OBJECTIVE To observe the clinical efficacy and safety of camrelizumab combined with sorafenib in the treatment of advanced liver cancer. METHODS Sixty patients with advanced liver cancer who were treated in our hospital from March 2020 to November 2021 were selected as the study subjects， and then were randomly divided into study group and control group， with 30 cases in each group. The control group was treated with Sorafenib tosylate tablets orally （0.4 g，bid）， and the study group was additionally given Camrelizumab for injection intravenously （200 mg， every 3 weeks） based on the control group； for all patients， the treatment was stopped until disease progression or intolerable side effects occurred. The clinical efficacy， progression-free survival （PFS）， total survival （OS） and 1-year survival rate of the two groups were compared， and the incidence of adverse reactions in two groups， and immune-related adverse reactions in the study group during treatment were recorded. RESULTS The objective remission rate of the study group was significantly higher than the control group （36.7% vs. 13.3%， P＜0.05）， and the median OS and median PFS were significantly longer than the control group （OS： 12.6 months vs. 7.9 months； PFS： 8.2 months vs. 5.3 months， P＜0.05）. There was no significant difference in the 1-year survival rate and the incidence of elevated aspartate aminotransferase and alanine aminotransferase， rash or pruritus， anorexia， diarrhea， fatigue and hypertension between the two groups （P＞0.05）. The adverse events immune-related in the study group mainly included 21 cases of reactive capillary hyperplasia （70.0%）， 6 cases of hypothyroidism （20.0%）， and 1 case of immune-associated pneumonia （3.3%）， which were improved or tolerable after symptomatic treatment. CONCLUSIONS Camrelizumab combined with sorafenib in the treatment of advanced liver cancer can effectively control and delay the disease progression， prolong the survival period of patients， and the adverse reactions can be tolerated.

Objective To investigate the CT features of hepatic mesenchymal hamartoma (HMH)in children.Methods Nine patients with HMH confirmed by postoperative pathology were enrolled,including 4 were males and 5 were females.Their age ranged from 3 days to 9 years 5 months (the median age was 7 months).All patients admitted due to palpable abdominal mass without jaundice.All patients were examed by contrast-enhanced CT before the operation.Results All the 9 cases showed solitary hepatic mass,among which 6 were in the right lobe,2 were in the left lobe and 1 involved in both lobes.The tumor size ranged from 7.0 to 22.5 cm (mean size was 13.5 cm) in diameter.The CT manifestations of HMH was related to the proportion and distribution of component in the masses.The masses were cystic (n =1),cystic-solid mixed (n =6) and solid (n =3).After contrast administration,the solid component and the septa of the mass showed enhancement while cystic component was not enhanced.Calcification was seen inside the tumor in one case.Conclusions The CT features of HMH in children are multitudinous which are related to postoperative pathological findings.With the clinical history,it is easy to distinguish HMH from the other hepatic tumors.

Objective To investigate the effects and mechanisms of Alpinia oxyphylla fructus (AOF) on learning and memory in D-galactose induced brain aging mice. Methods The brain aging model was induced by s. c D-galactose. Learning-memory ability was tested by passive avoidance test and Morris water maze test, and the expression of synapsin ( Syn), mitogen-activated protein kinase (MAPK) and protein kinase ( PKC ) in hippocampus were examined by Western blot. Results ① Passive avoidance test:the latency in brain aging group( ( 119.80 ±101.80)s) significantly decreased,and the number of errors (4.4 ± 1.3 ) significantly increased compared with the control group( latency: (279.30 ± 31.64) s; number of errors: ( 1. 8 ±0.9), P＜0. 01 ) ). The latency in low dose, middle dose and high dose AOF group( ( 170.25 ± 68.31 ) s, (226.31 ± 73.25 ) s, (263.20 ± 70.55 ) s) significantly increased, and the number of errors in middle dose and high dose AOF group ( ( 2.8 ± 1.2 ), ( 2.3 ±0. 9 ) ) significantly decreased compared with brain aging group (P ＜ 0. 05, P ＜ 0. 0 1 ). ② Morris water maze test:the escape latency in brain aging group was significantly longer, and the time spent in the original quadrant that previously contained the platform was significantly shorter compared with the control group (P＜0. 01 ). The escape latency in 3 AOF groups was significantly shorter (P＜ 0. 05 ), and the time spent in the original quadrant that previously contained the platform in middle and high dose AOF groups was significantly longer compared with brain aging group (P＜0. 05, P＜0. 01 ). ③ Western blot test:the expression of Syn,MAPK and PKC in hippocampus of brain aging group was significantly weakened than that of the control group. In contrast, the expression of Syn,MAPK, PKC were significantly enhanced in all AOF groups. Conclusion AOF could significantly improve the ability of learning and memory in brain aging mice. Its effects might be related to the increase of the expression of Syn, MAPK and PKC in hippocampus.

