Objective:To analyze the related risk factors for esophageal variceal bleeding(EVB)in patients with hepatocirrhosis and portal hypertension,so as to provide clinical evidences for establishing preventive measures for EVB. Methods:Using"*esophag*","varice*","bleeding","hemorrhage",and"risk factor*"as the key words,we searched the clinical studies(1986-2006)about the risk factors of EVB in hepatocirrhosis patients in PubMed,Medline,Chinese Biomedical Database,Elsevier Database,OVID Database,etc.for Meta-analysis.The odds ratio(OR)of each risk factor was estimated and the 95% confidence interval[95% CI]was calculated.Results:Totally 19 papers met our criteria and were included in this Meta-analysis.The 19 papers involved 995 EVB patients and 1854 controls.Meta-analysis revealed that a hepatic function of Child C,decreased prothrombin activity,hypoalbuminemia,severe esophageal varices,positive red-color sign,extended portal vein width and splenic vein width,thrombopenia,leucopenia and anemia were the risk factors of EVB;a hepatic function of Child A and mild esophageal varices were the protective factors of EVB.The gender,age,hepatic function of Child B,ascites, hepatic encephalopathy,hyperbilirubinemia and midrange esophageal varices were not significantly associated with EVB. Conclusion:Improvement of poor hepatic function,blood coagulation status,hypoalbuminemia and treatment & prevention of severe esophageal varices(by endoscopic variceal ligation,devascularization and shunt)can help to reduce the incidence of EVB.

Objective To summarize the characteristic findings on chest radiography and spiral CT of anomalous systemic arterial supply to normal basal segments of the left lower lobe of the lung.Methods Five patients with anomalous systemic arterial supply to normal basal segments of the left lower lobe of the lung were retrospectively reviewed.Chest radiography,and contrast-enhanced spiral CT scan were analyzed. Results On posteroanterior chest radiographs,the findings in 5 cases of this anomaly were all shown as a retrocardiac mass,narrowing lower lobar pulmonary artery shadow,and without normal lower lobar pulmonary artery branches but there were dilated abnormal markings in left lower lung zone.On contrast- enhanced spiral CT scans,the involved left lower lobe of the lung had mild volume loss but normal bronchial trees in all 5 cases and areas of ground-glass opacity in 2 cases.The absence of normal left lower lobar pulmonary artery distal to the origin of superior segmental artery,anomalous systemic artery originating from the descending aorta,diffuse dilatation of the systemic arterial branches distributed in the basal segments of the left lower lobe were also found in all the patients.One patient who underwent angiography had similar vessel features with spiral CT.Conclusion There are some characteristic findings on chest radiography in this anomaly.the contrast-enhanced spiral CT scans are important in diagnosing and avoiding invasive angiography and life-threatening lung biopsy.

To study the chemical components and the antifungal activity of extraction from conidia of Trichoderma viride LTR-2.The extraction were obtained by distilling with Methylene dichloride from conidia of Trichoderma viride LTR-2 cultured on wheat bran solid matrix.Antifungal activity were determined by mycelium growth method.The chemical components of the extraction were analysed by GC-MS,the relative components in the extraction were determined by area normalization.The extraction not only have broad-spectrum control,showed antibiosis against eleven different plant fungal pathogens in PDA dish,such as Rhizoctonia solani,Alternaria brassica,Verticillium dahliae,Macrophoma kawatsukai,Fusarium moniliforme,Botrytis cinerea,Rhizoctonia cerealis,Fusarium oxysporum f.sp.vasinfectum,Bipolaris sorokinana,Fusarium graminearum,Alternaria.mali,but also have high inhibitory effect,and had 89.3% suppressive rate to Rhizoctonia cerealis.About sixty components were separated and identified by GC-MS,majority components were Hydrocarbon,the number of the Hydrocarbon were fourty-three kinds.Ergosterol was the major chemical components of the extract,and has 41.90% content.Other components comprised:Ketone,Organic acid,Alcohol,Ene,et al.Conclusion:The extraction from conidia of Trichoderma viride LTR-2 have antifungal activity.The extration comprised 2H-Pyran-2-one,5,6-dihydro-6-pentyl,it has 2.35% content.reference others literature,2H-Pyran-2-one,5,6-dihydro-6-pentyl may be the suppressive component of the extration.

Objective To assess the value of CT perfusion imaging in differentiation of mild from moderate liver fibrosis .Methods 18 patients with mild liver fibrosis (F1 phase) and 21 ones with moderate fibrosis (F2 and F3 phase) confirmed by liver biopsy were analyzed ,and all patients underwent the liver 256‐slice CT perfusion imaging .The differences in the CT parameters including hepatic arterial perfusion (HAP) ,portal venous perfusion (PVP) ,total liver perfusion (TLP) and time to peak (TTP) between dif‐ferent fibrosis were analyzed .ROC curve was used to evaluate the ability of perfusion indexes to distinguish mild from moderate liver fibrosis ,then the maximum Youden index was selected as a cutoff point to calculate the sensitivity and specificity .Results Compared with the mild fibrosis ,the TTP [(43 .86 ± 13 .41)s vs (37 .84 ± 9 .97)s ,P=0 .034)] in liver with moderate fibrosis was significantly increased .However ,no differences in the HAP ,PVP and TLP were found .The ROC curve analysis showed that a TTP threshold of 41 .7 s allowed discrimination of mild from moderate fibrosis with a sensitivity of 72 .7% and a specificity of 75% .Conclusion 256‐slice CT perfusion imaging can reflect the hemodynamic changes of liver fibrosis ,and the TTP may help to discriminate mild from moderate fibrosis .

