Affiliated Hospital of Amy Medical University, respectively. After arbitration, there were 2 cases with AEG of Siewert type Ⅰ, 48 cases with AEG of Siewert type Ⅱ and 12 cases with AEG of Siewert type Ⅲ determined by the CT based three-section formula. There were 7 cases of stage T1, 10 cases of stage T2, 24 cases of stage T3, 14 of stage T4a and 7 cases of stage T4b of pathological T staging. There were 2 cases with AEG of Siewert type Ⅰ, 48 cases with AEG of Siewert type Ⅱ and 12 cases with AEG of Siewert type Ⅲ determined by pathological examination. (2) Consistence of judgements for CT examination between doctors: the consistency of Siewert classification determined by CT-based three-section formula between 2 doctors was good ( κ=0.74, P<0.001). (3) Consistence of judgements between pathological examination and CT examination: with Siewert classification determined by pathological examination as reference, the accuracy of Siewert classification determined by CT based three-section formula was 90.3%( κ=0.73, P<0.001). The sensitivity and specificity of CT-based three-section formula were 66.7%(95% confidence interval as 20.8%-93.9%) and 100.0%(95% confidence interval as 93.9%-100.0%) for AEG of Siewert type Ⅰ, 97.7%(95% confidence interval as 88.2%-99.6%) and 72.2%(95% confidence interval as 49.1%-87.5%) for AEG of Siewert type Ⅱ, 73.3%(95% confidence interval as 48.0%-89.1%) and 97.9%(95% confidence interval as 88.9%-99.9%) for AEG of Siewert type Ⅲ, respectively. Conclusion:The CT-based three-section formula can be used for identification of Siewert types of AEG, with a high accuracy.
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Objective:To investigate the predictive value of preoperative abdominal adipose tissue measurement for early recurrence after resection of hepatocellular carcinoma (HCC).Methods:The retrospective case-control study was conducted. The clinicopathological data of 238 patients with HCC who underwent surgical resection from January 2018 to January 2020 in 2 medical centers in China were collected, including 46 cases in the First Affiliated Hospital of Chongqing Medical University and 192 cases in the First Affiliated Hospital of Army Medical University. There were 207 males and 31 females, aged 51(48,65)years. All patients underwent abdominal computed tomography (CT) and/or magnetic resonance imaging (MRI) before surgery. Observation indicators: (1) measure-ment of abdominal adipose tissue; (2) follow-up; (3) analysis of influencing factors for early recurrence after resection of HCC; (4) prediction of early recurrence after resection of HCC. Follow-up was conducted by outpatient examinations and telephone interview to detect the postoperative survival of patients up to February 2022. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was performed by the t test. Measurement data with skewed distribution was represented by M(range) or M( Q1, Q3), and comparison between groups was performed by the Mann-Whitney U test. Count data were expressed as absolute numbers or percen-tages, and the chi-square test was used for comparison between groups. Univariate analysis was conducted using the corresponding statistical methods based on data type. Multivariate analysis was performed using the Logistic regression model advance method. The receiver operating characteristic curve was drawn, and the area under curve was used to evaluate the efficacy. Results:(1) Measure-ment of abdominal adipose tissue. Of the 238 patients, the total abdominal adipose tissue, visceral adipose tissue, subcutaneous adipose tissue, total adipose tissue index, visceral adipose tissue index, subcutaneous adipose tissue index were 292(198,355)cm 2, 153(99,194)cm 2, 128(95,154)cm 2, 106(76,130)cm 2/m 2, (57±27)cm 2/m 2, 46(34,58)cm 2/m 2 for 139 patients with early postoperative recur-rence, versus 174(114,251)cm 2, 78(50,110)cm 2, 88(55,127)cm 2, 64(42,91)cm 2/m 2, (30±16)cm 2/m 2, 31(19,46) cm 2/m 2 for 99 patients without early recurrence, respectively, showing significant diffe-rences between them ( Z=?7.39, ?7.87, ?5.03, ?7.25, t=?9.46, Z=?5.00, P<0.05). (2) Follow-up. All the 238 patients were followed up according to the plan. The survival time of 238 patients was 26(8,44)months. The survival time was 11(5,18)months for patients with postoperative early recur-rence, versus 36(32,43)months for patients without early recurrence, respectively. (3) Analysis of influencing factors for early recurrence after resection of HCC. Results of univariate analysis showed that body mass index, total adipose tissue, visceral adipose tissue, subcutaneous adipose tissue, total adipose tissue index, visceral adipose tissue index and subcutaneous adipose tissue index were related factors for early recurrence after resection of HCC ( t=?5.88, Z=?7.39, ?7.87, ?5.03, ?7.25, t=?9.46, Z=?5.00, P<0.05). Results of multivariate analysis showed that visceral adipose tissue index was an independent influencing factor for early recurrence after resection of HCC ( odds ratio=1.06, 95% confidence interval as 1.04?1.08, P<0.05). (4) Prediction of early recurrence after resection of HCC. According to the results of multivariate analysis, the receiver operating characteris-tic curve showed that the area under curve of visceral adipose tissue index was 0.80 (95% confidence interval as 0.75?0.86, P<0.05), with the sensitivity and specificity as 75.5% and 71.7%. Conclusions:Visceral adipose tissue index is an independent influencing factor for early recurrence after resection of HCC. The risk of early recurrence increases with the increase of visceral adipose tissue index.
