Objective To study the correlation of three different indexes of arterial elastic function(PWV, C_ 1 and C_ 2 , AI). Methods 1306 out-patients with hypertension were recruited. Two or three arterial elastic function were measured at the same time. Large and small arterial elastic indexes(C_ 1 and C_ 2 );pulse wave velocity(PWV)and augmentation index (AI) in 428 cases , C_ 1 , C_ 2 and PWV(n=208), C_ 1 , C_ 2 , PWV and AI(n=60). Results C_ 1 was negatively related to PWV and positively related with C_ 2 . No correlation between AI and PWV, AI and C_ 1 and C_ 2 was found. Conclusion PWV, C_ 1 and C_ 2 are consistent for the arterial elastic function measurement. However, little relevance between AI and PWV, AI and C_ 1 and C_ 2 was shown.

0.01). The tumor volume and the tumor weight were also significantly decreased in the treated group (P

Objective To investigate the incidence of acute kidney injury (AKI) post-orthotopic liver transplant (OLT) and its association with prognosis. Methods Data of 28 patients received single OLT in our hospital from 2004 to 2006 were retrospectively analyzed. The incidence of AKI was investigated by new acute kidney injury network (AKIN) criteria. The follow-up was over one year. The prognosis of AKI patients at day 28 and 1 year was evaluated by Kaplan-Meier survival analysis. The association between AKI and prognosis was examined. Results A total of 193 patients were enrolled. The average age was (48.07±10.02) years old. The ratio of male to female was 4:1. One hundred and sixteen (60.1%) patients of post-OLT AKI were found, whose AKI stage 1, 2 and 3 were 50.0%, 21.6% and 28.4% respectively. Ten (8.6%) patients required renal replacement therapy (RRT) after OLT. In AKI post-OLT patients, day 28 and 1 year mortality were significantly higher than those in non-AKI patients (15.5% vs 0, 25.9% vs 3.9%, respectively, both P<0.05). Kaplan-Meier survival analysis showed the 1-year survival rates of AKI stage 1, 2, 3 post-OLT and non-AKl were 84.0%, 81.0%, 42.4% and 90.9%, respectively. The 1-year survival rate of non-AKI was significantly higher than that of AKI stage 1, 2, 3. The 1-year survival rate of AKI stage 3 was significantly lower than that of stage 1 and 2. There was no significant difference between AKI stage 1 and 2. Sct at 1 year post-OLT was significantly higher than that of baseline [(88.35±37.15) vs (73.70±33.88) μmol/L, P<0.05). The change of Scr value at 1 year compared to baseline in AKI patients was similar to non-AKI patients. However such change in AKI stage 2 and 3 was higher than that in stage 1. Conclusions The incidence of AKI post-OLT is quite high and associated to the poor prognosis in short and long periods. Renal function may decrease gradually which is associated to the AKI stage pest-OLTI.

