Objective To investigate the feasibility and outcome of resection and reconstruction of hepatic artery in hilar cholangiocacinoma (HCC).Methods The data of 29 patients with HCC with hepatic artery reconstruction carried out from March 2009 to August 2013 in our center were retrospectively analyzed.23 right hepatic arteries and 6 common hepatic arteries were involved.In-situ anastomosis was carried out in 20 patients and a double anastomosis using gastrodoudenal artery grafts was carried out in 9 patients.Results There were no arterial thrombosis or other related complications on prolonged follow-up.Conclusion Hepatic artery resection and reconstruction should be carried out if the artery was invaded by a hilar cholangiocarcinoma to produce a high resection rate and a better outcome.

Objective To summarize the clinical experience of hepatic artery bypass reconstruction using gastroduodenal artery in radical resection of hilar cholangiocarcinoma,and to provide assistance for surgeons applying artery reconstruction technique correctly in radical operation of hilar cholangiocarcinoma.Methods 9 cases of hilar cholangiocarcinoma with hepatic artery invasion wcrc subjected to radical resection combined with tumor invaded hepatic artery resection and reconstruction.Hepatic artery bypass reconstruction was performed by end-to end anastomosis,using the gastroduodenal artery interposition graft.The clinical data of these patients were reviewed retrospectively.Results All tumors of these cases with hilar cholangiocarcinoma were involved right hepatic artery,and the in volvement length was not less than 2 cm.The artery reconstruction was one-time successfully per formed in all cases.The median time required for anastomosis was (23.0±3.1) min.No postoperative complications,the dysfunction of gastrointestinal peristalsis or abnormal gastric drainage volume for example,related to the gastro-duodenal artery resection was observed.None of the patients devel oped any complications related to the arterial bypass reconstruction in the follow-up period,which was confirmed by abdominal CT scan.Conclusion Hepatic bypass reconstruction using gastro duodenal artery graft decreases the morbidity related to artery reconstruction and has little effect on gastrointes tinal function,which is the optimal choice for arterial reconstruction in radical operation for hilar cholangiocarcinoma.

Four weeks after SD diabetic rats were induced by streptozotocin,skin thickness was obviously reduced with obscure multilayer epithelium features.Moreover,the thickness of epidermic layers in diabetic rat skin was significantly thinner than that ofnornlal rat skin at the eighth week[(0.016±0.006 vs 0.041±0.007)mm,P<0.01].The percentage of G2/M phase cells in epidermic layers of diabetic group was significantly lower than that in the normal group.At the twelfth week,skin microangiopathy was easily detected in the diabetic group.The blood levels of advanced glycation end products(AGEs)and malonialdehyde were significantly increased and glutathione decreased in diabetic rats compared with control rats(aU P<0.01),along with the increased contents of local glucose and AGEs in the skin of diabetic rats.These results suggest that the local accumulation of glucose and AGEs seems to be one of the important mechanisms in the pathogenesis of diabetic skin lesions.

Objective To explore the clinical value and safety of early enteral nutrition support in patients after liver transplantation.Methods We retrospectively analyzed the clinical data of 86 cases who used early enteral nutrition support therapy after liver transplantation between January 2008and October 2011.All of patients were uproot the gastric tube at the first day after the operation,and gradual to the normal diet.The patients who used parenteral nutrition support therapy were as the control group(n＝112).Then we compared the data of patients in the two groups.Results The early enteral nutrition is more useful to the patients after liver transplantation than intravenous nutrition [In the seventh day after the operation,the control group's ALT was (45.2 ± 12.9) U/L,AST was (40.2±9.4) U/L,ALBwas (35.6±2.5) g/L,P＜0.05].The early enteral nutrition also can decrease hospital stay and hospital costs [(14.2±3.4) d,P＜0.05].Conclusion The early enteral nutrition is useful and safe to the patients after liver transplantation.

