Objective:To analyze the impact of lymph node dissection on textbook outcomes (TO) and the prognosis of intrahepatic cholangiocarcinoma (ICC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 376 ICC patients who underwent hepatectomy in 4 medical centers, including Mengchao Hepatobiliary Hospital of Fujian Medical University et al, from December 2011 to December 2017 were collected. There were 242 males and 134 females, aged 57(range, 48-63)years. According to the criteria of TO, patients were classified as two cate-gories, including patients achieving TO and not achieving TO. Measurement data with normal distri-bution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M(range) or M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were represented as absolute numbers, and comparison between groups was conducted using the chi-square test, Yates adjusted chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the non-parameter rank sum test. Univariate and multivariate analyses were conducted using the Logistic regression model. The Kaplan-Meier method was used to draw survival curve. Survival analysis was conducted using the Log-rank test. Results:(1) TO situations. Of the 376 ICC patients who underwent hepatectomy, 199 cases achieved TO, including 40 cases with lymph node dissection and 159 cases without lymph node dissection, 177 cases did not achieve TO, including 76 cases with lymph node dissection and 101 cases without lymph node dissection. (2) Influencing factors for TO after hepatectomy of ICC patients. Results of multivariate analysis showed that lymph node dissection, microvascular invasion, nerve invasion and the volume of intraoperative blood loss >800 mL were independent risk factors for achieving TO after hepatec-tomy of ICC patients ( odds ratio=2.22, 2.95, 3.58, 4.09,95% confidence interval as 1.34-3.69, 1.43-6.07, 1.40-9.17, 1.35-12.43, P<0.05). Of the 116 patients with lymph node dissection, 40 cases achieved TO, 103 cases achieved R 0 resection, 38 cases had postoperative complications, 67 cases had delayed hospital stay. The above indicators were 159, 255, 41, 65 of 260 patients without lymph node dissection. There were significant differences in the above indicators between patients with and without lymph node dissection ( χ2=22.90, 15.16, 13.95, 37.78, P<0.05). (3) Follow-up. All the 376 patients were followed up for 19(range, 1-74)months. Of 199 patients achieving TO, the 1-, 2-and 3-year survival rates of 40 patients with lymph node dissection were 54.0%, 36.6% and 26.1%, respectively, versus 67.7%, 42.7% and 34.4% of 159 patients without lymph node dissection, showing no significant difference between them ( χ2=1.89, P>0.05). Of 177 patients not achieving TO, the 1-, 2-and 3-year survival rates of 76 cases with lymph node dissection were 58.9%, 25.7% and 10.3%, respectively, versus 53.0%, 28.5% and 17.2% of 101 cases without lymph node dissection, showing no significant difference between them ( χ2=0.25, P>0.05). Conclusions:Lymph node dissec-tion, microvascular invasion, nerve invasion and the volume of intraoperative blood loss >800 mL are independent risk factors for achieving TO after hepatectomy of ICC patients. Lymph node dissec-tion may increase the postoperative complication rate, prolong the hospital stay and decrease the rate of achieving TO. However, it does not affect the prognosis of patients.

Objective:To study the factors influencing repeatedly hospitalization in patients with acute pancreatitis (AP), and to analyse the predictive value of triglyceride for repeated hospitalization.Methods:The clinical data of 1 958 patients with AP treated at the First Affiliated Hospital of Anhui University of Science and Technology from January 2012 to April 2022 were analyzed. Of 1 733 AP patients who were enrolled, there were 1 000 males and 733 females, with mean ± s. d age being (49.4±16.4) years. Patients were grouped based on their ID numbers to determine their number(s) of hospitalization. Those who were admitted only once were included in the initial hospitalization group ( n=1 030), and those who were admitted twice or more were included in the repeated hospitalization group ( n=703). The factors influencing repeated hospitalization were analyzed by univariate analysis and multivariate logistic regression analysis. The predictive value of triglyceride for repeated hospitalization was evaluated by receiver operating characteristic (ROC) curve. Results:Multivariate logistic regression analysis showed that hypertriglyceridemia ( OR=1.445, 95% CI: 1.144-1.825, P=0.002) and biliary causes ( OR=3.184, 95% CI: 1.978-5.125, P<0.001) were independent risk factors for repeated hospitalization. When triglyceride <10.9 mmol/L, the prediction of AP patients without repeated hospitalization was 90.6%. The area under the ROC curve was 0.589, and the Yoden index was 0.170. Conclusion:Hypertriglyceridemia was risk factor for repeat hospitalization in AP patients and the efficacy of triglyceride in predicting repeat hospitalization in AP patients was good.