Objective To observe and analyze the expression of programmed cell death 4 (PDCD4) gene and apoptosis inhibitor Livin in triple negative breast cancer (TNBC) tissues and its relationship with prognosis.Methods One hundred cases of TNBC tumor tissue,50 cases of adjacent carcinoma tissue,50 cases of normal breast tissue were selected as the research data.The immunohistochemical technique was applied to detect and compare the expression positive rates of PDCD4 and Livin protein in three kinds of tissues.The patients were followed up.The overall survival (OS) and the progression free survival (PFS) were observed and compared.Results The expression positive rate of PDCD4 in TNBC tissue was significantly lower than that in adjacent carcinoma tissue or normal breast tissue,the differences were statistically significant (x2=26.613,32.000,P＜0.05).The expression was correlated with the clinical pathological features of tumor size,lymph node metastasis,clinical stage,axillary lymph node metastasis and cancer embolus (x2=26.936,13.210,22.774,27.463,5.803,P＜0.05);the expression positive rate of Livin protein in TNBC tissue was significantly higher than that in adjacent carcinoma tissue or normal breast tissue and the expression positive rate of Livin protein in adjacent carcinoma tissue was significantly higher than that in normal breast tissue,the differences were statistically significant (x2 =14.614,57.353,19.048,P＜0.05).The expression was correlated with the clinical pathological features of lymph node metastasis,clinical stage,axillary lymph node metastasis and cancer embolus (x2 =10.788,6.160,27.350,8.914,P＜0.05);OS,PFS in the patients with PDCD4 negative expression were significantly lower than those in the patients with PDCD4positive expression.OS,PFS in the patients with Livin positive expression were significantly lower than those in the patients with Livin negative expression,the above differences were statistically significant (x2 =23.931,19.163,22.649,17.213,P＜0.05).OS in the TNBC patients was correlated with age (RR=1.405),clinical stage (RR =2.897),tumor diameter (RR=2.722),axillary lymph node metastasis (RR=2.516),vascular invasion (RR=3.020),PDCD4 Expression (RR=1.752) and Livin expression (RR=2.051) (P＜0.05).PFS in the patients was correlated with clinical stage (RR =2.756),axillary lymph node metastasis (RR =2.437),PDCD4 expression (RR =1.649) and Livin expression (RR=1.804) (P＜0.05).Conclusion The PDCD4 low expression and Livin protein over-expression exist in TNBC tissues.Their abnormal expressions are correlated with the clinicopathological features of tumor and the prognosis of patient,and could be used as the auxiliary indexes in evaluation of progression and prognosis of TNBC.

Objective: To compare the safety and efficacy of the retrograde and the antegrade techniques in laparoscopic left hemihepatectomy. Methods: Of the 65 patients who underwent laparoscopic left hemihepatectomy between January 2016 to June 2018 at the Ningbo Li Huili Hospital of Medical Center, retrograde left hemihepatectomy was carried out in 31 patients, and antegrade left hemihepatectomy in 34 patients. The perioperative data, duration of operation, intraoperative blood loss, postoperative complications (including major bleeding, abdominal abscess and bile leakage), and post-operative hospital stay were retrospectively compared between the two groups. Results: There were no significant differences in the perioperative general status between the two groups (P>0.05). Both the duration of operation [(121.5±22.1) min vs. (190.9±48.9) min, P<0.05] and the amount of blood loss [(118.9±84.1) ml vs. (195.2±85.4) ml, P<0.05] were significantly less in the retrograde than the antegrade group. There were no statistical differences in the incidences of major complications such as post-hepatectomy hemorrhage, abdominal abscess, or bile leakage, and in the postoperative hospital stay [(10.0±2.8) d vs. (12.2±3.4) d, P>0.05]. Conclusions Occlusion of hepatic vascular inflow and outflow combined with retrograde left hemihepatectomy was safe and feasibly. The retrograde approach was superior to the antegrade approach in laparoscopic left hemihepatectomy.

Purpose: Caspase recruitment domain containing protein 9 (CARD9) has been demonstrated to be a pro-tumor factor in various cancers. However, our previous study found a significant decrease of CARD9 in malignant pleural effusion compared with benign pleural effusion. So we investigated the role of CARD9 in non-small cell lung cancer (NSCLC) and its working mechanism. Materials and Methods: Immunohistochemistry, western blot, and quantitative real-time polymerase chain reaction were used to detect the expression of CARD9 in specimens of NSCLC patients. The Cancer Genome Atlas (TCGA) databasewas also used to analyze the expression of CARD9 in NSCLC and its predicting value for prognosis. Immunofluorescence was used for CARD9 cellular location. Cell growth assay, clonal formation assay, wound healing assay, matrigel invasion assay, and flow cytometry were used to test cell proliferation, migration, invasion, apoptosis, and cycle progression of NSCLC cells with CARD9 knockdown or CARD9 overexpression. Co-immunoprecipitation was used to identify the interaction between CARD9 and B-cell lymphoma 10 (BCL10). SB203580 was used to inhibit p38 activation. Results: CARD9 was decreased in NSCLC tissues compared with normal tissues; low CARD9 expression was associated with poor survival. CARD9 was expressed both in tumor cells and macrophages. Downregulation of CARD9 in NSCLC cells enhanced the abilities of proliferation, invasion and migration via activated MAPK/p38 signaling, while overexpression of CARD9 presented antitumor effects. BCL10 was identified to interact with CARD9. Conclusion We demonstrate that CARD9 is an independent prognostic factor in NSCLC patients and inhibits proliferation, migration, and invasion by suppressing MAPK/p38 pathway in NSCLC cells.

