Objective To analyze the imaging manifestations of malignant transformation of ovarian mature teratoma.Methods The clinical data and CT and MRI imaging findings of four patients confirmed as malignant transformation of ovarian mature teratoma by operation and pathology were analyzed retrospectively.The following imaging features were assessed:size,shape,texture,enhancement degree and pattern,et al.Results Among the four cases,three lesions were located in the left ovary and one in the right ovary.The minimum size and maximum size were 87 mm×80 mm×87 mm and 171 mm×141 mm×215 mm,respectively.All of the lesions showed as round-like or ovoid cystic masses with fat-fluid level(4/4),and floating mixed density or signal masses(2/4).The demonstrated local thickening of the cyst wall(2/4)and/or soft mass growing across the wall(3/4),with significant inhomogeneous enhancement(2/3).Conclusion The malignant transformation of ovarian mature teratoma often presents as a cystic mass with fat-fluid level,and local thickening or soft mass of the cyst wall,with significant enhancement.It should be considered in the elderly patients with abnormal tumor markers and above imaging features.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Objective: To explore the safety and feasibility of laparoscopic liver resection in the treatment of intrahepatic cholangiocarcinoma (ICC). Methods: The retrospective study was adopted. The clinical data of 58 patients with ICC who underwent laparoscopic liver resection in the Department of Hepatobiliary Minimally Invasive Surgery of the First Affiliated Hospital of Hu′nan Normal University were collected From January 2016 to December 2018. Among them, 34 patients were males and 24 were females, aged from 34 to 71 years with a median age of 54 years. Observation indicators: (1) Surgical treatment: surgical methods, operation time, intraoperative blood loss, intraoperative blood transfusion rate, intraoperative hepatic portal blocking time, conversion rate, postoperative complications, postoperative hospital stay. (2) Postoperative pathological conditions. (3) Follow-up.Follow-up visits were conducted using an outpatient clinic and telephone to understand patient survival after surgery. The follow-up period was until June 2019. Measurement data with normal distribution were expressed as (Mean±SD), count data was expressed as frequency and percentage. Results: A total of 58 patients were included in this study, of which 48 patients underwent laparoscopic radical surgical resection of intrahepatic cholangiocarcinoma and 10 patients underwent laparoscopic conversion to laparotomy. (1) Surgical treatment: laparoscopic resection of the left liver (segments Ⅱ, Ⅲ and Ⅳ), laparoscopic resection of the right liver (segments Ⅴ, Ⅵ, Ⅶ and Ⅷ), laparoscopic resection of the right posterior lobe (segments Ⅵ and Ⅶ), laparoscopic extended resection of the right posterior lobe, laparoscopic resection of the middle lobe (Ⅳ, Ⅴ and Ⅷ), laparoscopic resection of the V and Ⅵ, laparoscopic resection of the left liver (segments Ⅱ, Ⅲ and Ⅳ) combined with the caudate lobe (segments I and Ⅸ), laparoscopic extended left hemihepatectomy, laparoscopic resection of the VI, laparoscopic resection of the Ⅶ and Ⅷ, laparoscopic resection of the left lateral lobe (segments Ⅱ and Ⅲ) and laparoscopic resection of the right hepatic mass; operation time: (320.38±107.68) min; intraoperative blood loss: (262.34±76.06); intraoperative blood loss: 0 (0/58); Intraoperative hepatic portal occlusion time: (48±15) min, the conversion rate was 17.2% (10/58); the incidence of postoperative biliary fistula was 6.8% (4/58), and the patient was discharged after conservative treatment and unobstructed drainage (T-tube vacuum suction); the postoperative gastrointestinal recovery time was (1.84±0.57) d; no other serious complications occurred.Postoperative hospital stay: (9.34±3.39) d; there were no deaths and unplanned surgeries during the perioperative period. (2) Pathological conditions: 32 cases received lymph node dissection during the operation, and 26 cases showed cholangiocarcinoma without lymph node dissection; pathological examination showed that the pathological reports of all tumor margins were negative, and 4 cases showed lymph node dissection and positive lymph node metastasis. (3) Follow-up results: of the 58 patients with ICC, 49 were followed up for 6 to 36 months. The tumor survival time was (4 to 36) months. 28 patients survived without tumor. 17 patients had intrahepatic metastasis with multiple lymph node metastasis. 4 patients were treated with microwave ablation after intrahepatic metastasis was found. 9 patients were lost to follow-up. Conclusion Laparoscopic treatment of intrahepatic cholangiocarcinoma is safe and feasible in experienced centers.

Acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) is a severe, life-threatening medical condition characterized by widespread inflammation in the lungs, and is a significant source of morbidity and mortality in the patient population. New therapies for the treatment of ALI are desperately needed. In the present study, we examined the effect of andrographolide sulfonate, a water-soluble form of andrographolide (trade name: Xi-Yan-Ping Injection), on lipopolysaccharide (LPS)-induced ALI and inflammation. Andrographolide sulfonate was administered by intraperitoneal injection to mice with LPS-induced ALI. LPS-induced airway inflammatory cell recruitment and lung histological alterations were significantly ameliorated by andrographolide sulfonate. Protein levels of pro-inflammatory cytokines in bronchoalveolar lavage fluid (BALF) and serum were reduced by andrographolide sulfonate administration. mRNA levels of pro-inflammatory cytokines in lung tissue were also suppressed. Moreover, andrographolide sulfonate markedly suppressed the activation of mitogen-activated protein kinase (MAPK) as well as p65 subunit of nuclear factor-κB (NF-κB). In summary, these results suggest that andrographolide sulfonate ameliorated LPS-induced ALI in mice by inhibiting NF-κB and MAPK-mediated inflammatory responses. Our study shows that water-soluble andrographolide sulfonate may represent a new therapeutic approach for treating inflammatory lung disorders.

Objective To compare the changes in TLR4-NF-κB signaling pathway in infant and adult mice infected with influenza virus, and to provide experimental evidence for the study of immunopathological mechanism in pediatric respiratory virus susceptibility. Methods Immunohistochemistry and RT-PCR were applied to detect the expressions of lung TLR4 and NF-κB P65 mRNA and proteins in the infant and adult mice, and to compare the changes in TLR4-NF-κB P65 signaling pathway after infection with influenza virus.Results (1) The infant model group showed the strongest expression of TLR4 protein in the lung tissue, compared with that in the normal group and adult model group showing significant differences (P<0.05).(2) The expression of NF-κB P65 protein in the lung tissue was strongest in the infant model group, and it was gradually increased over time, showing a significant difference between each time point and the next time point (P<0.05).(3) The infant model group showed the strongest expression of TLR4 mRNA in lung tissue, significantly higher than that in the normal and adult model groups (P<0.05).(4) The expression of NF-κB P65 mRNA in the lung tissue was highest in the infant model group, and significantly higher than that in the normal and the adult model groups ( P<0.05) , and it was gradually increased with the time.Conclusions The over-activation of TLR4-NF-κB P65 signaling pathway may be one of the immunopathological mechanisms of serious injury in the lung tissue in infant rats.

Objective:To observe the effect of metformin on the expression of SIRT1 and UCP2 in rat liver of type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver disease (NAFLD), and discuss the pathogenesis of T2DM with NAFLD, and the treatment with and possible mechanism of metformin.Methods:Thirty-six male SD rats were randomly divided into a normal control group (group NC, n=12), a T2DM with NAFLD group (group MC, n=12), and a metformin group (group A, n=12). We established the model of T2DM with NAFLD rats by feeding high-fat and high-sugar diet and injecting STZ. After the success establishment of the model, the metformin group was given metformin 300 mg/(kg.d) for 8 weeks. At the end of the experiment, we measured FBG, ALT, AST, TC, TG, HDL-C, LDL-C, VLDL, FFAs, FINs and HOMA-IR respectively in group NC, MC and A. We observed the change of liver tissue pathology by HE, determined the expression of SIRT1 and UCP2 in rat liver by immunohistochemical method and real-time quantitative method. Results:FBG, ALT, AST, TC, TG, LDL-C, VLDL, FFAs, FINs and HOMA-IR were higher in group MC than in group NC (P<0.05), while HDL-C was obviously lower in group MC than in group NC (P<0.05). After the metformin treatment, the serum parameters in the rats had improved in group NC compared with in group MC (P<0.05). On immunohistochemical staining and mRNA level, the expression of SIRT1 was obviously lower in group MC than in group NC (P<0.05), and the expression of UCP2 was obviously higher in group MC than in group NC (P<0.05). After the metformin treatment, the expression of SIRT1 was higher than in group MC (P<0.05), and the expression of UCP2 was lower than in group MC (P<0.05). There was negative correlation between the expression of SIRT1 and UCP2 (r=-0.61, P<0.01).
Conclusion:The expression of SIRT1 is low and the expression of UCP2 is high in rat liver of T2DM with NAFLD. Metformin can increase the expression of SIRT1 and reduce the expression of UCP2, with negative correlation between the expression of SIRT1 and UCP2.

OBJECTIVETo observe the expression of SIRT1 and mitochondrial uncoupling protein 2 (UCP2) in the liver of rats with type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver (NAFLD) and explore the possible pathogenesis of T2DM and NAFLD.