Objective To investigate the CT features of hepatic focal nodular hyperplasia (FNH) in children.Methods Thirteen patients with FNH,which was confirmed by postoperative pathology,were enrolled retrospectively.Plain and contrast CT were performed on all patients before operation.The CT imaging features of FNH including size,shape,density,style of contrast were analyzed retrospectively and compared with pathology.Results There were 13 patients with 16 lesions,8 lesions were found in the right lobe,5 lesions in the left lobe and 3 lesions involving both lobes.The tumor size ranged from 5.5 cm to 11.5 cm (media size 7.5 cm) in diameter.Histologically,2 cases were typical type,11 cases were atypical type.The lesions were regular morphology in 12 cases and 1 case with capsule.On plain CT,the lesions were isodensity (n=1) or slightly low-density (n=12).In 2 typical type lesions,there were slit-like,stellate-shaped low density central scars.Arterial phase demonstrated that 12 cases were significantly enhanced and 1 case showed mild enhancement.The central scar was not enhanced.In 12 cases,thickened and torturous arteries were seen.The enhancement was reduced at the portal venous phase in all the lesions,with 10 cases showing slightly higher density,2cases isodensity and 1 case low-density.Two cases showed mild enhancement of the central scar.The enhancement of the solid portion in all lesions decreased at the delay phase,with 12 cases showing isodensity and 1 case slightly low density.Two cases with central scar showed delayed enhancement with slightly higher density.Conclusion The CT features of FNH in children are diversified but distinctive which are related with postoperative pathological findings.Combining with clinical symptoms and CT features can be helpful for the early diagnosis of FNH in children.

Objective: To analyze the differences between the social support for breast cancer patients and healthy female, and to explore the correlation between social support and quality of life (QOL) in the patients. Methods: From January 2013 to December 2014, 101 patients with operable breast cancer treated at Xinyu City People′s Hospital were recruited as the experimental group. They completed questionnaires in the preoperative, postoperative chemoradiotherapy and rehabilitation periods, respectively.101 healthy female volunteers recruited from the community were included as control group, whose age and level of education were matched with those of the experimental group.The general questionnaire including basic information, disease conditions and other projects, perceived social support scale (PSSS), quality of life of breast cancer patients (FACT-B) were applied to evaluate the general situation, social support and QOL of the subjects. The differences in PSSS scores between the experimental and control groups were compared. The correlation between PSSS score and FACT-B score in the experimental group was analyzed. SPSS 18.0 software was used for statistical analysis. Results: The general situations of the experimental and control groups were comparable (all P>0.05). The rates of the total social support score ≥50 in the experimental and control groups were not significantly different (93.6% vs. 94.7%, P=0.067). Compared with that of the control group (23.2±4.8), the scores of family support in the experimental group in preoperative, postoperative chemoradiotherapy and rehabilitation periods were statistically higher (25.6±3.2, 24.2±4.2 and 24.0±3.4, respectively, P=0.034). The social support scores of patients with different demographic characteristics were different. Among the demographic characteristics, years of education and place of residence had the largest impact. The scores of social support in patients with longer education years and living in the urban area were higher than those with shorter education years and living in the rural areas (P<0.001). The scores of QOL among preoperative, postoperative chemoradiotherapy and rehabilitation periods in the experimental group were significantly different (all P<0.05). The patients gained the highest score of QOL in the preoperative period (110.7±5.1) and the lowest in the postoperative chemoradiotherapy period (95.3±18.1). The QOL of patients in the experimental group in preoperative, postoperative chemoradiotherapy and rehabilitation periods were all positively correlated with the overall social support (all P<0.01). Conclusions The QOL of breast cancer patients at different periods of treatment is positively correlated with the social support. The quality of life can be enhanced by improving the social support for the patients.

OBJECTIVETo investigate the activity of ChE in rats poisoned by dimehypo and then treated with pralidoxime methylchloride or unithiol.

METHODRats were divided into control group (dimehypo); intervention groups [dimehypo plus pralidoxime methylchloride or dimehypo plus unithiol (sodium dimercaptopropanesulphonate)]. Rats were dosed with 4 different doses of dimehypo: 1/16, 1/8, 1/4 and 1/2 of LD50 respectively(the LD50 of dimehypo is 342 mg/kg). After being poisoned with dimehypo orally, rats were immediately injected intramuscularly with pralidoxime methylchloride or unithiol. The activity of ChE in blood was detected before and 1/2, 1, 2, 4 and 24 h after poisoning in dimehypo and intervention groups.

