Objective To evaluate the effects of branched-chain amino acids-enriched early parenteral and enteral nutrition on the liver function and serum aminograms in cirrhotic rats after partial hepatectomy. Methods In this prospective randomized controlled study, 24 cirrhotic rats, induced by thioacetamide, were randomized into three groups: enteral nutrition (EN) group, EN + branched-chain amino acid (BCAA) group, and parenteral nutrition (PN) + BCAA group. After receiving partial hepatectomy, rats in all three groups were nutritionally supported with equal amount of calorie and nitrogen contents from the 1st postoperative day ( PO day 1 ) to PO day 5. On PO day 6, parameters including body weight, liver functions, prealbumin, transferring, and serum aminograms were measured or determined, and the level of liver albumin mRNA was detected by reversal transcription-polymerase chain reaction and morphological examinations such as HE staining and immunohistochemical staining, which were assessed by index of Ki67 protein index. Results Body weight was significantly decreased in all three groups on PO day 6 (P ＜0.05 ). Compared with EN + BCAA group, serum aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase after partial hepatectomy were significantly higher in PN + BCAA group (P ＜0.05 ). Serum alkaline phosphatase level was significantly higher in PN + BCAA group than in EN group ( P ＜0. 05). The level of prealbumin was significantly lower in PN + BCAA group when compared with EN group or EN +BCAA group ( both P ＜ 0. 05 ), although no such significant difference was noted in terms of transferrin ( P ＞0. 05 ). The levels of leucine and isoleucine elevated while those of tyrosine, phenylalanine, arginine and tryptophan declined in PN + BCAA group or EN + BCAA group when compared with EN group ( P ＜ 0. 05 ). Aminograms were not significantly different between EN + BCAA group and PN + BCAA group ( P ＞ 0. 05 ). Levels of total amino acid and aromatic amino acid (AAA) were significantly lower while BCAA and ratio between BCAA and AAA (BCAA/AAA) were significantly higher in PN + BCAA group or EN + BCAA group than in EN group (P ＜ 0. 05 ).Significantly lower level of albumin mRNA and index of Ki67 were observed in PN + BCAA group than in EN group or EN + BCAA group (P ＜ 0.05 ) on PO day 6. Conclusions BCAA-enriched EN or PN reverses amino acid disequilibrium and restores BCAA/AAA in cirrhotic rats after partial hepatectomy. Compared with PN, EN is superior in improving postoperative liver function, promoting protein synthesis, and speed up tissue regeneration in the postoperative liver. However, it still can not restore serum albumin in a short term.

Objective To explore a novel long-circulating dual-receptor targeting and dual-modal molecular probe and investigate its physicochemical properties and targeting effect on breast cancer cells in vitro. Methods Dual-receptor targeting and dual-modal molecular probe RGD@BBN-lipo(QDs)-SPIO was synthesized in the following steps: long-circulating liposome was prepared by film dispersion method;water-soluble superparamagnetic iron oxide (SPIO) nanoparticles and Quantum dots (QDs) were loaded in the hydrophilic and hydrophobic layer of liposome, respectively;RGD and BBN polypeptides were coupled on the former functional magnetic/fluorescent liposomes. Stability of the probe in different physiological solutions was investigated. Transmission electron microscopy (TEM) and particle size analyzer were used to measure nanoparticle sizes and the Zeta potential. Characterization of RGD and BBN was investigated through 1H-NMR and elemental analysis. The MRI T2 relaxivities (1/T2) of RGD@BBN-lipo(QDs)-SPIO was measured through T2 map scanning on 3.0 T MR system. HUV-EC-C cells were used for assessment of cells viability by MTS assay. Prussian blue staining and fluorescence imaging were carried out to determine the targeted breast cellular uptake of RGD@BBN-lipo(QDs)-SPIO nanoparticles. Results The targeting magnetic/fluorescent dual-model molecular probes appeared spherical or para-spherical,with a mean diameter of(118.2±3.9)nm,Zeta potential of (-24.78±1.68) mV,MR T2 magnetic relaxation rate of 0.498 1× 106 M-1 · s-1.RGD and BBN polypeptides were successfully coupled on the former functionally magnetic/fluorescent liposomes with the bind rates of 33.05%and 45.06%, respectively. There was low cytotoxity of the molecular probe on human umbilical vein endothelical cells(HUV-EC-C)by MTS study. Prussian blue staining and fluorescence imaging studies showed that the RGD@BBN-lipo(QDs)-SPIO nanoparticles could target any αvβ3 or gastrin releasing peptide receptor overexpression breast cancer. Conclusions RGD@BBN-lipo(QDs)-SPIO is a novel long-circulating dual-receptor targeting and dual-modal molecular probe and has excellent physicochemical properties and stability, high T2 relaxivities and strong targeting effect on cancer cells and has laid a solid foundation for early diagnosis of breast cancer.

