Objective To study the expression of high mobility group box 1 (HMGB1),matrix metalloproteinase-9(MMP-9) and vascular endothelial growth factor-C (VEGF-C)gene in papillary thyroid carcinoma (PTC) and their significance.Methods Expression of HMGB1,MMP-9,VEGF-C proteins and HMGB1 mRNA was detected by technology of immunohistochemistry(SP) and in situ hybridization in 58 cases of PTC tissues,20 cases of thyroid adenoma tissues,25 cases of nodular goiter tissues and 10 cases of normal thyroid tissues.Results Expression of HMGB1,MMP-9,VEGF-C proteins and HMGB1 mRNA in PTC tissues was much higher than that in the 3 non-cancerous tissues (P ＜ 0.05).The positive expression rate of HMGB1,MMP-9 proteins and HMGB1 mRNA was closely associated with the thyroid carcinoma size and lymph node metastasis (P ＜0.05).There was also closely association between the positive expression rate of VEGF-C protein and lymph node metastasis(P ＜ 0.05).The positive expression rate of HMGB1,MMP-9,VEGF-C proteins and HMGB1 mRNA had no association with patients' sex or age(P ＞ 0.05).The expression of HMGB1,MMP-9 and VEGF-C proteins had positive correlation with each other(P ＜ 0.05).The expression of HMGB1 protein and HMGB1 mRNA was also positively correlated with each other(P ＜0.05).Conclusion Expression of HMGB1,MMP-9,VEGFC proteins and HMGB1 mRNA in PTC is correlated with the progress,invasion,metastasis of PTC,by detecting them may help to predict the clinical progress and prognosis.

Objective To analyze the potential factors affecting the prognosis of patients with sepsis and evaluate their values in predicting the disease outcome. Methods A clinical prospective study was conducted. Fifty-three septic patients admitted to intensive care unit (ICU) of the First Affiliated Hospital of Guangzhou Medical University from October 17th, 2012 to August 8th, 2013 were enrolled, and in the same term 35 volunteers having passedphysical check-up were assigned in the healthy control group. According to the severity of the patients, they were divided into sepsis, severe sepsis and septic shock groups. Furthermore, based on the difference in scores of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), the patients were divided into low-risk (APACHE Ⅱ scores < 10), middle-risk (APACHE Ⅱ scores 10 - 19) and high-risk groups (APACHE Ⅱ scores≥ 20 ). According to whether the coagulation dysfunction occurred or not and whether the dysfunction was adjusted or not at the end of observation, the septic patients were divided into non-coagulation defect group, and adjusted and non-adjusted coagulation defect groups. After entrance of groups, the clinical data, including gender, age, body temperature, blood pressure, prothrombin time (PT), prothrombin time activity (PTA), activated partial thromboplastin time (APTT), international normalized ratio (INR), levels of D-dimer, fibrinogen (Fib), blood lactate, and serum procalcitonin (PCT) were recorded, and APACHEⅡscore was calculated. In 24 hours after admission, blood samples were collected, and the levels of interleukins (IL-6, IL-8) were tested by Bio-Plex 200 System. The prognostic factors related to sepsis were screened by binary multivariate logistic regression analysis. The receiver operating characteristic curve (ROC) were used to evaluate the prognostic values of blood lactate, PCT, IL-6, IL-8 and APACHE Ⅱ scores for patients with sepsis. Results Fifty-three patients were enrolled, including 17 patients in sepsis group in which blood coagulation dysfunction occurred in 8 cases, of them 7 being adjusted, and 5 died; 15 patients in severe sepsis group, in which blood coagulation dysfunction occurred in 7 cases, of them 2 being adjusted, and 7 died;21 patients in septic shock group in which blood coagulation dysfunction occurred in 18 cases, of them 4 being adjusted, and 18 died. Both IL-6 and IL-8 levels of sepsis group were significantly higher than those in healthy control group (both P<0.01). Univariate logistic regression analysis showed that the grade of sepsis severity, APACHEⅡscore, IL-6, IL-8, blood lactate, PCT and coagulation dysfunction were related to the prognosis of septic patients. Multivariate logistic regression analysis confirmed that blood lactate concentration [β=0.891,χ2 = 5.872, P = 0.015, odds ratio (OR) = 2.438, 95% confidence intervals (95%CI) was 1.186 - 5.013] and coagulation function status (non-adjusted coagulation defect group:β=3.563,χ2=9.980, P=0.002, OR=35.286, 95%CI was 3.868-3.563) were independent prognostic factors of septic patients. The ROC curve analysis showed:for the level of blood lactate, the area value under ROC curve (AUC) was 0.767, the best cutoff value was 2.15 mmol/L with the Youden index of 0.386;for PCT, the AUC was 0.698, the best cutoff value was 9.39μg/L with the Youden index of 0.406;for IL-8, AUC was 0.686, the best cutoff value was 20.06 ng/L with the Youden index of 0.312;and for IL-6, AUC was 0.681, the best cutoff value was 45.44 ng/L with the Youden index of 0.406. Multivariate logistic regression analysis confirmed that the plasma levels of IL-6 and IL-8 were the independent risk factors of septic patients' coagulation function. The IL-6 concentration of non-coagulation defect group was significantly lower than that in adjusted coagulation defect group (ng/L:29.26 vs. 67.98, P<0.05) and non-adjusted coagulation defect group (ng/L:29.26 vs. 128.00 P<0.05). There was no significant difference in IL-6 level between the adjusted and non-adjusted coagulation defect groups (P>0.05). The IL-8 level of non-coagulation defect group was significantly lower than that of adjusted (ng/L:24.67 vs. 27.23, P<0.05) and non-adjusted coagulation defect groups (ng/L:24.67 vs. 60.14, P<0.05). There was no statistically significant difference in IL-8 concentration between adjusted and non-adjusted coagulation defect groups (P>0.05). Conclusions The grade of sepsis severity, APACHEⅡscore, whether existence of coagulation dysfunction being present or not and whether its presence being adjusted or not during the septic patients' stay in ICU, the levels of blood lactate, PCT, IL-6 and IL-8 on the first day in ICU are significantly correlated to the prognosis of septic patients. Whether the existence of coagulation dysfunction being present or not, whether coagulation dysfunction being adjusted or not and the blood lactate level are the independent prognostic factors of septic patients, and the plasma concentrations of IL-6 and IL-8 are the independent affecting factors of whether coagulation dysfunction occurring or not, therefore they have predicting value concerning the occurrence of coagulation dysfunction in septic patients.