Objective To evaluate the diagnostic performance of plasma miR-499 in acute myocardial infarction (AMI) diagnosis.Methods Diagnostic accuracy test.The suspected AMI patients,who with chest pain for more than half an hour and been admitted in the Second People's Hospital of Wuxi and First People's Hospital of chuzhou during October 2010 and July 2011,were consecutively and prospectively enrolled in the present study.Sixty apparently healthy individuals were designed as healthy control.The plasma samples of the suspected AMI patients were collected within two hours after admission.The plasma miR-499 was determined by real time polymerase chain reaction (RT-PCR).The diagnostic performance of plasma miR-499 for AMI was estimated by receiver operating characteristic (ROC) curve analysis.The association between plasma miR-499 and AMI was analyzed by multivariable logistic model.The plasma miR-499 was determined and explained in blind fashion.Results Two hundred and nine suspected AMI patients,including 131 confirmed AMI patients (46 STEMI and 85 NSTEMI) and 78 AMI free patients were enrolled in the present study.The delta cycle threshold (ΔCT) was 1.01 ± 3.34 for AMI patients,-2.76 ± 2.90 for non-AMI patients and-3.79 ± 2.21 for healthy controls.The differences had statistical significance (x2 =96.77,P ＜ 0.01).The area under curve (AUC) of plasma miR-499 was 0.80 (95％ C I:0.74-0.86),lower than that of cardiac troponin Ⅰ (AUC =0.90,95％ CI:0.86-0.94) on admission (P ＜0.01).At the optimal cut-off of 0.18,the diagnostic sensitivity and specificity were 0.69 (95％ CI:0.61-0.77) and 0.77 (95％ CI:0.66-0.86),respectively.The coefficient of correlation between plasma miR-499 and cTnI was 0.72 (P ＜0.01).The odds ratio (OR) of plasma miR-499 ＞0.18 for AMI was 2.59 (95％ CI:1.10-6.07),after adjusted cTnI.Conclusions Plasma miR-499 is a useful biomarker for AMI diagnosis.It can provide additional diagnostic information beyond cTnI.Combination utility of plasma miR-499 and cTnI may improve the diagnostic accuracy for AMI.

Objective:To explore the relationship between vesicular monoamine transporter 2(VMAT2) density in the striatum and the non-motor symptoms(NMSs) in patients with Parkinson′s disease(PD).Methods:From December 2018 to December 2019, 29 normal controls (16 males, 13 females, age: (48.8±14.2) years), 31 patients with PD at the Hoehn-Yahr (mH-Y) Ⅱ stage (16 males, 15 females, age: (53.4±8.5) years) and 36 patients with PD at mH-Y Ⅲ stage (19 males, 17 females, age: (63.1±8.2) years) in the First Affiliated Hospital of Sun Yat-sen University were prospectively enrolled in this study. All subjects underwent 18F-fluoropropyl-(+ )-dihydrotetrabenazine( 18F-FP-(+ )-DTBZ, 18F-AV133) PET/CT imaging, then the specific uptake ratios (SURs) of striatal subregions were measured with the occipital cortex as the reference background region. The clinical data, laboratory data and imaging results were collected. The NMSs of each patient were evaluated with Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), Parkinson′s Disease Sleep Scale (PDSS), Montreal Cognitive Assessment (MoCA), Parkinson′s Disease Quality of Life Questionnaire (PDQL) and Non-Motor Symptoms Scale (NMSS). The independent-sample t test and one-way analysis of variance (the least significant difference t test) were used to compare data differences. Finally, the association of the striatal SURs with the clinical symptom scores were evaluated with Pearson correlation analysis and multivariable stepwise regression analysis. Results:Significant differences were found in depression (3.51±1.34 vs 11.36±3.87), anxiety (2.35±1.45 vs 6.00±3.32), sleep disorder (132.90±12.26 vs 110.34±19.69) and life quality (7.58±3.37 vs 24.01±10.15) scores between the mH-Y stage Ⅱ and the stage Ⅲ patients ( t values: from -10.573 to 5.439, all P<0.05), while cognitive scores did not differ significantly between the 2 PD groups ( t=1.067, P>0.05). Compared with healthy control group (1.28±0.22), the PD groups displayed a more marked decrease of SURs in the bilateral putamen and in the caudate nucleus (0.65±0.16 and 0.31±0.14; F=83.11, P<0.05), and the SURs of patients at stage Ⅱ were higher than those of the patients at stage Ⅲ ( t=9.116, P<0.05). NMSs scores of PD patients, with the exception of cognition scores, were correlated with striatal SURs ( r values: from -0.647 to -0.426, all P<0.05). Regression analysis showed that total striatum SURs was the best predictor of PDSS and NMSS scores ( R2 values: 0.234, 0.378, both P<0.001), while contralateral caudate nucleus SURs were best predictor of HAMD scores ( R2=0.402, P<0.001). The SURs of contralateral putamen were best variables for predicting HAMA scores ( R2=0.204, P<0.001). Conclusion:The correlation between the decreased striatal VMAT2 and a broad spectrum of NMSs in patients with PD is established, suggesting that the defect in dopamine supply may be an early abnormality promoting mechanisms leading to the development of NMSs in PD.