Objective:To explore the safety of clinical application of liver cysts under the mode of ambulatory surgery.Methods:Retrospective analysis of the data of 84 patients with liver cysts admitted to the Huainan First People′s Hospital, the Fourth Affiliated Hospital of Bengbu Medical College from January 2017 to December 2019, they were divided into study group ( n=42) and control group according to the random number table method ( n=42). The control group adopted the traditional perioperative management method, and the research group adopted the day surgery treatment mode. The two groups of patients were evaluated for their hospitalization days, total cost, satisfaction, activity of daily living (ADL) score of 7 days after surgery, temporary cancellation rate, unplanned readmission rate, total postoperative complications and other indicators. Normally distributed measurement data were expressed as mean±standard deviation ( Mean± SD), and independent sample t test was used for comparison between groups. Enumeration data was expressed as a percentage (%), and comparison between groups was performed by chi-square test. Results:The length of stay in the study group and the total cost of hospitalization were (1.76±0.82) d and (0.55±0.10) ten thousand yuan, respectively. The control group were (5.33±1.69) d and (0.90±0.22) ten thousand yuan, respectively. The study group was lesser than In the control group, the differences between the two groups were statistically significant ( P<0.001). The patient satisfaction score of the study group was (4.20±0.64) points, and the control group was (3.20±0.92) points. The study group was higher than the control group. The difference between the two groups was statistically significant ( P<0.001). The postoperative ADL score, temporary cancellation rate, unplanned readmission rate, and total postoperative complication rate in the study group were (46.45±9.75) points, 4.76%, 7.14% and 9.52%, respectively. The control group were (45.57±7.02) points, 2.38%, 4.76% and 7.14%, there was no significant difference between the two groups ( P>0.05). Conclusions:Ambulatory laparoscopic fenestration of liver cysts is safe and effective for the treatment of patients with liver cysts. Compared with traditional in-patient surgery, it can reduce the length of stay and the cost of hospitalization and increase the satisfaction of patients.

Objective:To investigate the risk factors for death in patients with corona virus disease 2019 (COVID-19).Methods:The clinical data of 141 cases of patients diagnosed with COVID-19 at Renmin Hospital of Wuhan University from February 1 to February 26, 2020 were included in this retrospective analysis. The gender, age, time of hospitalization after the onset, clinical manifestations, underlying diseases, laboratory examination indicators (inculding white blood cell counts, neutrophil counts, lymphocyte counts, lymphocyte subsets, immunoglobulin, complement 3, complement 4, D-dimer, fibrinogen), and short term prognosis were compared between the death group and the survival group. Logistic regression was used to analyze the factors influencing the death of COVID-19 patients. The t test, Mann Whitney U test or chi-square test were used for comparison between groups. Results:Of the 141 COVID-19 patients, 52 died and 89 survived. The age, hypertension, chronic respiratory diseases, cardiovascular and cerebrovascular diseases, fever and wheeze of patients in the death group were all higher than those in the survival group, which were (70.7±13.3) years old vs (50.4±15.3) years old, 51.9%(27/52) vs 14.6%(13/89), 15.4%(8/52) vs 4.5%(4/89), 30.8%(16/52) vs 7.9%(7/89), 80.8%(42/52) vs 61.8%(55/89) and 50.0%(26/52) vs 25.8%(23/89), respectively. The differences were all statistically significant ( t=7.972, χ2=22.104, 3.615, 12.392, 5.503 and 8.447, respectively, all P<0.05). The white blood cell count, neutrophil count, CD4 + /CD8 + T lymphocyte, immunoglobulin E, D-dimer, fibrinogen, CD19 + T lymphocyte proportion and CD19 + T lymphocyte count of patients in the death group were all higher than those in the survival group, which were 8.20(5.26, 13.01)×10 9/L vs 5.29(3.96, 7.04)×10 9/L, 7.40(4.54, 11.46)×10 9/L vs 3.16(2.20, 5.01)×10 9/L, 2.32(1.77, 3.11) vs 1.63(1.25, 2.08), 125.0(42.6, 275.0) IU/mL vs 66.8(38.3, 143.0) IU/mL, 7.27(2.11, 16.21) mg/L vs 0.95(0.38, 2.54) mg/L, 4.37(2.72, 6.78) g/L vs 4.10(2.78, 4.97) g/L, (23.19±13.43)% vs (15.38±6.38)%, and (181.5±115.4)/μL vs (98.89±77.64)/μL, respectively. The differences were all statistically significant ( Z=3.944, 4.210, 2.834, 1.190, 5.497, 1.180, t=3.987, 3.411, respectively, all P<0.05). The lymphocyte count, CD3 + T lymphocyte proportion, CD3 + T lymphocyte count, CD8 + T lymphocyte proportion, CD8 + T lymphocyte count, CD16 + CD56 + T lymphocyte count and CD4 + T lymphocyte count were all lower than those in survival group, which were 0.47(0.37, 0.96)×10 9/L vs 1.33(0.90, 1.55)×10 9/L, 48.72%(42.31%, 76.92%) vs 69.91%(65.05%, 75.36%), 223.0(100.0, 403.0)/μL vs 761.0(499.0, 1 092.0)/μL, 13.82%(10.32%, 19.82%) vs 24.90%(20.87%, 29.57%), 55.5(30.5, 106.0)/μL vs 318.0(162.5, 443.5)/μL, 63.0(29.0, 99.5)/μL vs 140.0(69.5, 195.5)/μL and (209.74±140.13)/μL vs (487.61±232.02)/μL, respectively. The differences were all statistically significant ( Z=6.937, 3.944, 5.883, 3.924, 5.703, 3.517 and t=7.558, respectively, all P<0.01). Age, history of hypertension, white blood cell count, D-dimer, and fibrinogen were the risk factors for death of COVID-19 (odds ratio ( OR)=1.170, 10.405, 3.055, 1.128 and 1.343, respectively, all P<0.05). Conclusion:Age, underlying hypertension, white blood cell count, D-dimer and fibrinogen are independent prognostic factors for COVID-19.

