ObjectiveTo investigate the expression and the clinical significance of diacylglycerol kinase α (DGKα) and protein kinase C (PKC) in human hepatocellular carcinoma (HCC).MethodsDGKα and PKC expressions in the samples from 60 pathologically confirmed HCC patients were analyzed by immunohistochemistry. The relationship between DGKo expression and clinical pathology factors was analyzed.ResultsThe expression positive rates of DGKo and PKC were highest in normal liver tissues [90.0％ (9/10) and 100.0％ (10/10)].The positive rates were 81.7 ％ (49/60) and 71.7 ％ (43/60) in HCC tissues,respectively,and were 58.3 ％ (35/60) and 61.7 ％ (37/60) in carcinoma adjacent tissues,respectively.In three liver tissues,the positive rates of DGKα and PKC were significantly different (P ＜0.05).The location of both kinases in hepatocytes translocated from cytoplasm/nucleus to membrane.The expressions of DGKα and PKC were positively correlation(r =0.495, P ＜ 0.05), The DGKα expression was correlated to differentiation type,portal venous tumor thrombus and TNM staging(all P ＜ 0.05).ConclusionDGKa is expressed with high activity in advanced stage and poorly differentiated HCC. It may be promote the pathological process of HCC.

ObjectiveTo evaluate the ability of high resolution magnetic resonance (MR) imaging at 3.0 tesla to depict the characterization of human carotid arterial vessel wall and detect atherosclerotic lesions ex vivo in comparison to histopathologic results. MethodsEighteen carotid arteries obtained from 9 elderly donors underwent fat-suppressed T1 - and T2-weighted MR imaging at 3.0 tesla MR system with a mouse coil. Corresponding histological sections were obtained for the comparison. Correlation between MR images and histopathologic slices was obtained by Pearson or Spearman correlation coefficient.Cohen K was computed to quantify the agreement between MRI and histopathologic findings.Results Lumen area,intima and media area measured on fat-suppressed T2-weighted images showed stronger correlation with the corresponding histopathologic slices [ MRI vs.histopathology:( 27. 53 ± 6. 77 ) mm2 vs.( 25.83 ±6. 69 ) mm2, r2 ＝ 0. 91,P2 ＝ 0. 024, ( 12.31 ± 3. 31 ) mm2 vs.( 12. 28 ± 3.71 ) mm2, r2 ＝ 0. 70, P2 ＝ 0. 020,Median 12. 29 mm2(Min 1.12 mm2, Max 33.18 mm2) vs.Median 11.62 mm2(Min 0.89 mm2, Max 32. 84 mm2 ), r2 ＝ 0. 74, P2 ＝ 0. 016, respectively]. The Cohen K score between the MR imaging and American Heart Association classifications was 0. 74, which corresponds to a good agreement. Conclusions 3.0 T high-resolution multi-sequence MRI can clearly show the structure of ex vivo carotid artery wall and allow quantitative assessment.Fat-suppressed T2Wimaging has a greater advantagein presenting atherosclerotic lesions.

Objective To investigate the effects of different treatment modes on the prognosis of patients with severe trauma.Methods The general data of 396 patients with severe trauma [injurey severity scores (ISS) ≥25] in our hospital emergency for treatment from January 1,2008 to January 1,2012 was collected.The trauma patients were divided into study group and control group.In the study group,the trauma patients were cared by emergency physician of our hospital for pre-hospital treatment during transportation by ambulance since January 1,2010.In the control group,the trauma patients were served with traditional pre-hospital emergency care by the 120 and 999 before January 1,2010.The injury severity score,medical care and outcomes were recorded in trauma database and the efficiency and quality of medical care were compared between two groups.Results The emergency treatment time,length of hospital stays,ICU admission rate,prehospital mortality rate,long-term (6 months) disability rate,and complication rate in the study group were lower than those in the control group,presenting (78.23 ± 21.57) min vs.(96.45 ± 35.14) min,(23.55±12.46) dvs.(28.67±20.72) d,8.1％ (18/222)vs.65.5％ (114/174),13.3％ (34/256) vs.21.6％ (48/222),4.1％ (9/222)vs.9.2％ (16/174),8.1％ (18/222)vs.18.4％ (32/174),in which the differences were statistically significant (P ＜ 0.05).Hospital mortality in the study group was also lower than that in the control group,showing 8.1％ (18/222) vs.12.6％ (22/174),but there was no statistically significant difference (P ＜ 0.05).There was no significant difference in time from occurrence of injury to receiving treatment between the two groups.Conclusion Emergency physicians-cared mode had advantages to improve treatment success rates and reduce mortality in patients with multiple trauma compared with the current conventional emergency mode.It is a good alternative emergency mode.

