Objective To observe the morphological and distribution feature of nestin-positive cells in liver during various stages of human fetal development.Methods 10-20 weeks old fetal liver tissues were obtained and fixed for paraffin sections as usual.Digoxigenin-labeled oligo-DNA probe was used for detect nestin by means of in situ hybridization histochemistry(ISHH).Results Nestin-positive cells are small,spherical cells with a large nucleus and sometimes a dual nuclei,and distribute mainly in limiting plate and surround the developing bile duct.Conclusion There are some nestin-positive cells in the liver.They can divide and proliferate and may be a group of cells hided in various tissues during development,which have the same function.They may play an important role in hepatocyte injure repair and tumor occur during the later days.

Duodenum-and bile duct-preserving pancreatic head resection is rarely carried out in China due to its complexity.From September 2013 to May 2014,5 patients (1 with mass-forming pancreatitis of the head of the pancreas,2 with mucinous cystadenoma of the pancreatic duct combined with focal cancerous,2 with chronic pancreatitis and pancreatic duct stones) received duodenum-and bile duct-preserving pancreatic head resection at the Zhangzhou Zhengxing Hospital.The lesions of the 5 patients were resected by the Takada method and then the pancreatic duct was reconstructed in situ.One patient received T-tube drainage of the bile duct.The operation time was 210-330 minutes,and the mean volume of intraoperative blood loss was 300 mL (range,100-500 mL).The stones of 2 patients were antler-shaped,and the other 3 patients were with tumor.No patients died intraoperatively.One patient was complicated by pancreatic leakage and 1 by bile leakage after the operation,respectively,and they were cured by non-surgical treatment.Patients were followed up for 3-11 months,and no abnormal glucose metabolism,common bile duct stricture,chronic indigestion and tumor recurrence occurred.The Takada method is safe and effective for the treatment of mass-forming pancreatitis of the head of the pancreas,benign lesions of the head of the pancreas and low-grade malignant tumor of the head of the pancreas.

Hepatectomy and liver transplantation are the most effective radical treatment for patients with hepatocellular carcinoma, but the high recurrence rate after surgery which seriously affects the prognosis of patients cannot be ignored. Microvascular invasion (MVI) is a risk factor for postoperative recurrence and metastasis in patients with hepatocellular carcinoma. There is no consensus or guideline recommendation locally or intermutually on postoperative adjuvant therapy of patients with hepatocellular carcinoma with MVI. Appropriate selection of postoperative adjuvant therapy is worth more in-depth discussion. This article reviews recent and relevant studies on postoperative adjuvant therapy for patients with hepatocellular carcinoma and MVI, including local anti-tumor therapy, systemic chemotherapy, immunotherapy, targeted therapy and combination therapy, with the aim to provide better reference to clinicians in managing these patients with postoperative adjuvant therapy.

OBJECTIVETo investigate the efficacy of catheter aspiration or combined with thrombolysis in the treatment of superior mesenteric artery embolism(SMAE).

METHODSClinical and imaging data of 25 SMAE patients who underwent catheter aspiration or combined with urokinase thrombolysis in the First People's Hospital and the Second People's Hospital of Changzhou from January 2005 to July 2013 were retrospectively analyzed.

RESULTSTwenty patients were confirmed as SMA trunk embolism and 5 as SMA branch artery embolism. The embolic SMA trunks were completely recannulated by catheter aspiration in the above 20 cases, but small emboli embolized distal branch artery in 6 cases. These 6 patients plus above 5 patients with branch artery embolism received catheter aspiration combined with thrombolytic therapy. Among these 11 patients, complete open, partial open and non-open of branch arteries were found in 5, 3, 3 cases respectively, while collateral circulation increased significantly in non-open patients. During the follow-up period of (4.1±2.2) months, clinical symptom relief and digestive function recovery were observed in 24 cases. Only one case underwent bowel resection because of intestinal necrosis 24 hours after treatment and developed short bowel syndrome.

CONCLUSIONCatheter aspiration or combined with thrombolysis is a safe and effective method in treating SMAE.

