Objective To investigate the silencing effect of RNA interference on MSTN gene ( myostatin, MSTN) expression, and detect the effects on the downstream genes in Schizopygopsis pylzovi. Methods To construct the recombi?nant adenovirus vector 1P3 (DSP MSTN 273+250+1737) and 1P2 (DSP MSTN 195+ 1670) for RNA interference of the MSTN gene in Schizopygopsis pylzovi, and to conduct the RNA interference in vivo experiment by injecting the vector in?to the muscle tissue of Schizopygopsis pylzovi. Real?time PCR and Western blotting were used to evaluate the silencing effects on MSTN gene expression, and to detect the regulatory function of M?CK at gene transcription level after RNA inter?ference of the MSTN gene. Results The result of real?time PCR showed that compared with the HK team ( Virus general negative control group) and N team (blank control group), the 1P3 had significant interference effect on the MSTN gene transcription in Schizopygopsis pylzovi (P<0?05), with an inhibition rate of 53?5%, but the 1P2 had no significant inter?ference effect on the MSTN gene transcription. The result of Western blotting was consistent with the results of real?time PCR. At the same time, after the 1P3 interference, the level of MSTN gene transcription was declined, and the level of M? CK gene expression was significantly increased. Conclusions Our results demonstrate that the expression of MSTN gene can be effectively suppressed, and the expression of M?CK gene can be up?regulated through the RNA interference. There?fore, it proves that MSTN gene can inhibit the transcription of M?CK gene in Schizopygopsis pylzovi, and reveals the regula?tory role of MSTN gene in the muscle growth and development in the plateau fish Schizopygopsis pylzovi.

Objective To evaluate the role of two-dimensional ultrasound combined with contrast-enhanced ultrasonography (CEUS) in the classification of liver nodules in cirrhotic patients.Methods Consecutively cirrhotic patients with intrahepatic nodules at Xixi Hospital of Hangzhou were included from November 2015 to December 2016.All (142 nodules in 109 patiens) presented as non-cancerous focal lesions on conventional magnetic resonance imaging and CT examination and had available information of liver biopsy.Each lesion was percutaneous biopsied under the guidance of two-dimensional ultrasound.Ultrasonographic parameters evaluated were as following:(1) sizes of nodules under US;(2) ultrasonographic characteristics of the nodular;(3) CEUS enhancement features of the nodules.Four types of hepatic nodule suggesting different histology were defined according to the ultrasonographicparameters.x2 test was used to compare the difference of hepatocellular carcinoma (HCC) incidence among liver nodules with varying sizes and nodules with different enhancement features under CEUS.As for the statistical differences of HCC and high-grade dysplastic nodule (HGDN) incidence between type Ⅲ & Ⅳ nodules and type Ⅰ & Ⅱ nodules,x2 test was also used for analysis.Results A total of 142 eligible nodules were detected in 109 patients with cirrhosis,including 16 HCCs,2 intrahepatic cholangiocellular carcinomas (ICC),41 HGDNs,40 low-grade dysplastic nodules (LGDN) and 43 regenerative nodules (RN).In terms of diameter,all (6/6) the nodules larger than 2.0 cm,20.0％ (8/40) of middle size nodules (1.5-2.0 cm),were HCCs.The remained 2 lesions of HCC came from two subgroups with even small size nodules [1.0-1.4 cm (n=93),and ＜ 1.0 cm (n=3),in diameter],respectively.Two lesions of ICC were attributed to nodules with a 1.0-1.4 cm diameter.About 28 nodules with a diameter of 1.5-2.0 cm,13 nodules with a diameter of 1.0-1.4 cm were HGDN.HCC incidences between these 4 groups were different significantly (x2=61.425,P ＜ 0.001).Asfor the CEUS,14 nodules exhibited a rapid enhancement feature in arterial phase,12 of which were HCC.In56 nodules with a slow enhancement feature,4 nodules were HCC.HCC incidences between these 3 groups were different significantly (x2=75.752,P ＜ 0.001).Under the combined ultrasonography,HCC incidences of type Ⅲ and type Ⅳ nodules were significantly higher than that of type Ⅰ and type Ⅱ lesions [21.9％ (16/73)vs 0 (0/65),x2=15.222,P ＜ 0.001],similar result was observed in the comparison of HGDN incidences between type Ⅲ & Ⅳ and type Ⅰ & Ⅱ nodules[53.4％ (39/73) vs 3.1％ (2/65),x2=38.842,P ＜ 0.001].Conclusion The classification presented by this study,combining the three ultrasonographic parameters,which is nodule size,nodular echo characteristics and enhancement features of the nodules under CEUS,could be helpful for the diagnosis of HCC in cirrhotic patients with ill-defined nodule on routine image examination.

