Objective To investigate the risk factors,prevention and therapy of hepatic artery thrombosis after liver transplantation.Methods The literatures on the risk factors,prevention and therapy of hepatic artery thrombosis after liver transplantation in recent years were collected and reviewed.Results The risk factors include factor Ⅴ Leiden,metabolic liver diseases of recipients,recipient sex,the use of Roux-en-Y biliary reconstructions,virus infection and so on.The measures of prevention and therapy include early diagnosis,detection of activated protein C resistance,postoperative anti-coagulation therapy,liver arteries reconstructions measures,hyperbaric oxygen therapy,continuous transcatheter arterial thrombolysis,liver retransplantation and so on.Conclusion The study of risk factors,prevention and therapy will promote the process of improving the prognosis of patients with liver transplantation.

Objective To analyze the negative experience from medical practice of medical students by Balint group case study,and to explore new approach for training doctor-patient communication skills.Methods 10 times of Balint group activities were held in Zhongshan Hospital of Fudan University,with one case each time.Grounded theory approach were applied for analyzing discussion record.Results The cases were occurred in doctor-patient interaction,teamwork,conflict between one's personal life and vocational development planning.Trigger events involved doctor-patient conflict,conflict of values,decision making problem while conffronted with incurable patients,role ambiguity,unfair treatment.Topics of discussion included emotional experience with patients,career development orientation,medical teamwork,clinical education of medical student.Conclusion Through practice of Balint group,medical students in teaching hospital can improve their awareness of complicating psycho-social problem of patients and themselves,as well as handling it.And it can improve the professional identity,professional growth and professional self-identity.

Objective:To explore the effect of regular aerobic exercise on oxidative stress, inflammatory reaction and apoptosis with a rat model of colitis.Methods:Forty-five C57BL/6 mice were randomly divided into a control group, a model group and a model exercise group, each of 15. Colitis was induced in the rats of the model and model exercise groups through administration of 3.5% sodium dextran sulfate. The control group and the model group were kept quiet in their cages, while the model exercise group performed voluntary wheel running for 8 weeks after the successful modelling. Any histopathological changes in the colon tissue were observed after hematoxylin and eosin staining. Oxidative stress, inflammatory reaction and apoptosis were measured from colon tissue homogenates.Results:Compared with the control group, the average expression of the tumor necrosis factor α (TNF-α), interleukin (IL)-1β, IL-6 and prostaglandin E2 (PGE2) as well as levels of reactive oxygen species (ROS), malondialdehyde (MDA) and nitric oxide (NO) and inducible nitric oxide synthase (iNOS) and Caspase-3 activity and the protein expression of cyclooxygenase 2 (COX2), nuclear factor kappa B (NF-κB) p65, apoptosis inducing factor (AIF), cytochrome c (Cyt C) and Bax had all increased significantly in the other two groups, while the levels of IL-10 and glutathione (GSH), the activity of superoxide dismutase (SOD) and glutathione peroxidase (GPx) and the protein expression of Bcl-2 protein had decreased significantly in the model group. Compared with the model group, the average content of TNF-α, IL-1 β, IL-6, PGE2, ROS, MDA and NO, the activity of iNOS and Caspase-3 and the protein expression of COX2, NF-κB p65, AIF, CytC and Bax had decreased significantly, while that of IL-10 and GSH, the activity of SOD and GPx and the protein expression of Bcl-2 protein had increased significantly in the model exercise group.Conclusion:Regular aerobic exercise has a protective effect against colitis through improving oxidative stress, inflammation and apoptosis, at least in rats.

Background and purpose:The impact of the two factors of von Willnbrang factor(vWF) and integrin?3 on tumor metastasis has not been recognized. This study was done to investigate the expression of vWF and integrin?3 in human lung cancer cell line H460,the association between the two factors and tumor metastasis effect of vWF and integrin?3 on adhesion of human lung cancer cell line H460. Methods:The expression of vWF and integrin ?3 protein was examined by immunohistochemical staining. The impact of vWF and integrin?3 on adherent effect of tumor cells was evaluated by adhesion experiment, antibody inhibiting experiment and MTT.Results:Positive expression of vWF and integrin?3 was detected in H460 human lung cancer cells. H460 human lung cancer cells were able to adhere to vWF. Using anti-integrin?3, we observed that the ability of cell adhesion to vWF was inhibited,and A Value decreased from 1.59?0.06 to 0.55?0.03(P=0.01619). Using anti-vWF, we observed cell adhesion to vWF was inhibited too and A Value decreased from 1.60?0.06 to 0.54?0.03(P=0.01598),which had the same effect when using anti-integrin?3.Conclusions:H460 human lung cancer cells are capable of producing vWF, and vWF expression contributes to metastasis by adhering to cancer cells, integrin?3 is the vWF receptor on H460 human lung cancer cells.