Objective:To study the clinical characteristics and death risk factors of the patients with fall-related injuries in parts of Kashgar Prefecture during 2019-2020.Methods:The clinical data were retrospectively analyzed of the 894 patients with fall-related injuries who had been admitted to Department of Trauma Center, The First People's Hospital of Kashgar Prefecture, Xinjiang Uygur Autonomous Region from January 2019 to December 2020. Recorded were the patient's gender, age, location of fall, month of fall, fall height, major injury site, injury severity score (ISS) and Glasgow score (GCS). The clinical characteristics and death risk factors of the fall patients were analyzed.Results:Of the 894 patients, 72.3%(646/894) were male and 86.9%(777/894) fell from a height from 1 to 6 meters. Their ages ranged mainly from 15 to 59 years old (74.3%, 664/894). Home was the most frequent site for falls (60.2%, 538/894) and the patients who fell in summer months (from June to August) were the most (32.3%, 289/894). Twenty-one patients (2.3%, 21/894) died. There were significant differences in the major injury site, blood transfusion, ISS score and GCS score between the dead and survival patients ( P<0.05). The multivariate logistic regression analysis showed that the injury to the head, face and neck [ OR=10.936, 95% CI: 1.177 to 101.627, P=0.035] and GCS score ≤12 [ OR=5.640, 95% CI: 2.658 to 11.968, P< 0.001] were the death risk factors for the patients with fall-related injuries in parts of Kashgar Prefecture during 2019-2020. Conclusions:In the patients with fall-related injuries in parts of Kashgar Prefecture during 2019-2020, males aged from 15 to 59 years old were the high-risk group of falls. Months with a high incidence of falls were from June to August. The fall patients with injuries to the head, face and neck and with a GCS score of ≤12 were at a high risk of death.

Objective:To explore clinicopathological features and prognosis of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in children induced by antithyroid drugs.Methods:The clinicopathological features, treatment and prognosis of 3 children with AAV induced by antithyroid drugs in the Department of Pediatric Nephrology and Rheumatology of the First Affiliated Hospital of Sun Yat-sen University were analyzed retrospectively, and the literatures were reviewed.Results:(1) Among the 3 cases, there were 2 females and 1 male, whose ages were 12.6, 13.9 and 13.1 years old, respectively. All patients had medication history of propylthiouracil (PTU) and/or methimazole (MMI) before onset. Initial manifestation was pallor and renal involvements with nephrotic proteinuria, hematuria and renal function abnormality, while 2 of them had hypertension. Extrarenal manifestations were also presented: case 1 presented with rash, arthralgia and cardiac insufficiency; case 2 had brain involvement with repeated convulsions; case 3 presented with arthralgia and lung involvement. They were all tested positive for p-ANCA and MPO-ANCA. Initial renal histopathology of the 3 cases were consistent with ANCA-associated glomerulonephritis, which were classified into sclerosis, crescentic and mixed class respectively. After 8 months of treatments, repeated renal biopsy of case 3 had demonstrated progression to sclerosis class. Antithyroid drugs (PTU or MMI) were discontinued in 3 cases, and the children were all treated with corticosteroid combined with intravenous pulse cyclophosphamide therapy. Plasma exchange was performed in case 2 and case 3 due to rapidly progressive glomerulonephritis and disease recurrence (suspected pulmonary hemorrhage), respectively. Case 3 was treated with rituximab combined with mycophenolate mofetil after recurrence. The extrarenal symptoms relieved quickly after treatments in all cases. P-ANCA and MPO-ANCA became negative in case 1 and case 2 after 6 months of treatments but they were persistently positive in case 3. Three cases were followed up for 24 months, 10 months and 12 months, respectively: case 1 develop chronic kidney disease (CKD) stage 2 with normal urinalysis; case 2 develop CKD stage 5 and had sudden death at home at 10-month follow-up; case 3 develop CKD stage 4 with nephrotic proteinuria and microscopic hematuria. (2) There were totally 30 pediatric cases with AAV induced by PTU and MMI, including 27 reported cases in the literature and 3 cases in this study. Symptoms of AAV appeared in children after an average administration of (37.5±4.0) months of PTU (range from one month to 96 months and 8 months of MMI alone). Kidney (28 cases, 93.3%) and lung (12 cases, 40.0%) were commonly involved, while brain (2 cases, 6.7%) was rarely involved. The pathological changes of kidney were crescent nephritis (5/23) and necrotizing pauci-immune complex nephritis (11/23). The total remission rate was 93.3% (28/30) after antithyroid drugs withdrawal and treatment with corticosteroids and immunosuppressive therapy, however, there were still severe cases with progression to CKD stage 5, and death. (3) Thirty cases were divided into complete response group ( n=19) and incomplete response group ( n=11) according to the treatment response. Compared with complete response group, the proportions of massive proteinuria (8/11 vs 5/19), fibrinoid necrosis (7/9 vs 4/14), deposition of immune complex in renal tissues (6/9 vs 2/14) and administration of immunosuppressants (10/11 vs 5/19), and degree of tubular atrophy (0/1/2/3 grade, 2/4/2/1 vs 9/5/0/0) in incomplete response group were higher (all P<0.05). Conclusions:PTU and MMI can both induce AAV in children, and AAV may occur after short-term course of administration. Kidney and lung are commonly involved while brain involvement is rarely seen. Timely withdrawal of antithyroid drugs and proper treatments with corticosteroids and immunosuppressants can result in high remission rate, though there are still some severe cases. Nephrotic-range proteinuria, renal fibrinoid necrosis, immune-complex deposition and tubular atrophy may be the risk factors of AAV for poor prognosis.

