Objective To evaluate the feasibility of applying spectral CT material suppressed iodine (MSI) imaging as virtual plain CT scan to replace traditional non-contrast (TNC) CT in head and neck neoplasms. Methods A total of 52 patients with initial diagnosis of head and neck neoplasms underwent TNC CT scanning and spectrum mode enhanced scanning in the head and neck with spectral CT. With GSI Volume Viewer software from GE AW4.6 workstation, the enhanced scanning data were processed and MSI images were acquired. The CT values of different tissues (fat, erector spinae, cervical vertebrae, thyroid, and brain parenchyma) and the enhancement rate in erector spinae, carotid sinus were compared between MSI and TNC images. Image quality was objectively evaluated in noise and SNR for MSI and TNC images, while the subjective evaluation included the visibility of lesions, subjective acceptance rate, diagnostic efficacy (with/without lesions or lesion calcification, necrosis). Radiation dose including volume CT dose index (CTDIvol) and effective dose (ED) was compared between MSI and TNC. Results (1) CT values of erector spinae on MSI and TNC imaging were(52 ± 6)and(52 ± 7)HU respectively, and the difference between the two image modes was not significant(t=0.39,P>0.05). CT values on MSI and TNC Imaging were[-74 (-86,-59)HU]and[-79(-73,-61)HU]for fat (Z=-2.71, P<0.05),[139(121,196)HU]and[282 (237,336) HU,Z=-5.46]for vertebrae (Z=-5.46, P<0.05),[57(48,61)HU]and[96(74,110) HU]for thyroid (Z=-4.85, P<0.05),[35(32,39)HU]and[35(32,39)HU]for brain parenchyma (Z=-4.74, P<0.05) respectively. (2) There was no significant difference in enhancement rate of erector spinae between MSI and TNC imaging 1.15(1.07,1.20) and 1.14(1.03,1.26) respectively, Z=-5.50, P>0.05). The difference of carotid sinus enhancement rate was significant 5.75(4.70,6.73) and 4.37(3.91,5.61) respectively, Z=-5.50, P<0.05). (3) The noise of MSI[10.61(8.34,13.57) HU)]was higher than that of TNC [9.32(7.40,11.42) HU](Z=-2.52,P<0.05), and the SNR of MSI [-6.59(-8.59—-4.25)] was lower than that of TNC[-7.94(-10.25,-5.51)] (Z=-2.73,P<0.05). (4) Median scores of subjective imaging quality evaluation were 4(3.00,4.75) and 4(3.00,4.00) in MSI and TNC images respectively, and the difference was not significant(Z=-0.45,P>0.05).Unacceptable and acceptable cases in imaging quality of MSI were 3 and 49 respectively, while those were 2 and 50 in TNC group. Subjective acceptance rate between MST and TNC images was not significantly different(?2=0.01,P>0.05). (5) Diagnostic performance evaluation showed that the consistency of two observers was good in detecting lesions, necrosis and calcification between MSI and TNC image, with K value 0.93, 0.83 and 0.90 respectively (P<0.05). (6) Radiation doses between pure energy spectrum enhanced mode and conventional pre plus post contrast enhanced mode were compared. And differences of CTDIvol[11.78(10.98,17.30) mGy]and[23.89 (22.42, 29.98) mGy] respectively],ED [1.89(1.63,2.29) mSv]and[3.77(3.21,4.16 ) mSv] respectively] were significant(Z=-6.28, P<0.05). Pure energy spectrum enhanced mode reduced 39.07% of CTDIvol and 45.75%of ED respectively. Conclusions MSI imaging can be a potential substitute for TNC imaging. And it has clinical values in the diagnosis of head and neck neoplasms.