Nursing case reports can provide reference for clinical nursing work experience for rare, special and difficult diseases. At present, the quality of case reports in Chinese nursing journals is uneven, and some of them do not follow the relevant reporting norms. By introducing the formation and content of the CARE guidelines, this paper illustrated the use of the CARE guidelines in case reports in the field of nursing with examples, and provided references for nursing researchers to use the CARE guidelines in writing, with a view to improving the clarity, integrity and transparency of the writing of nursing case reports in China.

Objective: To investigate the pathologic features of gonadal tissues of disorders of sexual development (DSD) in children. Methods: Fifty-three cases of gonadal developmental disorders were collected from July 2015 to August 2017 at Guangzhou Women and Children′s Medical Center. Clinical manifestations, karyotypes, sex hormone levels, ultrasound imaging, histology and immunophenotype of gonadal tissues were analyzed. Results: The age of patients ranged from 7 months to 17 years with an average of (50.7 ± 47.1) months. Social genders of the patients included 32 males and 21 females. Forty-eight patients had abnormal sex hormone levels. Clinical presentations included: toward female genitalia in 25 cases, male genitalia tendency in 17 cases and ambiguous external genitalia in 11 cases. Hypospadias was seen in 31 cases and short stature was seen in 8 cases. Chromosomal karyotyping of peripheral blood revealed 23 cases of sex chromosome disorders, 22 cases of 46 XY disorders, of which 3 cases were 5α-reductase deficiency and 8 cases of 46 XX disorders. Ultrasound examination showed cryptorchidism in 30 cases, including 16 cases of unilateral, 14 cases of bilateral and 1 case presenting a huge pelvic tumor. A total of 97 gonadal tissues from 53 cases of DSD were examined, including 9 cases of unilateral and 44 cases of bilateral gonads. Microscopically, 55 gonads (56.7%) showed dysplastic testes including 17 unilateral and 19 bilateral gonads. Fourteen were streak gonads (14.4%) including 8 unilateral and 3 bilateral gonadal tissues. Nine streak gonad with epithelial cord-like structures (9.3%) were found, of which 5 were unilateral and 2 were bilateral lesions. Seven gonads were ovotestis (7.2%), unilateral in 5 cases (the other side of the gonads of ovary in 4 cases, 1 case of dysplastic testes) and bilateral in 1 case. Seven gonads showed follicular-rich ovarian tissue (7.2%). One case showed bilateral dysplastic testes with gonadoblastoma and ectopic adrenal cortex. One case of streak gonad showed epithelial cord-like structures and undifferentiated glandular tissue embedded in malignant mixed germ cell tumors (mixed gonadoblastoma, dysgerminoma, mature teratoma and yolk sac tumor). One case had testicular microlithiasis. Uterus and fallopian tube structures were found in 11 cases. Immunohistochemical stains were performed in 15 cases. D2-40, PLAP and CKIT were expressed in germ cells and Calretinin, WT1 and inhibin were positive in Setoli cells. SALL4 and OCT3/4 were positive in 3 cases. Inhibin highlighted interstitial Leydig cells in 2 cases. GPC3 was positive in yolk sac tumor component. Conclusions Gonadal dysgenesis presents a broad spectrum of gonadal phenotypes with variable degrees of differentiation. The development of bilateral gonadal tissues has certain variability. Chromosomal karyotypes have no correlation with gonadal phenotypes. Accurate histopathologic diagnosis of gonadal dysgenesis plays an important role in the treatment and prognosis of the patient.