Objective:To investigate the mechanism of depression between social capital and cognitive function of the elderly in nursing institutions, and provide new ideas for improving the cognitive function of the elderly.Methods:This study was a cross-sectional survey. Using the convenient sampling method to collect the general information questionnaire, the Geriatric Depression Scale (GDS), Social Capital Scale and Montreal Cognitive Assessment Scale (MoCA) of 218 elderly people from three elderly nursing institutions including Shenyang Health Care Centre, Songpu Nursing Home and Colourful Sunshine City Pension Service Centre in Shenyang from July 2020 to January 2021.Results:A total of 218 questionnaires were distributed and 202 valid questionnaires were recovered. The effective recovery rate was 92.7%. The scores of the cognitive function, depression and social capital of the elderly were (23.60 ± 4.25), (6.38 ± 4.35) and (75.41 ± 8.61). Depression scores were negatively correlated with social capital scores and cognitive function scores ( r = - 0.401, - 0.481, both P<0.05); there was a positive correlation between social capital scores with cognitive function scores ( r = 0.338, P<0.05). There was a mediating effect of depression between social capital and cognitive function, accounting for 42.1%. Conclusions:While improving the cognitive function of the elderly in nursing institutions by improving the level of social capital, it is necessary to pay attention to the mediatingeffect of depression, strengthen the psychological counseling of the elderly, promote mental health, and further reduce the occurrence and development of cognitive decline in the elderly.

Objective To determine the acceptance and willingness to pay for breast cancer screening among populations at high risk of breast cancer in urban China. Methods From 2012 to 2014, a cancer screening program in urban China (CanSPUC) was carried out in 13 provinces. The current survey was conducted among participants who were evaluated as having"high?risk for breast cancer"using a Harvard model (community?based) and then underwent breast mammography or ultrasonography screening procedure (hospital-based). The study mainly focused on their acceptance and willingness to pay under certain self?payment assumption for breast cancer screening. Results A total of 3 049 participants, with a mean age of 52.4±7.0 years, were included. The group aged 45 to 55 years accounted for 50% of the patients, and the median annual income per capita in the recent 5 years was 22 000 (15 000-34 000) Chinese yuan (CNY). Educational level, occupation, and marital status may affect their full acceptance and voluntary payment (P<0.05). Of all the participants, 99% (3 016 participants) could totally or substantially accept the breast cancer screening. When the breast cancer screening was assumed to be conducted every 3 years in the low?cost self?paid context, 85% (2 581 participants) of the participants had the willingness to pay, while only 17% were willing to pay >100 CNY. The remaining 15% of the residents showed no willingness to pay, and the unaffordable expenditure (70%, 438 participants) and unnecessary screening (24%, 112 participants) were the primary considerations. Significant differences in acceptance, willingness to pay, and payment were found among the provinces. Conclusion Almost all high?risk populations for breast cancer could accept breast cancer screening. The willingness to pay was relatively high, but the amount of payment was limited and low.

In China, the survival rate of liver cancer remains low while the mortality rate is high. Effectively reducing the burden of liver cancer is still a major challenge in the field of public health and chronic disease prevention in the Chinese population. Optimizing screening strategies for liver cancer remains a profound approach to secondary prevention worthy of continuous explora-tion. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated the guideline develop-ment and convened a multidisciplinary expert panel and working group. Following the World Health Organization Handbook for Guideline Development, this guideline integrated the most up-to-date evidence of liver cancer screening, China′s national conditions, and existing practical experience in liver cancer screening. Evidence-based recommendations on the target population, screening technologies, surveillance strategies, and other key points across the process of liver cancer screening and surveillance management were provided. This guideline would help to standardize the practice of liver cancer screening in China.

Adolescent ; Adult ; Female ; Humans ; Liver Neoplasms ; diagnosis ; surgery ; Male ; Retrospective Studies ; Sarcoma ; diagnosis ; surgery ; Young Adult