Objective:To investigate the risk factors for intrahepatic cholangiocarcinoma (ICC) after hepatectomy for hepatolithiasis.Methods:The retrospective case-control study was conducted.The clinico-pathological data of 1 071 patients who underwent hepatectomy for hepatolithiasis at the Eastern Hepatobiliary Surgery Hospital of Navy Medical University between January 2010 and December 2011 were collected. There were 379 males and 692 females, aged (53±12)years, with the range of 12-86 years. Patients completed preoperative examinations. For regional hepatolithiasis, the anatomical hepatectomy was performed. For diffused hepatolithiasis, regional damaged lesions which confined to liver segment or lobe were resected. Hepaticolithotomy or cholangio-lithotomy was performed if necessary. When severe stricture of hilar bile duct affects biliary drainage, cholangiojejunostomy or biliary stricture plasty was performed. Observation indicators: (1) preoperative examination, surgical and postoperative situations; (2) follow-up; (3) risk factors analysis of ICC within the 5 years after hepatectomy for hepatolithiasis. Follow-up using outpatient examination and telephone interview was performed to detect the incidence of ICC after hepatectomy up to December 2019. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were described as M (range). Count data were described as absolute numbers or percentages. Continuous variables were converted into categorical variables according to the common clinical values or the best cut-off value of receiver operating characteristic curve. Binary logistic regression model was used for risk factors analysis. The factors with P<0.10 in univariate analysis were included for the multivariate analysis. Results:(1) Preoperative examination, surgical and postoperative situations. Results of preoperative examination: duration of hepatolithiasis-related symptoms of the 1 071 patients was 8.2 years(range, 0-27.0 years), the levels of CA19-9 and CEA were (163±87)U/mL and (5.0±2.1)μg/L, and stones located at left liver, right liver, bilateral sides, common hepatic duct or common bile duct were detected in 545, 245, 228, 53 patients. There were 226 patients complicated with biliary stricture and 172 with segmental atrophy. Of the 1 071 patients, 595 underwent anatomical hepatectomy, 272 underwent regional non-anatomical hepatectomy, 143 underwent cholangiolithotomy, and 61 underwent cholangiojejunostomy. Results of postoperative imaging examination showed residual biliary stricture in 26 patients and residual biliary stones in 74 patients. (2) Follow-up: 1 071 patients were followed up for (8.6±1.5)years. Of the 1 071 patients, 92 developed ICC, with an incidence of 8.590%(92/1 071). There were 32, 66, 90 patients developing ICC within 3, 5, 8 years after hepatectomy, with the incidence of 2.988%(32/1 071), 6.162%(66/1 071), 8.403%(90/1 071). (3) Risk factors analysis of ICC within the 5 years after hepatectomy for hepatolithiasis. The receiver operating characteristic curve of duration of hepatolithiasis-related symptoms for ICC within the 5 years after hepatectomy was constructed, and duration of hepatolithiasis-related symptoms was converted into categorical variable for following analysis using 7 years as the cut-off value based on Youden index. Results of univariate analysis showed that duration of hepatolithiasis-related symptoms>7 years, complication with metabolic diseases, segmental atrophy, postoperative residual stones were related factors for ICC within the 5 years after hepatectomy ( odds ratio=2.939, 2.654, 1.903, 2.361, 95% confidence interval: 1.582-5.460, 1.145-6.154, 1.068-3.390, 1.118-4.987, P<0.05). Results of multivariate analysis based on factors with P<0.10 in the univariate analysis showed that duration of hepatolithiasis-related symptoms>7 years, complication with metabolic diseases, segmental atrophy, postoperative residual stones were independent risk factors for ICC within the 5 years after hepatectomy ( odds ratio=2.843, 2.469, 1.922, 2.202, 95% confidence interval: 1.523-5.309, 1.042-5.851, 1.064-3.472, 1.021-4.747, P<0.05). Conclusions:There was risk of developing ICC after hepatectomy for cholelithiasis. The duration of hepatolithiasis-related symptoms >7 years, complication with metabolic diseases, segmental atrophy and postoperative residual stones are independent risk factors for ICC development within 5 years after hepatectomy.