Objective To investigate the vaginal microbilme characterization in women with human papillomavirus(HPV)16 and 18 infection and high-grade cervical intraepithelial neoplasia(CIN).Methods Three groups were set,including control group(without HPV infection and with colpitis),low-grade CIN group(with HPV 16 or/and 18 infection),and high-grade CIN group(with HPV 16 or/and 18 infection).Virginal microbial composition was determined by using 16S rRNA amplication sequencing and hierarchical clustering analysis among three groups was applied.Rank sum test was used to determine statistical significance.Results Diversity and complexity of bacteria was significantly elevated in high-grade group.Compared with the control,the growth of Lactobacillus crispatus(L.crispatus) and Lactobacillus casei(L.casei) was significantly decreased,while Lactobacillus iners(L.iners) was significantly increased in low-grade CIN group and high-grade CIN group,and both were proportionally correlated to the grade of the disease.Brucella canis(B.canis),as colonized bacteria,was significantly decreased in both low-grade and high-grade CIN groups,and the changes were proportional to the grade of disease.The growth of Dialistersuccinatiphilus(D.succinatiphilus),Gardnerella vaginalis(G.vaginalis) and Prevotellabivia(P.bivia) were significantly elevated and proportional to the grade of disease.Conclusion The diversity and complexity of virginal microbial composition could be significantly expanded in women with HPV infection and high-grade CIN.In contrast to the important role of lactobacillus in virginal health,L.inners could be pathogenic.The colonization of B.canis,D.succinatiphilus,G.vaginalis and P.bivia might be highly correlated with HPV chronic infection and further development of CIN.

Objective: To investigate the characteristics of quantitative electroencephalogram (EEG) in patients with amyotrophic lateral sclerosis (ALS) and their relationship with cognitive impairment. Methods: We recruited 38 patients with ALS and 26 healthy controls. All the patients underwent quantitative EEG examination to obtain the relative power of each frequency band and calculate the slow wave ratio (δ+θ)/(α+β) as comparison indexes. Among them, 27 patients with ALS underwent the ECAS scale examination to assess their cognitive function. At the same time, 25 healthy controls underwent the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) to determine the cut-off of scale score. We compared the slow wave ratio in ALS patients with and without cognitive impairment according to the cut-off score. Results: The relative powers of δ and θ bands and slow wave ratios of quantitative EEG in ALS patients were significantly higher than those in healthy controls, and there was no significant difference in relative powers of α and β bands. In the comparison of slow wave ratios in different brain regions, the proportion of slow waves in the bilateral temporal-occipital regions and the right parietal areas was significantly higher than that in healthy controls. The slow wave ratio in the left temporal area was positively correlated with the course of ALS (correlation coefficient 0.405, P=0.05). The ECAS scale screening revealed that 33.3% of ALS patients had cognitive impairment. ALS patients with cognitive impairment had higher slow wave ratios in the frontal and temporal areas than patients without cognitive impairment. The ALS specific item score, ALS non-specific item score and the total score of ECAS were all negatively correlated with the slow wave ratios in the frontal and temporal areas. Conclusion: The changes of EEG activity in patients with ALS are mainly the increase of slow wave activity, which is significant in the temporal, parietal and occipital areas. The slow wave ratios in frontal and temporal areas of ALS patients are correlated with cognitive impairment.

Objective:To evaluate a nano-carbon lymphatic tracing method for patients with rectal cancer after neoadjuvant radiotherapy and chemotherapy .Method:Retrospective analysis was made on 88 patients of rectal cancer undergoing neoadjuvant chemoradiation at the Department of General Surgery, He′nan Cancer Hospital from Jan 2016 to May 2020.According to whether nano-carbon lymph node was used or not, patients were divided into nanocarbon tracer group (study group) and non-nanocarbon tracer group (control group).Results:There was statistically significant in the number of havested lymph nodes between the two groups [15(11-19) vs.9(5-12), Z=5.227, P<0.001], There was no statistically significant in the number of positive lymph nodes between the two groups [0(0-0.25) vs.0(0-1), Z=1.199, P=0.231]. There were significant differences in the ratio of patients with less than 7 lymph nodes(0/34 vs.18/54, χ 2=14.248, P<0.001) and patients with less than 10 lymph nodes (4/34 vs.29/54, χ 2=15.657, P<0.001). Conclusions:The injection of nanocarbon after neoadjuvant chemoradiotherapy can increase the number of harvested postoperative lymph nodes and the ratio of patients with lymph nodes ≥7 and ≥10, which is more beneficial for prediction of the prognosis of patients.

