Objective:To compare MRI characteristics between hepatic benign nodules and hepatocellular carcinoma (HCC) associated with Budd-Chiari syndrome(BCS).Methods:A retrospective study was conducted on 130 consecutive patients with BCS who were treated at the Affiliated Hospital of Xuzhou Medical University from January 2011 to June 2018. There were 67 males and 63 females, age ranged from 18 to 78 years, with median age was 46 years. There were 45 patients with HCC and 85 patients with benign liver nodules. This study aimed to compare the clinical characteristics of BCS patients with HCC and benign nodules, and to compare the MRI features (distribution, capsule, plain scan signal, enhancement pattern) between HCC and benign nodules. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of each of the indicators in the diagnosis of hepatocellular carcinoma.Results:The age and alpha-fetoprotein levels of the BCS patients with benign nodules were significantly lower than the BCS patients with HCC, while the international standardized ratio was significantly higher than the BCS patients with HCC (all P<0.05). Of the 130 BCS patients, there were 337 benign and 78 hepatocellular carcinomas nodules. The diameter of benign nodules was significantly smaller than HCC, and the proportions of benign nodules with encapsulation, fat content, cystic necrosis and hemorrhage were significantly lower than HCC (all P<0.05). The proportions of benign nodules with T 1 weighted imaging high signal, T 2 weighted imaging (T 2WI) low or equal signal and diffusion-weighted imaging (DWI) equal signal were significantly higher than HCC (all P<0.05). The proportions of benign nodules with washout appearance, arterial phase hyperenhancement and washout appearance were significantly lower than HCC (all P<0.05). The areas under the ROC curve for the diagnosis of HCC by DWI high signal and T 2WI high signal were 0.936 and 0.927, respectively, with sensitivities of 96.2% and 92.3%, specificities of 91.0% and 90.1%, respectively. Conclusion:The MRI features of BCS patients with benign regenerative nodules were significantly different from those of BCS patients with HCC. The washout appearance had a low specificity for the diagnosis of HCC.

Objective To examine short-term outcomes and long-term survival of elderly patients (aged over 80 years) with colorectal cancer who received laparoscopic versus open surgery. Methods A total of 313 patients over 80 years old with colorectal cancer who underwent radical surgery were included.According to the surgical method, all patients were divided into open-surgery group (n=143) and laparoscopic surgery group (n=170).Baseline data were balanced between the two groups by using propensity score matching.Kaplan-Meier was used to draw the survival curve, and survival was compared by Log rank tests.Cox proportional risk model was used to analyze the effects of all factors on overall survival (OS) and disease-free survival (DFS). Results After matching, 93 patients were included in each group.The mean intraoperative blood loss, the incidence of overall postoperative complications and gradeⅠ-Ⅱ complications in the laparoscopic surgery group were significantly lower than those in the open surgery group (all P < 0.05).The time to first flatus, the time to oral feeding, and postoperative hospital stays in the laparoscopic surgery group were significantly shorter than those in the open surgery group (all P < 0.05).The mean number of lymph-node dissection was also significantly higher in the laparoscopic surgery group than in the open surgery group (P=0.030).Patients in both groups had similar 5-year OS (P=0.594) and DFS (P=0.295).Multivariate Cox prognostic analysis showed that CEA level > 5 ng/ml, pathological TNM stage Ⅲ, and perineural invasion were independent risk factors for poor OS and DFS. Conclusion Compared with open surgery, laparoscopic surgery can provide better short-term advantages and similar long-term outcomes for colorectal cancer patients over 80 years of age.

Objective To investigate the dynamic changes of dead space fraction (VD/VT) and its effect on the prognosis in the patients with acute respiratory distress syndrome (ARDS).Methods Thirtytwo patients with ARDS in EICU of the First Affiliated Hospital of Kunming Medical University from January 2015 to August 2016 were selected and divided into the survival group and the death group according to the 28 d mortality rate.VD/VT on 1-6 d in the two groups was calculated according to the formula.The parameters of basic condition,PaO2/FiO2,APACHE Ⅱ score,LIPS score,PEEP of the two groups were compared.Results LIPS and APACHE Ⅱ scores had statistical difference between the death group and survival group (P＜0.05);VD/VT on 1-3 d had no statistical difference between the two groups (P＞0.05),and VD/VT on 4-6 d in the death group was significantly higher than that in the survival group (P＜0.01).△PCO2,pH and PaO2/FiO2 had statistical difference between the death group and the survival group (P＜0.05).The binary classification Logistic regression analysis found that APACHE Ⅱ,LIPS,△PCO2,VD/VT were the risk factors.VD/VT on the 4th day was selected,its' cut off value was 0.62,and the sensitivity of the prognostic evaluation was 90.0 ％,the specificity was 95.5 ％.Conclusion The dead space fraction is an independent risk factor for the prognosis of ARDS patients,and VD/VT on 4th day could effectively identify the high-risk patients.