Objective To investigate the effects of ω-3 fatty acids on inflammation and coagulation function in hepatocellular carcinoma (HCC) patients after partial hepatectomy.Methods In this prospective randomized controlled trial,80 HCC patients were randomly divided into two groups based on the parenteral nutrition (PN) scheme that was provided 5 days after partial hepatectomy:fish oil group:20％ fish oil and 80％ mediumlong fatty acid; and control group:100％ medium-long fatty acid.The inflammation,liver function,blood coagulation indicators,and prognosis were compared between two groups.Results After 3 days of hepatectomy,the serum C-reactive protein levels in the control and fish oil groups were (119.6 ± 57.3) mg/L and (97.1 ± 46.1) mg/L(P =0.016),respectively; and on day 6 after surgery,C-reactive protein levels of two groups were (54.9 ± 26.1)and (40.7 ±21.8) mg/L,respectively (P =0.018).The plasma fibrinogen level in the fish oil group was significantly lower than that in the control group 3 days [(3.4 ± 1.1) vs.(4.1 ± 1.3) g/L,P ＜ 0.001] and 6 days [(3.3 ± 0.9) vs.(3.8 ± 1.2) g/L,P ＜ 0.001] after surgery.The retention rate of indocyanine green at 15 minutes on the 7th postoperative day were 8.6％ ±4.9％ and 9.2％ ±7.3％ in the control and fish oil groups,respectively (P=0.179).The recurrent rate (40.63％ vs.44.12％,x2 =0.082,P =0.774) and survival rate in the fish oil and control groups (90.62％ vs.88.24％,x2 ＜0.001,P =1.000) also showed no significant difference after 6 months of follow-up.Conclusion ω-3 fish oil emulsion can reduce postoperative inflammatory response and prevent thrombosis.

Objective To analyze the specimen types,ward distribution and risk factors for infections caused by extended-spectrum β-lactamase(ESBLs)-producing-Escherichia coli(ECO) in recent two years,so as to provide bacteriological basis for both hospital infection control and clinical anti-infection treatment.Methods Non-repetitive 443 ECO strains isolated from the hospitalized patients in the Third People′s Hospital of Shenzhen were collcted,and the phoenix100 system was employed for bacterial identification and antimicrobial susceptibility tests.ESBLs-ECO was further confirmed by the double-disk synergy test,and the risk factors caused ESBLs-ECO were statistically analyzed.Results A total of 115 strains of ESBLs-ECO were identified among the 443 strains of ECO,which accounted for 26.0%.The ESBLs-ECO strains were mainly isolated from the sputum,urine,and blood specimens.Among the isolated ESBLs-ECO strains,20.9% were isolated from the department of Tuberculosis,13.9% from the department of pediatric,12.2% from the department of live disease,and 8.7% from the department of infection.The male sex,surgery and use of the third generation cephalosporins were independent risk factors of ESBLs-ECO infection.Conclusion The isolation rate of ESBLs-ECO in this hospital is high.It is necessary for the hospital to strengthen the control of nosocomial infections according to the risk factors.More attention should be payed on male patients,the standardization of surgical operation and disinfection,and the restriction of using the third generation cephalosporins,so as to reduce the incidene of ESBLs-ECO infections.

Based on the reported IDO1 inhibitor U-3i,11 phenylsulfonamide derivatives were designed and syn-thesized by adopting bioisosterism and molecular docking technology.The inhibitory activities of the target compounds against IDO1 were determined by the HeLa cell-based kynurenine assay.The results demonstrated that most compounds showed different degrees of inhibitory effects on IDO1.Among them,compounds 3b and 3e displayed the most potent activity and could reverse IDO1-mediated immune suppression,which might be worth of further investigation.

Objective To explore the long-term prognosis and influence of social support and coping style of patients with post-traumatic stress disorder (PTSD) after suffering from floods.Methods Patients suffered PTSD due to Dongting lake flood in 1998 were selected through cluster random sampling.PTSD scale civilian version (PCL-C) was used to examine and diagnose the participants in this study.PTSD was then evaluated by the social support rating scale (SSRS) and the simple coping style questionnaire (SCSQ).Results Among all the 120 subjects,14(11.67％) of them were diagnosed as having PTSD.Compared with the rehabilitation group,scores on subjective support,objective support,total social support and positive coping,total of coping style from the nonrehabilitation group all appeared significant low (P＜0.05).Data from the multivariate logistic regression showed that social support (OR=0.281,95％CI:0.117-0.678) and coping style (OR=0.293,95％ CI:0.128-0.672) were protective factors of the chronic PTSD after the floods while disaster experience (OR=1.626,95％CI:1.118-2.365) appeared as a risk factor.Conclusion Chronic PTSD developed after the floods called for attention.Better social support,positive coping style could significantly improve the long-term prognosis of patients with PTSD after the floods.

Comprehensive improvement in course teaching quality is an important link in deepening the reform of undergraduate education and teaching. Since 2018, West China Medical School, Sichuan University, has implemented the collective lesson preparation system of "two meetings, seven decisions, and three preparation sessions" for undergraduate clinical courses, thereby effectively implementing subject cooperation, organizational guidance, and resource integration among clinical teachers and determining the key elements of the course through "teaching, learning, and exam preparations" before class. In the process of course operation, the concept of quality control based on plan-do-check-act cycle is deeply integrated with the collective lesson preparation system, and active implementation of the whole-process quality control loop of planning (plan), organization and implementation (do), inspection of results (check), and treatment and improvement (action) has effectively improved the teaching quality of undergraduate clinical courses.