Objective:To investigate whether adjuvant chemotherapy could be beneficial for patients with pT1N1M0 (stage ⅠB) gastric cancer.Methods:From Jan 2010 to Dec 2016, 185 patients with pT1N1M0 gastric cancer who were surgically resected at Henan Cancer Hospital were retrospectively analyzed. The patients were divided into chemotherapy group ( n=100) and non chemotherapy group ( n=85). Results:For disease-free survival (DFS) analysis, univariate survival analysis showed that age, examined lymph nodes, vascular invasion, nerve invasion and adjuvant chemotherapy were associated with DFS (all P<0.05); multivariate analysis showed that lymph node resection ≥ 16 ( HR=0.363, 95% CI: 0.160-0.827, P=0.016), vascular invasion ( HR=4.117, 95% CI: 1.796-9.436, P=0.001) and postoperative chemotherapy ( HR=4.530, 95% CI: 1.932-10.622, P=0.001) were independent risk factors for DFS. For disease-specific survival (DSS) analysis, univariate survival analysis showed that lymph node resection, vascular invasion, nerve invasion and adjuvant chemotherapy were associated with DSS; multivariate analysis showed that lymph node resection ≥ 16 ( HR=0.344, 95% CI: 0.144-0.822, P=0.016), vascular invasion ( HR=5.113, 95% CI: 2.029-12.887, P=0.001) and postoperative chemotherapy ( HR=4.694, 95% CI: 1.854-11.888, P=0.001)were independent risk factors for DSS. According to examined lymph nodes and vascular invasion , pT1N1M0 patients were divided into three risk categories (high, medium and low). DFS and DSS were significantly different among the three risk groups (all P<0.001, respectively). Conclusion:pT1N1M0 gastric cancer patients are expected to benefit from adjuvant chemotherapy. Patients with less than 16 lymph nodes and vascular invasion may be particularly suitable for adjuvant chemotherapy.

Background and purpose:The expression of dickkopf homolog 3 gene(DKK3)is always reduced or absent in tumors,instead part of the tumor vascular endothelial expressed DKK3.vWF is a macromolecular glycoprote synthesized and released by vascular endothelial cells and megakaryocytes.However,vWF was also expressed by tumor.The relationship between these 2 factors and the occurrence of cancer is still unclear.The purpose of this study was to observe the expression of DKK3 and vWF proteins in colorectal carcinoma and determine their clinical significance through finding their association with MVD and correlation with each other.Methods:Immunohistochemistry staining was used to detect the expression of DKK3,vWF proteins and MVD in the colorectal carcinoma tissue microarrays that contained 94 colorectal carcinoma specimens.Results:The expression of DKK3 in colorectal carcinoma was lower than or nonexistent compared to that in normal tissues(P＜0.05).The expression of vWF in colorectal carcinoma was higher than that in normal tissues(P＜0.05).Expression of DKK3 and vWF in colorectal carcinoma were not correlated to the age or gender of the patients,invasive depth,or tumor locus of the colorectal carcinoma (P＞0.05).Correlations with the expression of DKK3 and vWF in colorectal carcinoma were only found with differentiation and iynphnode metastasis (P＜0.05).However,the expression of DKK3 and vWF in colorectal carcinoma was not correlated to MVD(P＞0.05).The expression of DKK3 was not correlated to the expression of vWF in coiorectal carcinoma(r=0.1310,P=0.2090).Conclusion:A lowered expression of DKK3 and higher expression of vWF may be associated with the carcinogenesis,various biological behaviors and metastasis of colorecml carcinoma.These 2 factors can be used as important biological markers for colorectal cancer.

The application of structured education in patients with type 2 diabetes mellitus showed significant effect. This paper introduced relevant content of structured education, the application status quo of structured education in patients with type 2 diabetes mellitus at home and abroad, aiming to provide reference for exploring health education models of patients with diabetes mellitus and reduce patients' complications, thus improving their quality of life.