Minimally invasive treatment of liver cancer plays a very important role in clinical practice in China, because most patients had the background of hepatitis or cirrhosis and were prone to recurrence after radical resection of the tumor. In the past four decades, much progress has been made in controlling liver cancer, which is well consistent with the trends of minimally invasive treatment. Minimally invasive therapy is also the main goals of our practice and has a great potential developing future, although a good outcome is the prerequisite. Nowadays, minimally invasive treatment for liver cancer includes percutaneous transarterial chemotherapy or embolization (TAE or TACE), percutaneous ethand injection (PEI), and ablation with radiofrequency, micromave, cryosurgery or high intensity focused ultrasound.

Adult ; Aged ; Carcinoma, Squamous Cell ; surgery ; Esophagus ; surgery ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Male ; Middle Aged ; Phonation ; Postoperative Period ; Reconstructive Surgical Procedures ; methods ; Speech, Alaryngeal ; Trachea ; surgery

Objective To study the characteristics of pulmonary function in atypical asthmatic children with chest tightness or sighing breath as the sole presenting manifestation,and explore the diagnostic values of fractional exhaled nitric oxide (FeNO) for the atypical asthma.Methods Seventy-nine atypical asthmatic children with chest tightness as the sole presenting manifestation during January 2012 to June 2015 were selected as subjects.All of the subjects performed spirometry,FeNO measurement,total serum IgE and specific IgE determination on their first visit,and with either positive bronchial provocation test or positive bronchial dilation test.As well as 100 healthy children who perfomred FeNO measurement were selected as control group during the same period.The pulmonary function data and FeNO values were analyzed in children who were finally confirmed as atypical asthma.Results In atypical asthma children,the abnormal rate of forced expiratory flow 50％,75％ (FEF50,FEF75) and maximum mid-expiratory flow (MMEF) were 27％,43％ and 33％.Methacholine provocation dose causing a 20％ fall in FEV1 (PD20-FEV1) were 0.41 (0.19 ～0.67)mg and were positively related with MMEF(r =0.301,P =0.007).FeNO concentration in atypical asthma patients were 13.0 × 10-9 (7.0 ×10-9 ～24.0 × 10-9),higher than that in control group(P ＜0.05).Significant correlations were found between FeNO and total serum IgE (r =0.672,P =0.001).No correlations were found between FeNO and FEV1 (P ＞0.05),between FeNO and FEV1/FVC％ (P ＞0.05) or between FeNO and PD20-FEV1 (P ＞0.05).The diagnostic values of FeNO for the atypical asthma were analyzed using the receiver operating characteristic curve,the area under the curve was 0.600.Conclusion The characteristics of pulmonary function in atypical asthma are hypofunction mainly in small airway and patients with lower MMEF had higher airway hyperresponsiveness.The diagnostic values of FeNO in atypical asthma are limited.

Abstract:Objective To detect the expression of hepatic function indices and autoantibodies in patients with chronic hepatitis B patients, patients with autoimmune liver disease and patients with chronic hepatitis B combined with autoimmune liver disease, and to evaluate the clinical significance of autoantibodies and hepatic function indexes in the early diagnosis of chronic hepatitis B combined with autoimmune liver disease.Methods A total of 109 healthy controls (HC), 72 patients with chronic hepatitis B (CHB), 74 patients with autoimmune liver disease (AILD), and 24 patients with chronic hepatitis B combined with autoimmune liver disease (CHB+AILD) in the Fifth People’s Hospital of Suzhou from 2013 to 2021 were enrolled in this study. Basic information and the value of admission hepatic function indexes and autoantibodies were collected for all enrolled samples, while no autoantibody test was performed for healthy volunteers. All data were processed using GraphPad Prism and SPSS software.Results There were no significant differences in age and gender among the four groups. The detection rates of anti-mitochondrial antibody M2 (AMA-M2) and anti-soluble acidic phosphorylated nuclear protein antibody (anti-SP100 antibodies) in CHB+AILD group [29.2%(7/24), 17.4%(4/23)] were significantly higher than those in CHB group [5.1%(3/59), 0(0/59)], suggesting that the detection of these two autoantibodies is helpful to the differential diagnosis of CHB and CHB+AILD. In addition, eight hepatic function indexes displayed significant differences among the four groups. The levels of total bilirubin and direct bilirubin in CHB+AILD group were significantly higher than those in CHB and AILD groups, while the levels of total protein and albumin were significantly lower than those in CHB and AILD groups. Alkaline phosphatase and glutamyltranspeptidase in AILD group and CHB+AILD group were significantly higher than those in CHB group. The logistic regression analysis showed that total bilirubin, direct bilirubin, albumin, alanine aminotransferase and alkaline phosphatase could form a promising prediction model, which was useful for clinicians in the differential diagnosis of CHB and CHB+AILD (area under the curve, AUC=0.902).Conclusion The combination of autoantibody and hepatic function index detection can be helpful for clinicians in the differential diagnosis of CHB, AILD and CHB+AILD, thus contributing to the early and correct diagnosis of CHB+AILD and providing theoretical basis for patients to obtain reasonable treatment and clinical cure earlier.