METHODSTwenty-four male SD rat were randomized equally into control group and T2DM and NAFLD group (MC group), fed with standard diet and high-fat and high-sugar diet, respectively. At 12 weeks, the rats in MC group received a single dose of STZ (30 mg/kg) injected into the abdominal cavity for pancreatic islet destruction, and those in the control group received an equivalent volume of citric acid buffer. At 14 weeks, the body weight, FBG, hepatic function, blood lipid levels, FFAs, FINs and HOMA-IR of the rats were measured, and the liver pathology was examined with HE staining. The expression of SIRT1 and UCP2 in the rat liver was detected by immunohistochemistry and real-time quantitative PCR.

RESULTSAt 14 weeks, FBG, ALT, AST, TC, TG, LDL-C, VLDL, FFAs, FINs and HOMA-IR were significantly higher and HDL-C was significantly lower in MC group than in the control group (P<0.05). Pathological examination showed good structural integrity of the liver in the control group, and the liver cells were closely arranged with rich cytoplasm and round cell nuclei; in MC group, moderate to severe fatty liver was detected, and the liver cells showed severe ballooning degeneration and contained lipid vacuoles in the cytoplasm. The expression of SIRT1 was significantly lower and UCP2 significantly higher in MC group than in the control group (P<0.05).

CONCLUSIONThe expression of SIRT1 is significantly lowered and UCP2 increased in the liver of rats with T2DM and NAFLD.

Animals ; Diabetes Mellitus, Type 2 ; complications ; metabolism ; Fatty Liver ; complications ; metabolism ; Ion Channels ; metabolism ; Liver ; metabolism ; Male ; Mitochondrial Proteins ; metabolism ; Non-alcoholic Fatty Liver Disease ; Rats ; Rats, Sprague-Dawley ; Sirtuin 1 ; metabolism ; Uncoupling Protein 2

OBJECTIVE: To explore the effects of nuclear protein-like transcription factor nuclear receptor subfamily 2 group E member 1 (NR2E1) on the growth, division, and proliferation of neuroblastoma cell line IMR32. METHODS: A NR2E1 shiRNA plasmid vector was constructed and transfected into neuroblastoma cell line IMR32 using lipofedamine™2000. Subsequent cell growth was measured by cell counting and the protein expression of somatic nuclear division was examined by immunofluorescent staining. RESULTS: At 48 h after the neuroblastoma cells IMR32 were transfected with NR2E1-shiRNA vector, the related nuclear division protein and the proliferation of the transfected cells IMR32 were remarkably depressed. CONCLUSION Cells division and proliferation of neuroblastoma cell line IMR32 is inhibited through transfection with the NR2E1-shiRNA plasmid vector.
Cell Division ; genetics ; physiology ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Neuroblastoma ; pathology ; RNA, Small Interfering ; genetics ; Receptors, Cytoplasmic and Nuclear ; genetics ; metabolism ; Transfection

Objective To analyze the perinatal outcomes of those women experienced hypoglycemia during 75 g oral glucose tolerance test(OGTT).Methods A retrospective study was conducted in 774.pregnant women who underwent OGTT and delivered in our institution from January 2005 to January 2006.The distribution of glucose levels of the fasting,1 h,2 h and 3 h of the OGTT was analyzed.Plasma glucose level below the 5th percentile and above the 1h percentile was defined as hypoglycemia and those below the 1th percentile as exceeding hypoglycemia.Perinatal outcomes including birth weight,birth height,obstetric complications,the incidence of small for gestational age (SGA)were compared between women with hypoglycemia or exceeding hypoglycemia. Results The birth weight in exceeding hypoglycemia group of fasting glucose was significantly lower than that of the others [(2817±764)g vs(3439±487)g,t=3.344,P＜0.01]and the incidence of SGA in this group was also higher(3/7 vs 3.4%,x2=22.78,P＜0.01);the proportion of babies with birth weight＜3000 g in the same group was higher than the others(5/7 vs 14.73%,P＜0.01).The newhorns height was significantly shorter in the hypoglycemia group at 2 h than the normal glycemic group [(49.03±1.68)cm vs(49.48±1.65)cm,P＜0.05].Conclusions The plasma glucose 1evel is associated with the newborns'birth weight and height.Women with hypoglycemia during OGTT are more likely to have babies with lower birth weight and height.

Objectives To study the radiation-protective effects produced by the estrogenic activities of genistein(Gen) .Method After blocking estrogen receptor activities by Tamoxifen and Faslodex,the effects of Gen on 30d survival rate and average life span of the mice were monitored after exposure to lethal dose ? radiation(7.5Gy),and the effects of Gen on innate(nonspecific) immune response as well as humoral(B-cell mediated)immune response of the mice were examined after exposure to 4.0Gy ? radiation.Results Gen can enhance the survival rate,average life span,and immune response of the ?-radiation exposed mice.While Tamoxifen had no significant effects on survival rate and immune response of the exposed mice,Faslodex caused a decrease in survival rate and average life span and also inhibited the immune response in those exposed mice.Conclusion Genistein can enhance the radiation tolerance in mice through activation of estrogen receptor ? pathway.