Objective To investigate the nutritional risk,malnutrition rate,and nutritional support in elderly inpafients with hepatobiliary diseases.Methods Totally 156 eldedy inpatients(≥65 years)with hepatobiliary diseases were consecutively enrolled.Nutritional Risk Screening 2002(NRS 2002)was applied to screen nutritional risks on the next morning after admission and two weeks after admission or on the discharge day.Results Of 156 enrolled patients,151 patients(96.8%)completed the NRS 2002 screening.The nutrition risk and malnutrition rate were 36.9%(57/156)and 26.2%(41/156),respectively.The nutrition risk and malnutrition rate were significantly higher in patients with a hospital stay longer than 2 weeks than those with a hospital stay less than 2 weeks(49.6%and 36.7% vs.37.3%and 21.4%,respectively)(both P<0.05).In addition,100 patients(64.1%)with nutrition risk received nutrition support and 27 patients(17.3%)without nutrition risk received nutrition support.Among patients who had undergone major abdominal surgeries,137 patients(87.9%)with nutrition risk received nutrition support while 57 patients(36.8%)without nutrition risk received nutrition support.Conclusions NRS 2002 is a feasible nutritional risk screening tool for elderly inpatients with hepatobiliary diseases.A hospital stay more than 2 weeks the morbidity of the nutritional risk and malnutrition rate increased.Seems the value of nutritional support has not been well recognized in the department of hepatobiliary surgery,inappropriate application of nutritional support still exists.

Objective To investigate the risk of falling and nutritional status in elderly surgical patients,and to assess the correlation between them.Methods Patients aged ≥65 in Department of General Surgery of Beijing Hospital between January and June 2015 were enrolled in this study.The Morse Fall Scale was used to evaluate the risk of falling.Anthropometrics,body composition,and Nutritional Risk Screening 2002 (NRS 2002) scores were collected to evaluate the nutritional status of the patients.The correlation between risk of falling and nutritional status was analyzed.Results A total of 383 patients were included,including 314 cases under 80 (65-79 years) and 69 cases ≥ 80.Patients ≥ 80 years showed significantly lower grip [(24.53 ± 8.09)kgvs.(30.57 ±8.48)kg,P＜0.05] and4-meter gait speed [(0.66 ±0.19)m/s vs.(0.84 ± 0.20) m/s,P ＜ 0.05],but significantly increased undemutrition [15.9％ (11/69) vs.7.0％ (22/314),P ＜ 0.05] and nutritional risk [56.5％ (39/69) vs.38.2％ (120/314),P ＜0.05].Altogether 33.9％ of the patients (130/383) were at high risk of falling,and the prevalence was significantly higher in patients ≥80 than in patients ＜ 80 [44.9％ (31/69) vs.31.5％ (99/314),P =0.036].Compared with patients not at high risk of falling,high-risk patients had lower body mass index [(22.33 ± 1.82) kg/m2 vs.(23.76 ± 3.26) kg/m2] and grip [(24.95 ± 8.56) kg vs.(30.72 ± 8.39) kg],but higher prevalence of nutritional risk [46.9％ (61/130) vs.38.7％ (98/253)] (all P＜0.05).Conclusions Eldedy surgical patients have a high risk of falling,which may be related with their nutritional status.Nursing and nutrition intervention should be emphasized in there patients to prevent falling and improve clinical outcome.

Objective To explore the value of enhanced T2 star weighted angiography(ESWAN)in the treatment of uterine fibroids with high intensity focus ultrasound(HIFU) by analyzing the changes of ESWAN. Methods Uterine fibroids were detected through pelvic conventional MRI and ESWAN 1 day before and after HIFU operation. Different indexes of ESWAN were measured ,and differences were compared with the paired t-test. Results The preoperative and postoperative values of magnitude were 1624.59 ± 53.07 and 1750.13 ± 39.81, phase values were 0.0012 ± 0.0081 Hz and 0.0025 ± 0.1063 Hz,R2*value were 27.69 ± 1.27 Hz and 24.19 ± 1.20 Hz,and T2*values were 34.66 ± 2.07 ms and 36.46 ± 2.14 ms. After HIFU operation,magnitude value,phase value and T2*value were higher(P=0.04,P=0.91 and P=0.45),and R2*value was lower(P=0.019). Conclusions ESWAN can provide more information about histopathologic changes of uterine fibroids after HIFU.