Depression is a major mood disorder. Abnormal expression of glial glutamate transporter-1 (GLT-1) is associated with depression. Schisantherin B (STB) is one bioactive of lignans isolated from Schisandra chinensis (Turcz.) Baill which has been commonly used as a traditional herbal medicine for thousands of years. This paper was designed to investigate the effects of STB on depressive mice induced by forced swimming test (FST). Additionally, we also assessed the impairment of FST on cognitive function in mice with different ages. FST and open field test (OFT) were used for assessing depressive symptoms, and Y-maze was used for evaluating cognition processes. Our study showed that STB acting as an antidepressant, which increased GLT-1 levels by promoting PI3K/AKT/mTOR pathway. Although the damage is reversible, short-term learning and memory impairment caused by FST test is more serious in the aged mice, and STB also exerts cognition improvement ability in the meanwhile. Our findings suggested that STB might be a promising therapeutic agent of depression by regulating the GLT-1 restoration as well as activating PI3K/AKT/mTOR pathway.
Animals ; Cognition ; Cognition Disorders ; Depression ; Glutamic Acid ; Herbal Medicine ; Learning ; Lignans ; Memory ; Mice ; Mood Disorders ; Physical Exertion ; Schisandra

OBJECTIVETo determine whether smoking increases the risk for developing metabolic syndrome (MetS) in Chinese men.

METHODSA total of 693 men with no MetS at baseline were followed for 2.9-5.5 years. Subjects were divided into nonsmokers, ex-smokers, and current smokers according to baseline smoking status.

RESULTSAfter adjusting for age, education level, alcohol intake, fasting plasma insulin, HOMA-IR index, and BMI at baseline and weight change, current smokers were dose-dependently associated with increased risk for developing new MetS compared with nonsmokers. The odds ratio (OR) was 2.131 (95% CI, 1.264, 3.592; P<0.01) for the NCEPIII definition or 3.083 (95% CI, 1.807, 5.295; P<0.01) for the JCDCG definition of MetS. Ex-smokers who had quit for ≥13 years significantly decreased the risk for developing new MetS defined by the JCDCG definition. Compared with nonsmokers, current smokers were significantly associated with increased incidence of hypertriglyceridemia and low HDL-C.

CONCLUSIONSmoking is a risk factor for developing MetS in Chinese men after adjusting for age, education level, alcohol intake, fasting plasma insulin, HOMA-IR, BMI, and weight change. This could be due to an increased incidence of dyslipidemia. Smoking cessation for >13 years decreased the risk for developing MetS defined by the JCDCG definition.

Adult ; Aged ; Aged, 80 and over ; Blood Glucose ; metabolism ; Body Mass Index ; China ; epidemiology ; Cholesterol, HDL ; blood ; Diabetes Mellitus ; blood ; epidemiology ; Follow-Up Studies ; Humans ; Hypertriglyceridemia ; blood ; epidemiology ; Male ; Metabolic Syndrome ; blood ; epidemiology ; etiology ; Middle Aged ; Odds Ratio ; Risk Factors ; Smoking ; adverse effects ; blood ; epidemiology ; Waist Circumference

BACKGROUNDTo determine the long-term efficacy and persistence of Chinese infants after receiving only active plasma-derived hepatitis B vaccine, and to evaluate if providing booster vaccination after basic hepatitis B immunization is necessary.