Objective To investigate the ultrasonographic and pathological changes of peripheral pulmonary lesions in acquired immunodeficiency syndrome (AIDS) complicated with Penicillium marneffei pneumonia (PMP) and their clinical significance.Methods The ultrasonographic and pathological data of peripheral pulmonary lesions in 31 cases of AIDS complicated with PMP who were diagnosed in Fourth People's Hospital of Nanning were retrospectively reviewed.Results Among 31 cases of PMP,20 cases (64.5％) showed star-like diffuse sonogram,7 cases (22.6％) low solid echo and 4 cases (12.9 ％) black hole-like sonogram in ultrasonographic changes of peripheral pulmonary lesions.In pathological examination,Penicillium marneffei were seen in all samples:periodic acid-Schiff stain (PAS) and periodic acid-Schiff diastase stain (PAS-D) were all positive.Twenty four cases (77.4％) mainly showed infiltration of inflammatory cells,and 7 cases (22.6 ％) mainly showed necrosis and fibrous hyperplasia.Among 20 patients with star like diffuse sonogram,19 were mainly infiltration of inflammatory cells in pathological changes,and 19 were CD4+ T lymphocyte counts of 100-200/μL.Among 4 patients with black hole-like sonogram,all were necrosis in the central and hyperplasia in the peripheral in pathological changes,and CD4-T lymohocyte counts were all＜50/μL.Conclusions In AIDS patients complicated with PMP,ultrasonographic features were probably correlated with pathological changes in biopsy tissues and CD4-T lymphocyte counts.

To date, the efficacy of radical surgery (RS) versus conservative surgery (CS) for liver hydatid cysts (LHC) remains controversial. This meta-analysis was conducted to compare the two interventions. PubMed, Embase, and Web of Science were searched from their inceptions until June 2016. Meta-analysis was performed using STATA 12.0 software. We identified 19 eligible studies from 10 countries by retrieval. In total, 1853 LHC patients who received RS were compared with 2274 patients treated by CS. The risk of postoperative overall complication, biliary fistula, and recurrence was significantly lower, and operation time was significantly longer in the RS group. However, no statistically significant differences were found in terms of mortality risk and the duration of hospital stay between RS and CS. No significant publication biases were observed in all the above analyses. In conclusion, RS reduces the rates of postoperative complications and recurrence, whereas no trend toward such a reduction in mortality was observed in LHC patients.
Echinococcosis, Hepatic ; mortality ; surgery ; Humans ; Length of Stay ; statistics & numerical data ; Operative Time ; Postoperative Complications ; epidemiology ; Recurrence ; Treatment Outcome