Objective To characterize the clinical manifestations, laboratory findings of patients with occult sys?temic malignant neoplasms, whose initial manifestation presented as multiple acute cerebral infarcts including coagula?tion function,radiological imaging and microembolic signals (MES) detection by transcranial Doppler sonography (TCD) and to explore the possible underlying mechanisms. Methods All clinical records, laboratory hematological tests includ?ing hypercoagulable states measured by D-dimer levels, brain MRI including DWI, and TCD monitoring MES, the treat?ment and prognosis were retrospectively reviewed in 12 patients with multiple acute cerebral infarcts as the first manifes?tation of occult systemic malignancy. Results The clinical manifestations presented as localized neurological dysfunction, e.g. hemiparesis, aphasia, hemiparesthesia, dysarthria, vertigo and seizures, etc. DWI revealed multiple disseminated acute cerebral infarcts in multiple arterial territories such as the bilateral anterior or anterior plus posterior cerebral circu?lation in all patients. Eleven of 12 patients tested had elevated D-dimer. TCD detected MES in 5 of 7 patients. There were 12 patients diagnosed with occult systemic malignancy including 5 lung cancer, 3 pancreatic cancer, 1 gastric can?cer, 1 colon cancer, 1 endometrial adenocarcinoma and 1 metastatic poorly differentiated mucinous adenocarcinoma with unknown primary. Ten patients already had remote metastasis at diagnosis. The prognosis was usually poor and there were 7 cases with ischemic stroke recurrence, 4 cases with acute myocardial infarction, 3 cases died during hospitaliza?tion. Conclusions When patients present with multiple disseminated acute cerebral infarcts involving multiple arterial territories as initial manifestation, the underlying occult systemic malignancy should be considered. Hypercoagulopathy and MES might provide the clues to the diagnosis.

Objective To investigate the clinical features and TCD-detected microembolic signals in patients with hypercoagulability related multiple acute cerebral infarcts within non-single arterial territories, and to explore the possi?ble underlying mechanisms. Methods A retrospective review was conducted on all clinical, laboratory, radiological and TCD monitoring records from patients with hypercoagulability related multiple acute cerebral infarcts within non-single arterial territories, who admitted to the neurology department in our hospital. Results The data from twenty-two cases were finally included in this study. All patients presented with acute-onset localized neurological dysfunction, e.g. hemi?paresis, aphasia, hemiparesthesia, dysarthria, hemianopsia and cortical blindness. Their hypercoagulability related diseas?es included 10 cases of systemic malignancy, 5 moderate to severe hyperhomocystynemia (HCY>50μmol/L), 2 nephrot?ic syndrome, 2 antiphospholipid syndrome, 1 ulcerative colitis, 1 polycythemia vera,1 paroxysmal nocturnal hemoglobin?uria. In 18 cases, the hypercoagulability related diseases were diagnosed after their initial stroke onset. DWI showed mul?tiple disseminated acute cerebral infarcts in non-single arterial territories involving bilateral anterior or anterior plus pos?terior cerebral circulation simultaneously. Foci involved lobar cortex/subcortex of cerebral hemisphere in 22 cases, deep cerebral hemisphere in 12 cases, cerebellum foci in 10 cases,brainstem foci in 2 cases. TCD revealed microembolic sig? nals in ten of 22 patients monitored. Conclusions Patients with multiple acute cerebral infarcts involving non-single arte?rial territories, should be screened for hypercoagulability as in that hypercoagulability and microembolism might be in?volved in the etiology of cerebral infarction.

OBJECTIVETo study the efficacy of hepatitis B immunoglobulin (HBIG) combining hepatitis B vaccine in high risk infants born to HBsAg positive mothers through a follow-up study program.

METHODS184 infants (4 twin pairs) born to HBsAg carrier mothers who were consecutively recruited from December 2002 to August 2004 were followed. Major HBV serologic markers in all infants were detected by enzyme-linked immunosorbent assay (ELISA) when they were at birth, at 7th, at 24th and at 36th months.

RESULTS7 of the 184 infants were HBsAg positive at birth, making the transplacental intrauterine infection rate of HBV as 3.80% (7/184). 125 infants were followed up at 7th months and 108 infants were followed up at 24th and 36th months. Only 2 of the 7 infants born to HBsAg-positive and HBeAg-positive mothers were persistently sera positive for HBsAg, making the chronic infection rate of HBV as 28.57%. The other 140 infants were HBsAg negative during t he follow-up period. The rate o f detectable anti-HBs i ninfants was 7.02% at birth. After infants were immunized by HBIG combining hepatitis B vaccine, the anti-HBs-positive rate reached 92% at 7th months, and gradually descended thereafter. 72.04% of the infants at 24th and 60% at 36th months showed detectable levels of anti-HBs. There was significant correlation between the produce of anti-HBs in infants and HBsAg-positive at birth while HBsAg-positive and HBeAg-positive in mothers did not relate to the produce of anti-HBs in their infants. Of 39 infants born to HBsAg-positive and HBeAg-positive mothers, 25 showed detectable levels of HBeAg. During the follow-up peirod, HBeAg was still detectable in 2 infants who were also HBsAg positive and the others all became HBeAg-negative but no infant became HBeAg-positive.

CONCLUSIONThe efficacy of HBIG combining hepatitis B vaccine in high risk infants was fine.