Objective To investigate the clinical characteristics and perioperative management of 1aparoscopic cholecystectomy(LC) in the elderly with gallbladder diseases. Methods From January 2006 to December 2016,the clinical data of two hundred and sixteen elderly patients with LC in the Sixth Affiliated People's Hospital of Jinshan Branch were analysed retrospectively. Results The operations of LC were successfully done in 206 patients ( 95. 8%) and 9 cases ( 4. 2%, 9/216 ) underwent conversion to open cholecystectomy for various reasons. Postoperative complications occurred in 22 cases (10. 2%,22/216). 2 cases died within 1 weeks after the operation,and the remaining patients recovered from the hospital. Conclusion Adequate perioperative management,strict surgical indications and operative skills are the necessary conditions for the successful implementation of LC in the elderly.

Objective To investigate the clinical significance of serum miR-187 and miR-143 in the development and diagnosis of gallbladder cancer.Methods 75 serum samples in patients with gallbladder cancer were selected as gallbladder cancer group.75 serum samples in patients with gallbladder benign disease and 45 serum samples in healthy physical examinations at same period were selected as the benign gallbladder disease group and healthy control group.Quantitative RT-PCR was used to detect the serum miR-187 and miR-143 expression in each group,and the expression of those related with the clinicopathological factors,the proliferation and migration of gallbladder cancer cells,and the efficacy in diagnosis of gallbladder cancer was observed.Results The serum miR-187 expression in gallbladder cancer group was significantly higher than that in benign gallbladder disease and healthy control;the serum expression of that in benign gallbladder disease was significantly higher than that in healthy control;after surgery,the expression of that was significantly lower than that before treatment (all P ＜ 0.05).The serum expression of miR-143 in gallbladder cancer group was significantly lower than that in benign gallbladder disease and healthy control;the serum expression of that in benign gallbladder disease was significantly lower than that in healthy control;after surgery the serum expression of that was significantly higher than that before surgery (all P ＜0.05).The serum expression levels of miR-187 and miR-143 in gallbladder cancer were not correlated with gender and age (both P ＞ 0.05),and were significantly correlated with Nevin stage,TNM stage,differentiation and lymphatic metastasis (all P ＜ 0.05).Furthermore,it was confirmed that miR-187 promoted the proliferation and migration of gallbladder cancer cells in vitro,while miR-143 inhibited the proliferation and migration.In the diagnosis of gallbladder,the diagnostic efficacy of miR-187 and miR-143 was significantly better than that of CA199 and CA242 (both P ＜ 0.05).Combined detection could further improve the efficacy in diagnosis of gallbladder cancer.Conclusions miR-187 and miR-143 are involved in the development of gallbladder cancer.Combined detection of serum miR-187 and miR-143 in gallbladder cancer has a high diagnostic efficiency in the diagnosis of gallbladder cancer.

Objective To investigate the methods for prevention and treatment of unexpected hemorrhage during operation of biliary tract.Methods The clinical data of 28 patients with intraoptrative hemorrhage from Jan.2006 to Dec.2016 in our hospital were retrospectively analyzed.Results The cause of introoperative hemorrhage included:iatrogenic biliary injuries in 14 cases (50％),cholelithasis complicated biliary infection in 9 cases (32.1％),bleeding in gall bladder bed in 3 patients (10.7％),and other causes in 2 cases (7.1％).The intraoperative blood loss was 600 to 3000 ml.According to the specific location of bleeding,the amount of blood loss,the cause of bleeding and other conditions,the individual treatment was given.26 were cured and 2 died of hemorrhagic shock and MODS.Conclusions The major causes of hemorrhage during operation of biliary tract comprise iatrogenic biliary injuries,biliary infection,and biliary lithiasis.The reasonable treatment of intraoperative hemorrhage should be based on the concrete bleeding etiologies.