Oxidative stress and cardiomyocyte apoptosis are involved in the pathogenesis of doxorubicin (DOX)-induced cardiotoxicity. Matrine is well-known for its powerful anti-oxidant and anti-apoptotic capacities. Our present study aimed to investigate the effect of matrine on DOX-induced cardiotoxicity and try to unearth the underlying mechanisms. Mice were exposed with DOX to generate DOX-induced cardiotoxicity or normal saline as control. H9C2 cells were used to verify the effect of matrine . DOX injection triggered increased generation of reactive oxygen species (ROS) and excessive cardiomyocyte apoptosis, which were significantly mitigated by matrine. Mechanistically, we found that matrine ameliorated DOX-induced uncoupling protein 2 (UCP2) downregulation, and UCP2 inhibition by genipin could blunt the protective effect of matrine on DOX-induced oxidative stress and cardiomyocyte apoptosis. Besides, 5'-AMP-activated protein kinase 2 () deficiency inhibited matrine-mediated UCP2 preservation and abolished the beneficial effect of matrine in mice. Besides, we observed that matrine incubation alleviated DOX-induced H9C2 cells apoptosis and oxidative stress level activating AMPK/UCP2, which were blunted by either AMPK or UCP2 inhibition with genetic or pharmacological methods. Matrine attenuated oxidative stress and cardiomyocyte apoptosis in DOX-induced cardiotoxicity maintaining AMPK/UCP2 pathway, and it might be a promising therapeutic agent for the treatment of DOX-induced cardiotoxicity.

Objective To investigate the effect of lycopene (Lyc) on H9c2 cell apoptosis induced by angiotensin Ⅱ (Ang Ⅱ).Methods Using Ang Ⅱ (10 μmol/L) to stimulate H9c2 cells,we observed the protective effect of Lyc on H9c2 cells apoptosis.The H9c2 cells viability induced by different consideration of Lyc or Ang Ⅱ or both was detected by CCK8 assay.The expression levels of Bax and Bcl-2 in H9c2 cells were determined by real-time quantitative reverse transcription polymerase chain reaction (RT-PCR).Western blot was conducted to detect the protein expressions of Bax,Caspase 3,Caspase 9 and Bcl-2 in H9c2 cells.The apoptotic ratio of H9c2 cells was observed by TUNEL assay.Results Compared with control group,Ang Ⅱ could decrease the viability of H9c2 cells to (92.87±4.37)％.The result of RT-PCR showed that Ang Ⅱ decreased the expression level of Bcl-2,and Bax level was increased under the stimulation of Ang Ⅱ (P＜0.05),while the expression level of Bcl-2 was increased and Bax level was decreased under the co-stimulation of Ang Ⅱ and Lyc in a concentration dependent manner,which indicated that Lyc ameliorated the apoptosis of H9c2 cells.The result of western blot showed that the protein expressions of Bax,Caspase 3 and Caspase 9 were increased,but Bcl-2 was decreased after the stimulation of Ang Ⅱ (P＜0.05).While these phenomenon reversed apparently under the co stimulation of Ang Ⅱ and Lyc.A large number of apoptotic cells were observed under the stimulation of Ang Ⅱ through TUNEL assay.But the number of apoptotic cells reduced significantly under the co-stimulation of Lyc and Ang Ⅱ (P ＜0.05).Conclusions Lyc ameliorates the H9c2 cell apoptosis induced by Ang Ⅱ,which indicates that Lyc may have an important role in the treatment of various cardiovascular diseases.