METHODSInfants who were born in 1986-1988 in four demonstrative hepatitis B immunization trial areas of Hunan, Guangxi, Hebei and Shanghai after receiving only active plasma-derived hepatitis B vaccination, had been randomly followed up for 15 years. HBsAg,anti-HBs and anti-HBc in 21 680 person-times were tested using commercial SPRIA kits.

RESULTSPrevalence of HBV carriers was less than 1.66% among all children vaccinated with only active plasma-derived hepatitis B vaccine in 4 clinical trial areas. Prevalence of HBsAg did not increase with years after vaccination,90%(95% Cl:83.1%-97.2%) effectiveness of hepatitis B vaccine persisted for 15 years in preventing chronic HBV infection. Carriage, HBV infection and efficacy were not different among all age groups (P>0.05). Seroprotection rate (anti-HBs?10 mIU/ml) and quantity of anti-HBs were significantly decreased with years after vaccination. Seroprotection rates of anti-HBs were 40%-50% and 30%-42% during the 9th-10th year and the 13th-14th ear of vaccination, respectively. Titer of anti-HBs declined?by 90% after 14 years.

CONCLUSIONSThese results showed that long-term efficacy of only active plasma-derived hepatitis B vaccination, which was not affected by decline in seroprotection rate and titer of anti-HBs. For children and adults whose immune status is normal, booster doses of vaccine are not recommended.

Adolescent ; Child ; Child, Preschool ; Follow-Up Studies ; Hepatitis B ; prevention & control ; Hepatitis B Antibodies ; blood ; Hepatitis B Surface Antigens ; blood ; Hepatitis B Vaccines ; immunology ; Humans ; Infant ; Infant, Newborn ; Vaccination

Establishing fever clinic was an important achievement of the fight against severe acute respiratory syndrome (SARS) in 2003, and played an important role in the subsequent outbreaks of H1N1, H7N9 and Middle East respiratory syndrome (MERS). Fever clinics have significant emergency characteristics, but there are no rescue conditions in the fever clinics. Consequently, the problem of establishment and management of fever clinics is still outstanding. Based on the development of fever clinics, this paper analyzes the operational dilemma of fever clinics, explores the measures of establishment and management of fever clinics, and constructs the operational mechanism of fever clinics in order to provide the basis for the emergency management system of public health emergencies, which is suitable for Chinese health system.

Objective:To evaluate the effectiveness,safety and economics of absorbable drug-eluting coronary stent systems using rapid health technology assessment tools,and to provide evidence-based basis for rational use for clinicians use and expert evaluation.Methods:A computer search was performed on PubMed,CNKI,Wanfang,VIP and other databases from 1 January 2014 to 1 January 2023 for relevant literature on patients with coronary artery disease who were treated with coronary artery stent interventional surgery.The 210 collected literatures were screened and extracted according to the inclusion and exclusion criteria,and the literature quality evaluation was carried out.The extracted data related to the intravascular thrombosis rate,myocardial infarction rate,cardiac mortality rate,all-cause mortality rate,target lesion revascularization rate and intravascular adverse event incidence of absorbable drug-eluting coronary stents and drug-eluting coronary stents were meta-analyzed by Revman5.4 software.Results:7 studies were ultimately included in the comparative study of absorbable drug-eluting coronary stents and drug-eluting coronary stents.The thrombosis rate,all-cause mortality rate and intravascular adverse event rate of absorbable drug-eluting coronary stents were lower than those of drug-eluting coronary stents,and the difference was statistically significant(Z=2.16,1.89,2.22,P＜0.05).There were no statistically significant difference in the myocardial infarction rate,cardiac mortality rate and target lesion revascularization rate between absorbable drug-eluting coronary stents and drug-eluting coronary stents(P＞0.05).Conclusion:There was no significant difference in safety and efficacy between absorbable drug-eluting coronary stents and drug-eluting coronary stents.In terms of economy,the cost of absorbable drug-eluting coronary stents is significantly higher than that of drug-eluting coronary stents,and patients can choose stents according to their own economic conditions and other actual conditions.