Objective To explore the value of multiple non-gaussian distribution models DWI in evaluating hepatic ischemia reperfusion injury (HIRI) model in rats.Methods Forty-two SD rats were divided into 7 groups by random numeric table method.Each group had 6 rats.The 7 groups were 6 h,12 h,1 d,3 d,7 d,14 d group after HIRI and control group,respectively.The experimental groups underwent right hepatic portal vein and hepatic artery ligation,and received reperfusion 3 h after operation.MRI scanning (T1WI,T2WI,single b-values DWI and 15 b-values DWI) was performed at 6 h,12 h,1 d,3 d,7 d and 14 d after reperfusion.The control group underwent sham operation and MRI scanning.According to monoexponential model,biexponential model,threxponential model,stretched-exponential model DWI and diffusion kurtosis imaging,many parametres were obtained and their dynamic changes at each time point were observed.The parameters included standard apparent diffusion coefficient (ADCs),pure diffusion coefficients (D),pseudodiffusion coefficients (D*),perfusion fraction (f),ultra-high apparent diffusion coefficient (ADCu),distributed diffusion coefficient (DDC),water diffusion heterogeneity index (or),mean diffusion coefficient (MD) and mean diffusion kurtosis (MK).One way ANOVA was used to compare the differences of parameters among different groups.Results MRI examination and pathological examination were successfully completed in all rats.The right hepatic lobe in the experimental groups appeared hypointense on T1WI and hyperintense on T2WI relative to control group from 6 h after operation.The infarcted liver lobe in the experimental groups became significantly smaller at 1 week after HIRI and almost disappeared at 2 weeks after HIRI.The findings of DWI at different b-values were consistent with those at T2WI.There were significant differences in parameters among 6 h,12 h,1 d,3 d,7 d,14 d groups after HIRI and control group (P＜0.05).There were significant differences among 12 h after HIRI,1 d after HIRI,3 d after HIRI and 6 h after HIRI,7 d after HIRI,14 d after HIRI,control group concerning ADCs values respectively (P＜0.05).There were significant differences among 6 h after HIRI,12 h after HIRI,1 d after HIRI,3 d after HIRI,7 d after HIRI and 14 d after HIRI,control group concerning D,D*,f,ADCu,α,DDC,MK values respectively (P＜0.05).In addition,there were significant differences among 1 d after HIRI,3 d after HIRI and 6 h after HIRI,12 h after HIRI,7 d after HIRI and 14 d after HIRI,control group concerning D values respectively (P＜0.05).There were significant differences among 6 h after HIRI,12 h after HIRI,1 d after HIRI,3 d after HIRI and 7 d after HIRI,14 d after HIRI,control group concerning f values respectively (P＜0.05).There were significant differences among 12 h after HIRI and 14 d after HIRI,control group concerning MD values respectively (P＜0.05).There were significant differences between 1 d after HIRI and 14 d after HIRI concerning MD values (P＜0.05).Conclusion Multiple non-gaussian distribution models DWI is superior to conventional DWI in evaluating HIRI model in rats.

Objective To explore the public's cognition and attitude towards general medicine,general practitioners,and pre-hospital first-aid knowledge in Ludian County,Yunnan Province,to find out the training and learning methods that are more acceptable to the public for this kind of related knowledge,and to propose targeted solutions.Methods A complete random sampling survey was conducted among the nucleic acid collection office at the gate of the vegetable market from October 15,2022,to December 30,2022,and the outpatient clinic of Wenping Street Health Center from January 1,2023,to February 28,2023,by using electronic questionnaire and paper questionnaire.Results Nearly 50%of the people in Ludian County of Yunnan Province lack the knowledge of general medicine and pre-hospital emergency care,especially the knowledge of electrical defibrillation.People with higher education and the medical profession have a higher understanding of general medicine,and people with a higher understanding of general medicine are more willing to participate in pre-hospital emergency care.The average Ridit value is:very familiar with general medicine(0.774)>Knowledge of some general practices(0.565)>Never heard of general practice(0.400).The higher education level and the more comprehensive understanding of general medicine had a positive impact on participation in pre-hospital emergency care,with B values of 0.624 and 0.619,OR 95%CI of 1.867(1.544～2.257)and 1.857(1.298～2.657),respectively.Taking medical staff as a reference,the B value of medical students was = 0.942,P = 0.234,the difference was not significant,and the B value of non-medical professional population was all less than 0,the effect is negative.In addition,most people have a positive attitude towards learning pre-hospital first aid,and more than 70%of people are willing to learn and train related knowledge of pre-hospital first aid.Conclusions People in urban areas of Ludian County,Yunnan Province have poor understanding of general practice,low recognition of general practitioners,low demand for general practitioners,and lack of awareness of the importance of pre-hospital emergency treatment.Because of the cognitive differences among different groups,it is necessary to conduct specific training for different groups.

Chinese medicinal resources are the cornerstone of the sustainable development of traditional Chinese medicine industry. However, due to the fecundity of species, over-exploitation, and limitations of artificial cultivation, some medicinal plants are depleted and even endangered. Tissue culture, a breakthrough technology in the breeding of traditional Chinese medicinal materials, is not limited by time and space, and can allow the production on an annual basis, which plays an important role in the protection of Chinese medicinal resources. The present study reviewed the applications of tissue culture of medicinal plants in the field of Chinese medicinal resources, including rapid propagation of medicinal plant seedlings, breeding of novel high-yield and high-quality cultivars, construction of a genetic transformation system, and production of secondary metabolites. Meanwhile, the current challenges and suggestions for the future development of this field were also proposed.
Sustainable Development ; Plants, Medicinal/genetics* ; Plant Breeding ; Medicine, Chinese Traditional ; Technology