Objective To evaluate the clinical application value of Hopkins endoscope on removal of esophageal foreign bodies. Methods The clinical data of 96 patients with esophageal foreign body were analyzed retrospectively. Then the differences of the operation time between the visual surgery guided by Hopkins endoscope and conventional surgery of removal of esophageal foreign bodies were compared. Results Improved surgical operation time is significantly shorter than the traditional operation group. In addition,the operation time of improved surgery in the denture group,≥50 years old age group,≥24 h course group and the first stenosis of esophagus group is significantly shorter than the traditional ones. Conclusion Compared with the traditional surgery,the visual surgery of removal of esophageal foreign bodies guided by Hopkins endoscope with rigid esophago?scope has more advantages,especially for complex esophageal foreign body,which can significantly short the operation time and improve the opera?tion efficiency.

Objective To investigate the effect of Lycopene (Lyc) on Ang Ⅱ induced oxidative stress in H9c2 cell line derived from rat cardiac tissue,and to explore related mechanisms.Methods H9c2 cells were divided into 6 groups:control group,Ang Ⅱ group (1 μmol/L),Ang Ⅱ (1 μmol/L) + low dose Lyc (3.125 nmol/L) group,AngⅡ (1 μmol/L) + moderate dose Lyc(6.25 nmol/L)group and Ang Ⅱ (1 μmol/L) + high dose Lyc(12.5 nmol/L) group and Lyc group (12.5 nnmol/L).Cell growth was determined by CCK8 assay,ROS generation was detected using a Microplate reader and Fluorescence microscopy,the expression of NOX2 was determined by Western blot,mRNA expression of p47phox,SOD1 and SOD2 were determined by Real Time-PCR,MDA was detected by ELISA kit.Results Compared to control group,cell survival was significantly reduced and ROS generation was significantly increased post Ang Ⅱ stimulation,cotreatment with Lyc significantly improved cell survival and reduced ROS generation in a dosedependent manner (all P ＜ 0.01).mRNA expression of SOD1 and SOD2 was significantly downregulated while MDA concentration was significantly increased in Ang Ⅱ treated cells,which could be significantly reversed by cotreatment with Lyc in a dose dependent manner (all P ＜ 0.01).Protein expression of NOX2 and mRNA expression of p47phox were significantly upregulated post Ang Ⅱ and which could be significantly downregulated by cotreatment with Lyc in a dose-dependent manner (all P ＜ 0.01).Conclusion Lyc could attenuate Ang Ⅱ induced oxidative stress and this effect is linked with its capacity of reducing ROS generation and enhancing cellular ROS scavenging ability in H9c2 cells.

Objective To explore changes of gray matter volume in patients with obsessivecompulsive disorder (OCD) in Chinese Han population using optimized voxel-based morphometry (VBM) ,and investigate its relationship with clinical symptoms. Methods Twenty patients with OCD and 20 age,sex and handedness matched healthy controls were scanned using 3D-T1 images on a 3.0 T MR system. The high resolution T1WI was preprocessed according to the optimized VBM protocol in Statistical Parametric Mapping (SPM5). Two-sample t test was performed to characterize the differences of the gray matter volume (GMV) between the OCD patients and healthy controls, and the correlations between the GMV and symptom severity and cumulative illness duration were examined using Pearson correlation in SPSS 16. 0, respectively.Results Compared to controls, OCD patients demonstrated increased GMV in left thalamus, right thalamus and left cerebellum after false discovery rate (FDR) correction. No areas of significantly decreased GMV was observed in OCD patients in relative to healthy controls. The mean eigenvalue ranged from 0. 5782 to 0. 889 representing the left thalamus volume of OCD patients was 0. 6813 ± 0. 0718, and that ranged from 0. 5546 to 0. 9062 was 0. 6869 ± 0. 0808 tor right thalamus. The mean eigenvalues were positively correlated in bilateral thalamus (r = 0. 94, P ＜ 0. 01). Conclusion Using optimized VBM, the current research indicates that the pathophysiology of OCD is associated with GMV abnormalities not only in corticostriato-thalamo-cortical (CSTC) circuit, but also in the cerebellum.

This study sought to reveal the difference in resting-state brain functions between subjects with major depressive disorder and normal controls. Fifty-three depressed patients diagnosed with DSM-IV and 38 normal controls underwent resting-state functional magnetic resonance imaging (fMRI), and the data were analyzed using a new method called Regional Homogeneity (ReHo). Then voxel wised comparison was made to derive the resting-state brain function differences between groups. Compared with normal controls, depressed subjects showed decreased ReHo in bilateral anterior cingulate cortex (ACC), left medial frontal gyrus, and left middle temporal gyrus. Significant decreased ReHo in ACC might suggest less spontaneous neuronal activities or lower baseline brain activities of ACC in depressed subjects in comparison with normal controls.
Adult ; Brain ; physiopathology ; Case-Control Studies ; Depressive Disorder, Major ; physiopathology ; Female ; Gyrus Cinguli ; physiopathology ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Young Adult