RESULTThe ChE activity of four dose subgroups at 1 h after poisoning were (1.04 +/- 0.21), (0.84 +/- 0.12), (0.71 +/- 0.12), (0.66 +/- 0.07) U/ml respectively; the ChE activity of pralidoxime methylchloride intervention groups were (1.01 +/- 0.18), (1.17 +/- 0.11), (1.01 +/- 0.04), (1.03 +/- 0.12) U/ml respectively; and the ChE activity of unithiol intervention groups were (1.15 +/- 0.15), (1.26 +/- 0.27), (1.08 +/- 0.08), (1.04 +/- 0.12) U/ml respectively. The inhibited ChE in blood was recovered by either treatment with pyraldoxime methylchloride or unithiol. These two drugs had similar effects of recovering the activity of ChE(P > 0.05), but at higher doses(1/4 and 1/2 of LD50) the effects of both were not so good.

CONCLUSIONPralidoxime methylchloride and unithiol could partly recover the activity of ChE inhibited by dimehypo.

Animals ; Antidotes ; pharmacology ; Cholinesterase Inhibitors ; poisoning ; Cholinesterases ; blood ; Dose-Response Relationship, Drug ; Insecticides ; poisoning ; Pralidoxime Compounds ; pharmacology ; Rats ; Unithiol ; pharmacology

OBJECTIVETo determine whether and to what degree the activity of cholinesterase(ChE) is inhibited by dimehypo at different doses of dimehypo [scientific name: 2-dimethylamine-1,3-bi(sodium hyposulfit)].

METHODRats were dosed with dimehypo or methamidophos orally, and were randomly divided into four subgroups according to the pesticide doses, which were 1/16, 1/8, 1/4 and 1/2 of LD50 respectively(the LD50 of dimethypo and methamidophos is 342 mg/kg and 20 mg/kg respectively). The activity of ChE in blood was determined before and 30 min, 1, 2, 4 and 24 h after exposure. The modified Ellman Method was employed to measure the activity of ChE.

RESULT1/16 LD50 dose of dimehypo did not affect the activity of ChE. When the dose increased, the activity of ChE decreased accordingly. 1/2 LD50 dose of dimehypo inhibited the activity of ChE by 35.9% compared with that of control group(P < 0.01). In rats dosed with methamidophos, even 1/16 LD50 dose inhibited the activity of ChE by 42.4% compared with that of control group. When the dose of methamidophos increased, the activity of ChE decreased accordingly. 1/2 LD50 dose of methamidophos inhibited the activity of ChE by 52.9%. The activity of ChE in the rats dosed with dimehypo at various doses was significantly lower than that in the rats dosed with corresponding doses of methamidophos(P < 0.01).

CONCLUSIONHigher doses of dimehypo may inhibit the activity of ChE. However, as compared with methamidophos, dimehypo is a weaker inhibitor of ChE.

Animals ; Cholinesterase Inhibitors ; toxicity ; Cholinesterases ; blood ; Dose-Response Relationship, Drug ; Insecticides ; toxicity ; Lethal Dose 50 ; Organothiophosphorus Compounds ; toxicity ; Rats

Objective To analyze the imaging features of solid pseudopapillary neoplasm of pancreas (SPN) in children, and to improve the awareness of the disease. Methods From January 2007 to December 2016, 12 patients with SPN proven pathologically were enrolled in the study,of whom 12 cases underwent CT scanning and 3 cases underwent MRI scanning. The imaging data of SPN were analyzed retrospectively. The tumor parameters included the location, size, shape, margin, capsule, form, inhancement degree, and presence of calcification, biliary obstruction, surrounding, ascites, lymph node metastasis, as well as distant metastasis, which were comparative analyzed with that of pathology. Results CT showed that 3 cases were located in the head of pancreas,7 cases were located in the body/tail of pancreas, and 2 cases were ectopic. Twelve cases were circular tumors, the diameter of which ranged from 28—76 mm (median diameter 48 mm). Capsules were showed in 10 cases, calcification was seen in 4 cases and hemorrhage was seen in 1 case. Three cases were solid, 8 cases were solid and cystic mixed,and 1 case was cystic. The tumors were heterogeneous, and the solid portion of SPN was moderately to obviously enhanced gradually whereas the cystic part remained unenhanced. Nine cases showed that the tumors growed to the outside of pancreas,in which 4 cases covered by the normal pancreas tissue, 1 case located inside of the pancreas. One case caused biliary obstruction and the collateral circulation of splenic arteriovenous was established in 2 cases due to tumor compressed. Ascites was seen in 2 cases. MRI showed that the cystic components of tumor in 3 cases showed low signal in T1WI and high signal in T2WI, with no enhancement. The solid components of the tumor showed equal signal in T1WI and slightly higher signal in T2WI, with obvious enhancement. Capsules were showed in 3 cases with low signal in T1WI and T2WI, which were obviously enhanced in 2 cases and without enhancement in 1 case;hemorrhage was showed high signal in T1WI in 1 case. No lymph node metastasis and distance metastasis were observed in 12 cases. Conclusions The characteristic imaging findings of SPN in children are boundary clear, capsules, calcification, circular pancreas tumors, which grow to the outside of pancreas, with varied degrees of hemorrhage and necrosis. The solid portion of SPN is moderately or obviously enhanced gradually.