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Objective@#The study aimed to investigate the diurnal variation in cervical disc hydration and its relationship with cervical degeneration. @*Materials and Methods@#C3–C7 discs of 86 prospectively enrolled participants (37 males, 49 females; mean age ± standard deviation, 23.5 ± 2.5 years) were assessed using T2 mapping in the morning and evening. All discs were stratified by Miyazaki grade or C2–C7 Cobb angle and T2 values (T2). The degree of diurnal T2 variation (T2-DDV), defined as (morning T2 – evening T2)/morning T2 x 100%, was measured for the entire disc, annulus fibrosus (AF), nucleus pulposus (NP), and endplate zones. @*Results@#T2 of the entire disc decreased significantly after the daytime load (p < 0.001), with a T2-DDV of 13.3% for all discs and 16.0%, 12.2%, and 13.0% for healthy (grade I), mild degenerative (grade II), and advanced degenerative (grade III/IV) discs, respectively. T2 of regional NPs and AFs decreased significantly from morning to evening (p ≤ 0.049) except in the healthy anterior inner AF (p = 0.092). Compared with healthy discs, mild degenerative discs displayed lower T2 and T2-DDV in regional NPs (p < 0.001). Advanced degenerative discs showed higher T2-DDV in the anterior inner AF compared with healthy discs (p = 0.050). Significant diurnal T2 changes in the endplate zones were observed only in healthy discs (p = 0.013). Cervical discs in the low Cobb angle group showed higher T2-DDV in the anterior AFs and anterior NP and lower T2-DDV in the posterior AF than those in the high Cobb angle group (p ≤ 0.041). @*Conclusion@#This study characterized the diurnal variation in hydration of the cervical discs as assessed using T2 mapping and revealed early chemo-mechanical coupling dysfunction in degenerating discs. Cervical sagittal alignment on MRI can affect the diurnal stress patterns of the cervical discs. T2 mapping is sensitive to disc biomechanical dysfunction and offers translational potential from biomechanical research to clinical application.
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OBJECTIVE To stud y the regulation mechanism of miRNA- 18a and miRNA-4802 on drug resistance of lymphoma cells via autophagy. METHODS Using human burkitt ’s lymphoma cell Daudi and human mantle cell lymphoma cell JeKo- 1 as the research objects ，adriamycin（ADR）and vincristine （VCR）as experimental drugs. After treatment of ADR and VCR ，relative cell viability was detected with CCK- 8 kit；the expression of apoptosis marker protein activated cleaved caspase- 9 and cleaved caspase-6 were detected by Western blot assay. The drug resistances of the two cells to ADR and VCR were investigated. The difference of autophagy activity between the two kinds of cells by expression detection of autophagy related proteins LC 3-Ⅱ and p62，autophagy flow experiment and transmission electron microscope observation. Fluorescence quantitative polymerase chain reaction was used to investigate the expression differences of miRNA- 18a and miRNA- 4802，ULK1 and ATG 7 mRNA in the two cells，and to detect the expression differences of ULK 1 and ATG 7 proteins. Taking JeKo- 1 cells as the research object ，the changes of autophagy activity and drug resistance were investigated after treatment with endogenous miRNAs （miRNA-18a mimics ， miRNA-4802 mimics）of two simulated organisms. RESULTS After ADR and VCR treatment ，compared with Daudi cells ，JeKo-1 cells had stronger drug resistance and autophagy activity. The expression of miRNA- 18a and miRNA- 4802 in JeKo- 1 cells were significantly lower than Daudi cells ，mRNA and protein expression of ULK 1 and ATG 7 were significantly higher than those of Daudi cells （P＜0.001）. After treatment of miRNA- 18a mimics and miRNA- 4802 mimics，the autophagy activities and drug resistances of JeKo- 1 cells were decreased significantly. CONCLUSIONS miRNA-18a and miRNA- 4802 can decrease drug resistances of lymphoma cells to ADR and VCR by reducing 2 the expression of autophagy-initiating genes ULK1 and ATG7， and inhibiting the autophagy activity of lymphoma cells.