Adult ; Enzyme-Linked Immunosorbent Assay ; Female ; Follow-Up Studies ; Hepatitis B Antibodies ; immunology ; Hepatitis B Vaccines ; immunology ; therapeutic use ; Hepatitis B e Antigens ; immunology ; Humans ; Immunoglobulins ; immunology ; therapeutic use ; Infant, Newborn ; Pregnancy ; Young Adult

From June 1998 to May 2007, 9566 urine samples were collected from patients with psychomotor deficits, seizures, vomiting and unconsciousness in Peking University First Hospital. Their urine organic acids profiles were analysed using gas chromatography - mass spectrometry (GCMS), GCMS solution and Inborn Errors of Metabolism Screening System software. In all patients, blood acylcarnitines were analysed using tandem mass spectrometry. One hundred and sixty-eight patients (1.76%) with organic acidurias were detected. Among them, 116 (116/ 168, 69.0%) had methylmalonic aciduria, 63 (54.3%) of these 116 patients had methylmalonic aciduria combined with homocysteinemia. Sixteen (9.5%) of those patients detected with organic acidurias had propionic aciduria, and 15 (8.9%) had multiple carboxylase deficiency. Seven (4.2%) had glutaric aciduria type 1. After dietary treatment, medicine and rehabilitation, clinical improvements were observed in more than half of the patients. Twenty-eight of the 168 patients (16.7%) recovered and led a normal life. The method of urine organic acid analysis by gas chromatography - mass spectrometry and blood acylcarnitines analysis by tandem mass spectrometry have been established and applied successfully in China, namely Beijing, Shanghai, Wuhan and Guangzhou. The prognoses of Chinese patients with organic acidurias have also improved significantly.
Child ; Child, Preschool ; China ; Humans ; Infant ; Infant, Newborn ; Metabolic Diseases ; urine ; Methylmalonic Acid ; urine ; Multiple Acyl Coenzyme A Dehydrogenase Deficiency ; urine ; Propionic Acidemia ; urine

Objective To explore the diagnostic value of ESWAN in uterine fibroids by analyzing the ESWAN signal of uterine fibroid. Methods Conventional MRI and ESWAN were carried out in thirty-seven patients with uterine fibroids.The differences of ESWAN indexes between uterine fibroids and myometrium were analyzed by paired t-test.The value of ESWAN on diagnosing uterine fibroids was analyzed by receiver operating characteristic curve(ROC curve).Results The magnitude value,phase value,R2* value and T2*value of uterine fibroids were 1 661.69 ± 45.24,(0.006 7 ± 0.007 7)Hz,(26.69 ± 1.04)Hz and(34.68 ± 1.73)ms,respectively.The magnitude value,phase value,R2* value and T2* value of myometrium were 1 790.95 ± 49.04,(0.013 1 ± 0.011 8)Hz,(22.35 ± 0.84)Hz and(42.53 ± 2.16)ms.The magnitude value,phase value and T2* value of uterine fibroids were lower than those of myometrium (P=0.008,P=0.659 and P=0.002).While the R2* value of of uterine fibroids was higher than that of myometrium(P=0.001). The area under curve(AUC)of magnitude value,phase value,R2* value and T2* value were 0.604,0.553,0.666 and 0.662.Conclusion ESWAN can show the differences between uterine fibroids and myometrium ，while the ability to independently diagnose uterine fibroids was modest.

Radiotherapy is one of the most important components of cancer treatment. Image-guided radiotherapy (IGRT) is the mainstream tool in the precision radiation oncology. Magnetic resonance (MR) accelerator can perform MRI for tumors during radiotherapy, deliver real-time tracing and monitoring of tumors and thus realize the MRI-guided adaptive radiotherapy. Here, the latest research status and clinical application of MR accelerator in lung cancer were reviewed.

Aim Human TMPRSS2 is a transmembrane serine protease.In this paper, the structure and func¬tion of the protein were systematically analyzed by bioinformatics, the codon was optimized and the pro- karvotie expression vector was constructed to explore the molecular mechanism of SARS-CoV-2 infecting host cells.Methods The recombinant expression vector pET-22b-TMPRSS2 was generated by molecular clo¬ning technology.The homology, functional sites, sub¬cellular localization, three-dimensional structure and evolutionary characteristics of TMPRSS2 protein were systematically analyzed by using analytical tools such as Protparam, NetPhos3.1, Blast, Clustal X2 and MEGA7.0.Results The prokarvotic expression plas- mid was constructed correctly; TMPRSS2 belongs to medium molecular weight protein, which is composed of 492 amino acid residues.The theoretical isoelectric point is 8.12, the molecular extinction coefficient is 118 145 L • mol~1 • cm"1 , and the half-life is 30 h; TMPRSS2 has 15 potential glycosylation sites and 49 possible phosphorylation sites.It is a transmembrane hydrophilie protein without signal sequenee.In addi¬tion, the protein has 13 potential B-cell epitopes and 7 T-eell epitopes.Seeondarv structure analysis showed that random coil accounted for the highest proportion of TMPRSS2 protein ( 0.453 3) , followed by extended strand (0.252 0).Sequence comparison and evolu¬tionary analysis showed that the highest sequence con¬sistency and closest genetic relationship with human TMPRSS2 was Pan troglodytes, followed by gorilla.Conclusions Human-derived TMPRSS2 protein is ev- olutionarilv conserved and functionally important.Hie results of this study can help to reveal the structure and mechanism of action of TMPRSS2 protein, provide ide¬as for the diagnosis and treatment of COYID-19, and accelerate the research and development process of new drugs targeting TMPRSS2 protein.