OBJECTIVETo investigate the prevalence and possible influencing factors of depressive disorder in surgical inpatients.

METHODSTwo hundred and sixty-six surgical inpatients meeting the inclusion criteria were first screened with the self rating depression scale (SDS), and then the subjects screened positive and 20% of those screened negative were evaluated with Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) as a gold standard for diagnosis of depressive disorder. Possible influencing factors were also analyzed by experienced psychiatrists.

RESULTSThe standard score of SDS in the surgical inpatients were significantly higher than those in the Chinese norm, and the incidence of depressive disorder in the surgical inpatients was 37.2%. Unvaried analysis showed that depressive disorder were associated with gender, education, economic condition, variety of diseases, hospitalization duration, and treatment methods. Logistic regression analysis revealed that gender, economic condition, treatment methods and previous history were the main influencing factors.

CONCLUSIONSThe incidence of depressive disorder in the surgical inpatients is high, and it is mainly influenced by gender, economic condition, treatment methods and previous history.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Depressive Disorder ; epidemiology ; Female ; Humans ; Inpatients ; statistics & numerical data ; Male ; Middle Aged ; Prevalence ; Surgery Department, Hospital ; statistics & numerical data

Objective To explore the imaging appearances and the value of multi-slice CT (MSCT)with post-processing tech-niques in diagnosis and treatment of lumbar hernia (LH).Methods The imaging and clinical data of 1 6 patients with LH which were confirmed by surgery were analyzed retrospectively.Results In 1 6 patients,1 7 lesions of LH were revealed by MSCT.There were superior lumbar hernias in 13 (76.5%),inferior lumbar hernias in 3 (1 7.6%)and diffuse lumbar hernia in 1 (5.9%).Hernia ring in diameter ranged from 1.5 to 9.3 cm,and the hernia sac size ranged from 1.8 cm×2.4 cm to 1 1.3 cm× 6.2 cm.MSCT showed oval or flask shaped mass of extraperitioneal fat with or without peritoneum and visceral contents protruded through the de-fecting fascia floor into lumbar triangle.Superior lumbar hernia was bounded by the 12th rib superiorly,the erector spine muscle medially and the internal oblique muscle laterally.Inferior lumbar hernia was bounded by latissimus dorsi muscle medially,the ex-ternal oblique muscle laterally and the iliac crest inferiorly.Hernia contents included colon in 3 patients and small bowel in 2 with in-carcerated hernia with small bowel obstruction in 1,and adipose tissue and mesentery in other 12.All patients received surgery treatment,and the appropriate surgical methods were selected according to the MSCT findings.The surgical findings were consistent with MSCT results.No recurrence was found during follow-up.Conclusion LH has characteristic CT manifestations.MSCT volu-metric scanning with post-processing techniques can clearly display the type of LH,the size of abdominal wall defect,hernia contents and their complications.It is helpful for diagnosis of the LH and differentiation from other diseases,which may provide important information for clinical surgery.

This study aimed to investigate viral infections and the prevalence of influenza-like illness (ILI) in Shijiazhuang, China, in 2011 and to provide a scientific basis for the diagnosis and control of respiratory tract infections. Throat swab specimens were collected from 483 cases of ILI who were outpatients in the influenza surveillance sentinel hospitals in Shijiazhuang between January and December 2011. All specimens were examined by multiplex RT-PCR for the following 15 respiratory tract viruses: adenovirus (ADV), human rhinovirus (HRV), human parainfluenza virus (PIV types 1-4), influenza virus A (FluA), influenza virus B (FluB), human enterovirus (HEV), respiratory syncytial virus (RSV-A and -B), human metapneumovirus (HMPV), human coronavirus (HCoV-229E/NL63 and -OC43/HKU1), and human bocavirus (HBoV). Among the 483 cases of ILI, 214 (44.31%) were positive for viruses, including ADV (8.7%), HEV (8.7%), RSV-A (8.07%), HRV (7.45%), FluA (5.38%), HCoV-OC43/ HKU1 (2.9%), PIV-3 (2.9%), HMPV (1.86%), PIV-1 (1.24%), HCoV-229E/NL63 (1.04%), PIV-2 (1.04%), HBoV (0.83%), and FluB (0.41%). Twenty-six (5.38%) of all cases were co-infected with two or more viruses, most commonly HEV/HRV with other viruses. Cases of viral infection were detected throughout the year, with peaks in January and February. ADV and HRV were detected throughout almost the whole year without obvious seasonality. HEV was detected between April and November, with a peak of prevalence in summer and autumn. FluA and FluB reached epidemic levels mainly in winter and spring. All cases of RSV were identified to be subtype A. PIV infection was mainly caused by PIV-3. The positive rate of HCoV-OC43/HKU1 infection was significantly higher than that of HCoV-229E/NL63. The leading five viruses that resulted in ILI Shijiazhuang in 2011 were HEV, ADV, RSV-A, HRV, and FluA, and these viruses have different epidemiological features.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Influenza, Human ; epidemiology ; virology ; Male ; Middle Aged ; Respiratory Tract Infections ; epidemiology ; virology ; Virus Diseases ; epidemiology ; virology ; Viruses ; classification ; genetics ; isolation & purification ; Young Adult