Objective:To compare the consistency in diagnosing and staging acute kidney injury (AKI) in children with chronic kidney disease (CKD) according to three criterias.Methods:Children with CKD hospitalized in the First Affiliated Hospital of Sun Yat sen University from January 2013 to December 2019 were analyzed retrospectively. These patients underwent serum creatinine examination more than twice during hospitalization. The AKI diagnosis and staging were performed for each patient according to the 2007 pRIFLE, 2012 KDIGO and 2018 pROCK criteria respectively. All the children were followed up for 1 year after discharge through outpatient visit, re-hospitalization or online consultation. The clinical characteristics and prognosis of CKD children with or without AKI that were diagnosed by 3 criteria were compared. Analysis of variance and chi-squared tests were used for the comparison among groups. Concordance between the different diagnostic criteria was evaluated using Cohen′s kappa coefficient.Result:A total of 2 551 children with CKD were included in this study, with an age of (8±4) years. There were 1 628 boys and 923 girls. Nephrotic syndrome was the most prevalent primary disease (55.4%), followed by lupus nephritis (11.2%) and purpura nephritis (8.2%). Among all stages of CKD, CKD category G1 was the most common type (2 146 cases, 84.1%), followed by CKD category G2 (221 cases, 8.7%). AKI occurence rates according to pRIFLE, KDIGO and pROCK criteria were 33.9% (866/2 551), 26.2%(669/2 551) and 19.5% (498/2 551) respectively (χ2=136.3, P<0.01). The diagnostic consistency within three criteria for AKI was high in children with CKD ( κ=0.702), but AKI staging consistency was low ( κ=0.329). Both the diagnosis and staging consistency of three AKI criteria were poor in children with CKD category G5 (all κ<0.400). The length of hospital stay (LOS), hospitalization costs, the occurence of intensive care unit (ICU) admission and in-hospital mortality were significantly higher in children with AKI diagnosed by different criteria ( P<0.05). After 1-year follow-up, the repeated admission rate and CKD staging progress significantly increased in children with AKI ( P<0.05). In children with baseline serum creatinine≥200 μmol/L, compared with children who did not experience AKI during hospitalization, the LOS and the hospitalization costs in children who were diagnosed AKI according to pRIFLE or pROCK criteria was significantly higher ( P<0.05). However, there was no significant difference in the LOS and hospitalization costs between children with or without AKI who were diagnosed according to KDIGO criteria (all P>0.05). Conclusions:AKI diagnosed by all of the three criteria (pRIFLE, KDIGO and pROCK criteria) was associated with the poor prognosis in children with CKD. However, in those whose baseline serum creatinine≥ 200 μmol/L, AKI diagnosed by pRIFLE and pROCK criteria could better reflect the poor outcomes than by KDIGO criteria.