Clinical data of 655 patients with acute ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) in Luoyang Central Hospital during January 2017 to March 2020 were analyzed retrospectively. There were 425 cases who first visited PCI-capable hospital (PCI hospital group) and 230 cases who were transferred to PCI-capable hospital (transfer group). Compared with PCI hospital group, STEMI patients in the transfer group had a shorter first diagnosis time [2.0 (0.8, 4.2)h vs. 2.5(1.2, 4.1)h, Z=3.66, P<0.01], longer time from first medical contact to the balloon through (FMC2B) [175 (113, 344) min vs. 75 (57, 112) min, Z=-8.92, P<0.01], longer total ischemic time [5.4 (3.5, 9.8) h vs. 3.9 (2.4, 6.0) h, Z=-5.43, P<0.01]. There was no significant difference in the time from PCI hospital entry to balloon passage (DTB) between the two groups [43(29, 103) min vs. 46 (61, 94) min, Z=-0.56, P=0.573]. The compliance rate of FMC2B time<120 min in the transfer group was only 25.9% (50/193). However, the different first-visit hospital had no significant effect on the risk of heart failure ( OR=0.54, 95 %CI:0.16-1.79, P=0.311) and risk of death ( OR=1.14, 95 %CI:0.20-6.36, P=0.885). The results suggest that STEMI patients referred to PCI hospitals have considerable time delay, and the rate of compliance with FMC2B time<120 min is low.

Objective:To investigate the safety and effectiveness of Willis covered stent in patients having carotid artery rupture during transnasal endoscopic pituitary tumor resection.Methods:A retrospective analysis was performed. Six patients having carotid artery rupture during transnasal endoscopic pituitary tumor resection admitted to the 3 hospitals from May 2016 to December 2019 were chosen; their clinical data were collected. The surgical processes and complications were concluded, and the prognoses were evaluated by modified Rankin scale (mRS).Results:One patient was treated with intraoperative simple tamponade compression for hemostasis, and died for massive intracranial hemorrhage 2 weeks after surgery. Five patients were occluded by Willis covered stents; the occluded success rate was 100% but ophthalmic arteries were blocked in all. During the perioperative period, diabetes insipidus occurred in one patient and incomplete oculomotor paralysis occurred in one patient; 5 patients were followed up for 3-12 months: MRI indicated subtotal resection of tumor in 4 patients and total resection in one patient, no new bleeding or ischemic stroke events occurred in these 5 patients, and the prognosis was good.Conclusion:Willis covered stent is safe and effective in patients having carotid artery rupture during transnasal endoscopic pituitary tumor resection.

Aiming at the problems of missing important features, inconspicuous details and unclear textures in the fusion of multimodal medical images, this paper proposes a method of computed tomography (CT) image and magnetic resonance imaging (MRI) image fusion using generative adversarial network (GAN) and convolutional neural network (CNN) under image enhancement. The generator aimed at high-frequency feature images and used double discriminators to target the fusion images after inverse transform; Then high-frequency feature images were fused by trained GAN model, and low-frequency feature images were fused by CNN pre-training model based on transfer learning. Experimental results showed that, compared with the current advanced fusion algorithm, the proposed method had more abundant texture details and clearer contour edge information in subjective representation. In the evaluation of objective indicators, Q ^AB/F, information entropy (IE), spatial frequency (SF), structural similarity (SSIM), mutual information (MI) and visual information fidelity for fusion (VIFF) were 2.0%, 6.3%, 7.0%, 5.5%, 9.0% and 3.3% higher than the best test results, respectively. The fused image can be effectively applied to medical diagnosis to further improve the diagnostic efficiency.
Image Processing, Computer-Assisted/methods* ; Neural Networks, Computer ; Tomography, X-Ray Computed ; Magnetic Resonance Imaging/methods* ; Algorithms