Objective: To explore the influence of three-level collaboration network of pediatric burns in Anhui province on treatment effects of burn children. Methods: The data of medical records of pediatric burn children transferred from Lu′an People′s Hospital and Fuyang People′s Hospital to the First Affiliated Hospital of Anhui Medical University from January 2014 to December 2015 and January 2016 to September 2017 (before and after establishing three-level collaboration network of pediatric burns treatment) were analyzed: percentage of transferred burn children to hospitalized burn children in corresponding period, gender, age, burn degree, treatment method, treatment result, occurrence and treatment result of shock, and operative and non-operative treatment time and cost. Rehabilitation result of burn children transferred back to local hospitals in 2016 and 2017. Data were processed with t test, chi-square test, Mann-Whitney U test, and Fisher′s exact test. Results: (1) Percentage of burn children transferred from January 2014 to December 2015 was 34.3% (291/848) of the total number of hospitalized burn children in the same period of time, which was close to 30.4% (210/691) of burn children transferred from January 2016 to September 2017 (χ²=2.672, P>0.05). (2) Gender, age, burn degree, and treatment method of burn children transferred from the two periods of time were close (χ²=3.382, Z=-1.917, -1.911, χ²=3.133, P>0.05). (3) Cure rates of children with mild, moderate, and severe burns transferred from January 2016 to September 2017 were significantly higher than those of burn children transferred from January 2014 to December 2015 (χ²=11.777, 6.948, 4.310, P<0.05). Cure rates of children with extremely severe burns transferred from the two periods of time were close (χ²=1.181, P>0.05). (4) Children with mild and moderate burns transferred from the two periods of time were with no shock. The incidence of shock of children with severe burns transferred from January 2014 to December 2015 was 6.0% (4/67), and 3 children among them were cured. The incidence of shock of children with severe burns transferred from January 2016 to September 2017 was 3.9% (2/51), and both children were cured. The incidences and cures of shock of children with severe burns transferred from the two periods of time were close (χ²=0.006, P>0.05). Incidence of shock of children with extremely severe burns transferred from January 2014 to December 2015 was 57.1% (32/56), significantly higher than that of burn children transferred from January 2016 to September 2017 [34.5% (10/29), χ²=3.925, P<0.05]. Shock of 25 children with extremely severe burns transferred from January 2014 to December 2015 were cured, and shock of 9 children with extremely severe burns transferred from January 2016 to September 2017 were cured. The cures of shock of children with extremely severe burns transferred from the two periods of time were close ( χ²=0.139, P>0.05). (5) Time of operative treatment of children with moderate, severe, and extremely severe burns transferred from January 2014 to December 2015 was obviously longer than that of burn children transferred from January 2016 to September 2017 (t=2.335, 2.065, 2.310, P<0.05). Time of operative treatment of children with mild burns transferred from the two periods of time was close (Z=-0.417, P>0.05). Costs of operative treatment of children with moderate and severe burns transferred from January 2014 to December 2015 were significantly more than those of burn children transferred from January 2016 to September 2017 (Z=-3.324, t=2.167, P<0.05). Costs of operative treatment of children with mild and extremely severe burns transferred from the two periods of time were close (t=0.627, 0.808, P>0.05). (6)Time of non-operative treatment of children with mild, moderate, and severe burns transferred from January 2014 to December 2015 was obviously longer than that of burn children transferred from January 2016 to September 2017 (t=2.335, Z=-2.095, t=2.152, P<0.05). Time of non-operative treatment of children with extremely severe burns transferred from the two periods of time was close (t=0.450, P>0.05). Costs of non-operative treatment of children with moderate and severe burns transferred from January 2014 to December 2015 were obviously higher than those of burn children transferred from January 2016 to September 2017 (Z=-2.164, t=2.040, P<0.05). Costs of non-operative treatment of children with mild and extremely severe burns transferred from the two periods of time were close (t=0.146, 1.235, P>0.05). (7) Sixty-seven burn children transferred from January 2016 to September 2017 were transferred back to local hospitals for rehabilitation under the guidance of experts of the First Affiliated Hospital of Anhui Medical University, with 25 patients in 2016 and 42 patients in 2017. Effective rehabilitation rates of burn children transferred back to local hospitals for rehabilitation in 2016 and 2017 were both 100%. Conclusions The three-level collaboration network of pediatric burns treatment in Anhui province can effectively increase cure rate of children with mild, moderate, and severe burns, reduce incidence of shock of children with extremely severe burns, shorten time of operative treatment of burn children with moderate, severe, and extremely severe burns, and time of non-operative treatment of children with mild, moderate, and severe burns, reduce treatment costs of children with moderate and severe burns, and improve rehabilitation effectiveness of children transferred from Lu′an People′s Hospital and Fuyang People′s Hospital to the the First Affiliated Hospital of Anhui Medical University.