Objective:To explore the change trajectory and influencing factors of benefit finding of family caregivers of patients with lung cancer, so as to provide reference for formulating individualized intervention strategies.Methods:This study was a cross-sectional survey. From September 2021 to October 2022, 232 family caregivers of patients with lung cancer from General Hospital of PLA Central Theater Command and Tianyou Hospital affiliated to Wuhan University of Science and Technology were collected by convenience sampling method. The level of benefit finding of family caregivers was investigated at 1 month, 3 months and 6 month, after the patients were diagnosed. Growth Mixture Model was applied to identify distinct trajectory categories. Multinomial Logistic regressions were performed to analyze predictors of trajectory categories.Results:The overall level of benefit finding of family caregivers of lung cancer patients showed an upward trend over time ( F=83.06, P<0.01), from 1 month (47.02 ± 14.79) to 6 months (58.13 ± 13.18). Three categories of benefit finding trajectories were identified, named as "the high level-decline group" 12 cases, "the moderate level-stability group" 67 cases, and "the low level-elevation group" 153 cases. Univariate analysis showed that age and education level of family caregivers, average income per person in patient family, type of medical payment, whether the tumor was metastasized, the treatment method of the patient, whether they lived with the patient, and whether they had co-caregivers were related to the category of benefit finding trajectory ( χ2 values were 6.71-15.05, all P<0.05). Multivariate Logistic regression analysis showed that age and education level of family caregivers, average income per person in patient family, treatment method of the patient and whether they lived with the patients were the main influencing factors of benefit finding trajectory categories(all P<0.05). Conclusions:The benefit finding of family caregivers of lung cancer patients showed different trajectories with the time of diagnosis, and the overall level shows an upward trend. More than half of the family caregivers belong to the low level-elevation group. Medical staff should give family caregivers stage and specific nursing intervention according to the change trajectory of benefit finding and its influencing factors.

OBJECTIVETo analyze the quantity and size distribution of 24-hour urinary extracellular vesicles (uEVs) from healthy adults.

METHODSThe 24-hour uEVs from 9 healthy adults were isolated by hydrostatic filtration dialysis (HFD). The effectiveness of uEVs enrichment was evaluated using Western blotting and transmission electron microscopy (TEM). The quantity and size distribution of the uEVs was analyzed with BCA protein quantification, TEM, and nanoparticle tracking analysis (NTA).

RESULTSuEVs with different sizes and morphologies were observed under TEM. Western blotting confirmed the expression of TSG101 in all the uEV fractions from the 9 donors, ranging from 132.50 to 760.70 ng/mL. NTA results showed that the number of 24-hour uEVs amount ranged from 3.56 × 10¹² particles to 5.12 × 10¹² particles, with a CV of 14.23%. The proportion of the vesicles with a diameter <40 nm was 0.04%-0.69% with a number range of (1.80-26.49)× 10⁹ particles; the proportion of vesicles with a diameter of 40-100 nm (which is consistent with the size of exosomes)was 22.07%-42.08% with a number range of (1.00-1.77)× 10¹² particles. The proportion of vesicles with a diameter of 100-1000 nm (consistent with the size of microvesicles) was 57.88%-77.85% with a number range of (2.09-3.86)× 10¹² particles.

CONCLUSIONThe established HFD method allows efficient and convenient isolation of uEVs from a large amount of urine samples. The 24-hour uEVs from healthy adults show narrow differences between individuals and thus can be an ideal source of samples for relevant studies.

Adult ; Blotting, Western ; Cell-Derived Microparticles ; Exosomes ; Extracellular Vesicles ; Humans ; Microscopy, Electron, Transmission ; Nanoparticles ; Urine