Objective To describe a new kind of Y-shaped metallic stent delivery system and evaluate its feasibility and preliminary effect for managing multiple airway stenoses involving the lower trachea and the tracheal carina.Methods The Y-shaped metallic stent delivery system consisted of three- tier structure.The inner-tier was composed of four parallel guiding tubes,which was used for two guidewires and two threads passing through,the middle-tier was delivery catheter,which contained the four guiding tubes,and the outer-tier was introducer sheath.Under the fluoroscopic guidance,15 patients with multiple stenoses involving the lower trachea and the tracheal carina were treated with the new covered self-expandable Y-shaped metallic stents.Results Stent placement in the tracheo-bronchial tree was technically successful in all patients with obliteration of the dyspnea immediately after stent placement,and SaO_2 was increased form preoperative 75%—89% to postoperative 96%—99%.During follow-up a period of 3—58 weeks (M 22 weeks),all stenosis were resolved without stent-related complications,and the general physical of all 15 patents was improved with no occurrence of obviously dyspnea and bleeding.Karnofsky performance status(KPS)was improved from preoperative 26%—45% to postoperative 72%—95%.Five patients died of the following causes unrelated to stent insertion:multiple organ failure(n=3),cachexia(n=1)and pulmonary infection caused by gastrobronchial fistula(n=1),and the remaining 10 patients were alive with no evidence.of dyspnea at the time of this report.Conclusion Deployment of the covered Y-shaped metallic stent with the use of Y metallic stent delivery system in the management of airway stenoses involving the lower trachea and the tracheal earina was a simple and safe procedure and with a good short-term clinical efficacy.

Objective:To investigate the expression of hypoxia-inducible factor-2α (HIF-2α)in non-small cell lung cancer (NSCLC)tissue,and to analyze its relationships with angiogenesis,cell proliferation and chemotherapy resistance. Methods: Total 112 cases of NSCLC and 20 cases of normal lung tissues were selected, immunohistochemical method was used to detect the expressions of HIF-2α,CD31,Ki67 and GST-π in 112 cases of cancer tissue and 20 cases of normal lung tissue,and the correlations of HIF-2α expression with microvessel density (MVD),Ki67, and GST-π were analyzed.Results:The positive expression rate of HIF-2α in NSCLC tissue was significantly higher than that in normal lung tissue (P < 0.05 ), the expression rate of HIF-2α in 112 cases of NSCLC was 47.3% (53/112).The MVD in HIF-2α protein high expression NSCLC group (31.1 ± 14.7)was higher than that in HIF-2αprotein low expression NSCLC group (24.3±15.8)(P <0.05).The cases of high expression of Ki67 in HIF-2αhigh expression group occupied 54.7% (29/53),and it was higher than that in HIF-2αlow expression group (16/59,27.1%);there was significant difference (r = 0.281,P = 0.003).The high expression of HIF-2α had no obvious correlation with the expression of GST-π (r = 0.122,P = 0.202). Conclusion:HIF-2αmay play an important role in the carcinogenesis and development of NSCLC by promoting the angiogenesis and enhancing the cell proliferation of NSCLC,but it may have no correlation with chemotherapy resistance.

To investigate the effect and possible mechanism of echinacoside-containing serum on the osteogenic differentiation in rat bone marrow mesenchymal stem cells. Rat bone marrow mesenchymal stem cells were cultivated by the whole bone marrow adherence method. The 3rd generation of cells were divided into 3 groups: the blank control group, the classic osteogenic-induced group and the 10% echinacoside-containing serum group. The expression of alkaline phosphatase and osteocalcin were detected by ELISA. The ex- pression of ZHX, protein was detected by Western blot technique. RT-PCR technique was used to detect the expression of ZHX₃mRNA. According to the result, the expressions of the alkaline phosphatase and osteocalcin in the classic osteogenic-induced group and the 10% echinacoside-containing serum group were significantly higher than that of the blank control group (P <0. 01). And expressions of the alkaline phosphatase activity and osteocalcin in the 10% echinacoside-containing serum group were significantly higher than that in the classic osteogenic-induced group (P < 0.01). Meanwhile, the classic osteogenic-induced group and the 10% echinacoside-containing serum group showed obviously higher ZHX₃ protain and mRNA expression than that of the black control group, with significant differences (P < 0.01); the 10% echinacoside-containing serum group showed obviously higher ZHX₃ protain and mRNA expression than that of the classic osteogenic-induced group, with a significant difference (P < 0.01). In conclusion, 10% echinacoside-containing serum can promote the differentiation of the bone marrow mesenchymal stem cells cultured in vitro. Its mechanism may be correlated with the increase in the ZHX₃expression.
Animals ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Female ; Glycosides ; blood ; pharmacology ; Homeodomain Proteins ; genetics ; metabolism ; Male ; Mesenchymal Stromal Cells ; cytology ; drug effects ; metabolism ; Osteogenesis ; drug effects ; Rats ; Rats, Sprague-Dawley ; Serum ; chemistry ; Transcription Factors ; genetics ; metabolism