3' Untranslated Regions ; Animals ; Biomarkers ; metabolism ; Cell Proliferation ; Cell Survival ; Embryonic Stem Cells ; cytology ; metabolism ; Induced Pluripotent Stem Cells ; cytology ; metabolism ; Mice ; Swine ; Transcription Factors ; genetics ; metabolism

[Abstract] Objective: To investigate the molecular mechanism of miR-143-3p regulating the proliferation, migration and invasion of colon cancer RKO cells via targeting enhancer of zeste homolog 2 (EZH2). Methods: A total of 40 pairs of colon cancer tissues and corresponding para-cancerous tissues resected in the First Affiliated Hospital of Kunming Medical University from March 2015 to July 2017 were collected for this study. In addition, colon cancer cell lines (COLO320, RKO and CL-11) and normal intestinal mucosa NCM460 cells were also collected. qPCR was applied to detect the expression level of miR-143-3p in colon cancer tissues and cell lines. miR-143-3p mimics, miR-143-3p inhibitor, EZH2 siRNA and negative control plasmids were transfected into RKO cells, respectively. The effect of miR-143-3p/EZH2 axis on the proliferation, migration and invasion of RKO cells were detected by CCK-8 and Transwell assay, respectively. Western blotting was used to detect the expression level of EZH2 protein in RKO cells. The targeting relationship between miR-143-3p and EZH2 was verified by Dual luciferase reporter gene assay. Results: The expression level of miR-143-3p was downregulated in colon cancer tissues and cell lines (all P<0.01). Overexpression of miR-143-3p significantly inhibited the proliferation, migration and invasion of RKO cells (all P<0.01). Dual luciferase reporter gene assay confirmed that EZH2 was a target gene of miR-143-3p. Simultaneous knockdown of miR-143-3p and EZH2 attenuated the inhibition of EZH2 knockdown on the proliferation, migration and invasion of RKO cells. Conclusion: miR-143-3p suppresses the proliferation, migration and invasion of colon cancer cells via targetedly down-regulating EZH2.

Animals ; Cells, Cultured ; NAV1.8 Voltage-Gated Sodium Channel ; metabolism ; Pain ; chemically induced ; metabolism ; Proto-Oncogene Proteins c-akt ; metabolism ; Rats ; Scorpion Venoms ; pharmacology ; Up-Regulation

Objective: To carry out the 4^th round of third-party evaluation on the implementation and effect of the 1^st year of the 2^nd Phase National Healthcare Improvement Initiative(abbreviated as Initiative)since 2015. Methods: The 4^th round of the evaluation survey adopted the same methods, organization and execution, and technical roadmap as the former three rounds of evaluations. Results: The 4^th round of evaluation was carried out from 18 March to 9 April, 2019 at 185 public hospitals in 31 provinces(autonomous regions, municipalities directly under the Central Government)and Xinjiang Production and Construction Corps.Facility survey, health professional survey and patient survey were conducted at each of the sample health facilities. A total of 120 782 valid questionnaires were collected from 144 non-psychiatric health facilities, 16 246 valid questionnaires were obtained from 41 psychiatric health facilities, and 252 cases of outstanding departments/hospitals in healthcare improvement were also collected. The average overall scoring of the 12 dimensions to assess Initiative implementation at 144 non-psychiatric health facilities was 84.4%. The overall outpatient satisfaction scoring was 91.1%, 96.7%for the inpatients. The overall inpatient satisfaction(family members inclusive) at 41 psychiatric health facilities was 93%. Areas remaining to be improved include day-surgery, telemedicine and medical social work. Compared with technical services, non-technical care should be further strengthened. The compensation, workload and work environment of the healthcare providers are still to be improved. Conclusions The implementation of the Initiative by health facilities has been greatly improved. The percentage of health facilities and patients who had positive perceptions of improved doctor-patient relationship has been increasing. Patient care experiences at public hospitals have been generally improved, and the implementation of promoting traditional Chinese Medicine practices also made progress. However, work satisfaction of healthcare providers was found to be rather low, compared to the high level of patient satisfaction.