Objective:To investigate the diagnosis, classification and treatment of pancreatic duct stones (PDS) .Methods:Clinical data and prognosis of 32 patients with PDS treated in our hospital from Jan. 2010 to Dec. 2019 were retrospectively analyzed. The treatment methods were summarized.Results:All 32 cases were diagnosed with PDS by imaging examinations such as B ultrasonography, CT, endoscopic retrograde cholangiopancreatography (ERCP) or magnetic resonance cholangiopancreatography (MRCP) . The diagnosis accuracy was 81.3% (26/32) for B-ultrasound, 86.2% (25/29) for CT, 90.4% (19/21) for MRCP, and 100% (8/8) for ERCP. According to the location of stones and intraoperative exploration, the 32 patients were divided into 3 groups: Type I, 17 patients, the stones were located in the main pancreatic duct; TypeⅡ, 11 patients, the stones were located in both main and branch pancreatic duct; Type Ⅲ, 4 patients, the stones were located in the branch pancreatic duct. Different treatment methods were employed according to the different types. No patient died in the perioperative period. 11 (34.3%) patients had postoperative complications. 3 (9.3%) patients had postoperative residual stones. 32 cases were followed up for a period of 6 to 60 months. The abdominal pain and steatorrhea disappeared or significantly improved postoperatively. 2 patients complicated with pancreatic cancer died 12 to 35 months after operation.Conclusions:The treatment and diagnosis of the PDS still remains complicated. Imaging examinations are the main methods for diagnosis of PDS. The accurate classification and individual treatment are important. Surgery is the most commonly used method for PDS.

Objective:To compare the safety and short-term efficacy of percutaneous thermal ablation for liver cancer at hepatic dome guided by ultrasound with assisted technologies or computed tomography.Methods:Patients who underwent thermal ablation of liver cancer at hepatic dome from January 2016 to October 2019 in the Xixi Hospital affiliated to Zhejiang Chinese Medical University were studied. Using the different guidance methods, the patients were divided into the ultrasound guidance combined with assisted technologies group (the ultrasound guided group) and the CT guided group. Assisted technologies included contrast-enhanced ultrasound, fusion imaging and artificial ascites. The complications during and within one week of ablation were recorded to compare the safety between the two guidance methods. One month after ablation, contrast-enhanced CT or contrast-enhanced MRI was performed to evaluate the short-term efficacy.Results:Of 52 patients who were included in the study, 39 had no previous treatment while 13 had recurrent liver cancer (7 underwent previous surgical resection and 6 thermal ablation). There were 41 males and 11 females, age ranged from 38.0 to 76.0 (57.3±10.0) years. The tumor size was 12.0 to 46.0 (30.7±8.8) mm. Of the 34 patients in the ultrasound guided group, the age ranged from 38.0 to 73.0 (56.6±10.2) years, and the tumor size ranged from 17.0 to 46.0 (30.6±8.7) mm. Of the 18 patients in the CT guided group, the age ranged from 39.0 to 76.0 (58.1±9.8) years, and the tumor size ranged from 12.0 to 45.0 (30.9±9.2) mm. There were no significant differences in age and tumor size between the two groups ( P>0.05). During and within one week of ablation, 3 patients developed hydrothorax in the ultrasound guided group and 8 patients developed hydrothorax, and 7 patients pneumothorax in the CT guided group. The difference between the two groups was significant ( P<0.05). All complications were successfully treated with conservative treatment. One month after ablation, the complete ablation rate was 91.2% (31/34) in the ultrasound guided group and 88.9% (16/18) in the CT guided group. There was no significant difference between the two groups ( P>0.05). Conclusion:The two methods of guidance resulted in similar short-term efficacy after thermal ablation for liver cancer at hepatic dome. Compared with computed tomography guidance, ultrasound guidance with assisted technologies significantly reduced the incidence of thoracic complication rates.

Despite the advancement of treatments, adults with relapsed/refractory (R/R) B-lineage acute lymphoblastic leukemia (B-ALL) have poor prognosis, with an expected five-year overall survival (OS) rate of 10%‒20% (Nguyen et al., 2008; Oriol et al., 2010). Extramedullary relapse of B-ALL is regarded as a high-risk factor generally associated with poor survival, occurring in about 15% to 20% of all relapsed patients (Ding et al., 2017; Sun et al., 2018). The central nervous system (CNS) and the testes are the most common sites of extramedullary relapse of B-ALL. In addition, extramedullary leukemia can appear in the skin, eyes, breasts, bones, muscles, and abdominal organs. The prognosis of relapsed extramedullary B-ALL after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is extremely poor (Spyridonidis et al., 2012; Dahlberg et al., 2019). Conventional chemotherapy or radiation is often ineffective in such patients. At present, there are no optimal treatment strategies for treating extramedullary leukemia after allo-HSCT.
Adult ; Antigens, CD19 ; Hematopoietic Stem Cell Transplantation ; Humans ; Immunotherapy, Adoptive/adverse effects* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy* ; Receptors, Chimeric Antigen ; Recurrence