Objective To investigate the efficacy of catheter aspiration or combined with thrombolysis in the treatment of superior mesenteric artery embolism (SMAE). Methods Clinical and imaging data of 25 SMAE patients who underwent catheter aspiration or combined with urokinase thrombolysis in the First People′s Hospital and the Second People′s Hospital of Changzhou from January 2005 to July 2013 were retrospectively analyzed. Results Twenty patients were confirmed as SMA trunk embolism and 5 as SMA branch artery embolism. The embolic SMA trunks were completely recannulated by catheter aspiration in the above 20 cases, but small emboli embolized distal branch artery in 6 cases. These 6 patients plus above 5 patients with branch artery embolism received catheter aspiration combined with thrombolytic therapy. Among these 11 patients , complete open, partial open and non-open of branch arteries were found in 5, 3, 3 cases respectively, while collateral circulation increased significantly in non-open patients. During the follow-up period of (4.1±2.2) months, clinical symptom relief and digestive function recovery were observed in 24 cases. Only one case underwent bowel resection because of intestinal necrosis 24 hours after treatment and developed short bowel syndrome. Conclusion Catheter aspiration or combined with thrombolysis is a safe and effective method in treating SMAE.

Objective To investigate the efficacy of catheter aspiration or combined with thrombolysis in the treatment of superior mesenteric artery embolism (SMAE). Methods Clinical and imaging data of 25 SMAE patients who underwent catheter aspiration or combined with urokinase thrombolysis in the First People′s Hospital and the Second People′s Hospital of Changzhou from January 2005 to July 2013 were retrospectively analyzed. Results Twenty patients were confirmed as SMA trunk embolism and 5 as SMA branch artery embolism. The embolic SMA trunks were completely recannulated by catheter aspiration in the above 20 cases, but small emboli embolized distal branch artery in 6 cases. These 6 patients plus above 5 patients with branch artery embolism received catheter aspiration combined with thrombolytic therapy. Among these 11 patients , complete open, partial open and non-open of branch arteries were found in 5, 3, 3 cases respectively, while collateral circulation increased significantly in non-open patients. During the follow-up period of (4.1±2.2) months, clinical symptom relief and digestive function recovery were observed in 24 cases. Only one case underwent bowel resection because of intestinal necrosis 24 hours after treatment and developed short bowel syndrome. Conclusion Catheter aspiration or combined with thrombolysis is a safe and effective method in treating SMAE.

As a member of the AFF (AF4/FMR2) family, AFF4 is a transcription elongation factor that is a component of the super elongation complex. AFF4 serves as a scaffolding protein that connects transcription factors and promotes gene transcription through elongation and chromatin remodelling. Here, we investigated the effect of AFF4 on human dental follicle cells (DFCs) in osteogenic differentiation. In this study, we found that small interfering RNA-mediated depletion of AFF4 resulted in decreased alkaline phosphatase (ALP) activity and impaired mineralization. In addition, the expression of osteogenic-related genes (DLX5, SP7, RUNX2 and BGLAP) was significantly downregulated. In contrast, lentivirus-mediated overexpression of AFF4 significantly enhanced the osteogenic potential of human DFCs. Mechanistically, we found that both the mRNA and protein levels of ALKBH1, a critical regulator of epigenetics, changed in accordance with AFF4 expression levels. Overexpression of ALKBH1 in AFF4-depleted DFCs partially rescued the impairment of osteogenic differentiation. Our data indicated that AFF4 promoted the osteogenic differentiation of DFCs by upregulating the transcription of ALKBH1.
Biomarkers ; metabolism ; Cell Differentiation ; Cells, Cultured ; Dental Sac ; drug effects ; metabolism ; Gene Expression Regulation ; Humans ; Osteogenesis ; genetics ; Repressor Proteins ; Transcription Factors ; genetics ; metabolism ; Transcriptional Elongation Factors ; metabolism