Objective: To investigate the relationship between clinical parameters related to acute bacterial dysentery and other infectious diarrhea in adults. Methods: From April to October 2018, 70 patients with clinical diagnosis of acute bacterial dysentery, 180 patients with clinical diagnosis of infectious diarrhea and 399 patients with diarrhea to be examined were investigated retrospectively. The collected data included gender, age, time from onset to treatment, maximum body temperature, main symptoms, epidemiological history, blood routine, C-reactive protein and stool routine. Analysis of these clinical factors related to acute bacterial dysentery and other infectious diarrhea. Results: A total of 70 patients with acute bacterial dysentery, 180 patients with other infectious diarrhea and 399 patients with diarrhea of unknown origin were investigated. The positive rate of epidemiology in the three groups was statistically significant (P<0.05); the age of onset of bacterial dysentery was younger than that in patients with diarrhea of unknown origin (P<0.05). Compared with the other two groups of patients, the onset to visit time was earlier, the number of vomiting was higher, the incidence of fever and tenesmus was higher, and the levels of white blood cells, neutrophils and C-reactive protein were significantly increased (P<0.05). Conclusions Patients with acute bacterial dysentery, other infectious diarrhea, and diarrhea of unknown origin have some differences in epidemiological history, age at onset, clinical manifestations, and laboratory tests.

OBJECTIVE: To assess the value of fluorescence in situ hybridization (FISH) technique for the verification of the clonalities of non-clonal cytogenetic abnormalities (n-CCA) identified by conventional chromosome banding analysis (CBA) in patients with Myelodysplastic syndrome (MDS). METHODS: Clinical data and results of karyotyping and FISH assays for 91 patients of MDS with n-CCA identified by CBA were retrospectively analyzed. In total 94 non-clonal +8, 5q-, -7/7q- or 20q- were detected by CBA, among which 43 (45.7%) were verified to be clonal abnormalities by FISH. RESULTS: The detection rates for +8, 5q-, -7/7q- and 20q- by FISH were 47.6% (30/63), 25% (2/8), 41.7% (5/12), 40% (2/5) and 66.7% (4/6), respectively, with the positive cells accounting for 4% to 90% of all counted cells, with a median value of 7%. The 91 patients were divided into three groups including ≥ 20, 10 ~< 20 and < 10 based on the numbers of metaphase cells in CBA, and the detection rates by FISH for the three groups were 43.7% (31/71), 33.3% (3/9) and 63.6% (7/11), respectively, which showed no statistically difference (P > 0.05). Continuous CBA and FISH surveys were conducted for 26 patients who received supportive treatment, and the results revealed that 91.7% (11/12) of FISH-verified positive abnormalities had persisted, whereas 92.9% (13/14) of the n-CCA verified as negative by FISH was transient. CONCLUSION Nearly half of the CBA identified n-CCA have been verified as clonal aberrations by FISH, and the FISH detection rate showed no correlation with the number of metaphase cells. FISH test is strongly recommended for verifying the clonalities of n-CCA detected by CBA, and continuous cytogenetic survey of the patients with MDS is necessary.
Humans ; In Situ Hybridization, Fluorescence ; Retrospective Studies ; Chromosome Aberrations ; Karyotyping ; Myelodysplastic Syndromes/genetics*

Background/Aims: The accuracy of endosonographers in diagnosing gastric subepithelial lesions (SELs) using endoscopic ultrasonography (EUS) is influenced by experience and subjectivity. Artificial intelligence (AI) has achieved remarkable development in this field. This study aimed to develop an AI-based EUS diagnostic model for the diagnosis of SELs, and evaluated its efficacy with external validation. Methods: We developed the EUS-AI model with ResNeSt50 using EUS images from two hospitals to predict the histopathology of the gastric SELs originating from muscularis propria. The diagnostic performance of the model was also validated using EUS images obtained from four other hospitals. Results: A total of 2,057 images from 367 patients (375 SELs) were chosen to build the models, and 914 images from 106 patients (108 SELs) were chosen for external validation. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the model for differentiating gastrointestinal stromal tumors (GISTs) and non-GISTs in the external validation sets by images were 82.01%, 68.22%, 86.77%, 59.86%, and 78.12%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in the external validation set by tumors were 83.75%, 71.43%, 89.33%, 60.61%, and 80.56%, respectively. The EUS-AI model showed better performance (especially specificity) than some endosonographers.The model helped improve the sensitivity, specificity, and accuracy of certain endosonographers. Conclusions We developed an EUS-AI model to classify gastric SELs originating from muscularis propria into GISTs and non-GISTs with good accuracy. The model may help improve the diagnostic performance of endosonographers. Further work is required to develop a multi-modal EUS-AI system.