Animals ; Chimera ; Humans ; Liver ; Mice

Objective To study the inducement of U251 glioblastoma cell apoptosis in vivo through up-regulating PUMA expresion and knocking down miR-221/222, and explore its mechanism.Methods Nude mouse xenograft models were established in 5-week-old BALB/c nude mice by subcutaneous vaccination of U251 glioblastomas; 1 week later, they were treated with intratumoral injection of lipofcctamine-mediated miRNA-221/222 antisense oligonucleotides (GroupA), nonsense sequences (Group B) and controls (Group C),respectively (n=8).The tumor growth was monitored until the end of observation period (28 d after the treatment) and pathological changes of the glioblastoma tissues were observed by HE staining at the end of observation.Fluorescence in situ hybridization (FISH) and real-time PCR were employed to measure the miR-221 and miR-222 expressions. Terminal deoxynucleotidyl transferase-mediated uridine 5'-triphosphate-biotin nick end labeling (TUNEL) assay was used to detect the apoptosis of glioblastomas.Immunohistochemistry and Westem blotting were used to detect the expressions of PUMA,bax,bcl-2 and p53 in removed tumor specimens. Results The volume in Group A was significantly smaller than that of those in group B and group C 6-28 dater treatment (P=0.006). The miR-221 and miR-222 mRNA expressions in Group A were significantly decreased as compared with those of those in group B and group C.HE staining indicated that decreased heteromorphism and reduced number of new vessels in Group A were noted as compared with those in group B and group C.The cell apoptotic index in Group A was significantly higher than that in group B and group C (P＜0.05).Immunohistochemistry showed that the expression levels of PUMA and bax in Group A was significantly up-regulated as compared with those in group B and group C, while the expression of bcl-2 in Group A was significantly down-regulated as compared with that in group B and group C; and no significant changes were noted in the p53 expression. Conclusion By up-regulating PUMA expresion,knocking down miR-221/222 can induce U251 glioma apoptosis in vivo.

OBJECTIVETo study the clinical and pathological features, diagnosis, therapy and prognosis of primary small intestine malignant tumor.

METHODSA retrospective analysis was performed on the clinical data from the 120 cases of primary small intestine malignant tumor.

RESULTSAbdominal pain, gastrointestinal bleeding, anemia, abdominal mass and jaundice were the main clinical features. The pathology was confirmed by abdominal X-ray, gastrointestinal barium, CT, MRI, endoscopy and surgical exploration. Most tumors originated in the duodenum (54.1%), and adenocarcinoma (55.8%) was the main pathological type. The median survival time of the patients was 19.2 months and the 1-year survival rate was 55.4%. Chemotherapy did not seem to significantly improve the 1-year survival rate of the patients (P=0.842).

CONCLUSIONPrimary small intestine malignant tumors lack specific clinical manifestations and surgical resection should be performed as early as possible.

Adenocarcinoma ; diagnosis ; surgery ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Female ; Humans ; Intestinal Neoplasms ; diagnosis ; drug therapy ; surgery ; Intestine, Small ; pathology ; surgery ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo study the risk factors related to the survival rate, recurrence and metastasis of malignant fibrous histiocytoma of bone.

METHODSFrom July 1997 and July 2010, 56 patients with malignant fibrous histiocytoma of bone were treated. Univariate and multivariate analysis were performed to determine the probable risk factors including gender, age, tumor location, tumor size and so on.

RESULTSForty-four cases were followed up ranged from 2 weeks to 78 months (medium 33.3). The 5-year overall survival rate was 50.1%, local recurrence rate 40.9% with a median time of 12 months (3 to 60 months) and metastatic rate 27.5% (11/40) with a median time of 6.5 months (2 to 23 months). Univariate analysis indicated that gender, condition of presentation (primary case or recurrence case), tumor location, surgical margin and surgical stage were significantly related to survival rate (P < 0.05), and tumor location and surgical margin were related to local recurrence rate (P < 0.05), and important vessel or nerve invasion was related to metastatic rate (P < 0.05). Multivariate analysis showed that surgical margin and surgical stage were independent risk factors for survival rate, of which surgical margin was the independent risk factor for recurrence rate.

CONCLUSIONSSurgical margin and surgical stage are independent risk factors for survival rate, of which surgical margin is the independent risk factor for recurrence rate.

Adolescent ; Adult ; Aged ; Bone Neoplasms ; diagnosis ; pathology ; Female ; Histiocytoma, Malignant Fibrous ; diagnosis ; pathology ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local ; pathology ; Prognosis ; Retrospective Studies ; Survival Rate ; Young Adult

Objective: To evaluate the impact of coronavirus disease 2019 ( COVID-19 ) prevention and control measures in Huzhou on influenza epidemic strength and characteristics in 2020, so as to provide reference for formulating influenza prevention measures. Methods: Using the influenza surveillance data of the national influenza sentinel surveillance system from January 2015 to July 2020, the seasonal characteristics of influenza epidemic were analyzed, the proportion of influenza-like illness cases ( ILI% ) and the positive rate of influenza virus in January to July of 2020 were compared with those of the same period in 2015-2019, in order to evaluate the impact of COVID-19 prevention and control measures. Results : The ILI% and the positive rate of influenza virus in Huzhou were 3.90% and 15.32% during 2015-2019, while were 4.41% and 12.63% from January to July of 2020. The trends of ILI% during 2015-2019 fluctuated similar, but continued to drop since January 2020. The positive rate of influenza virus peaked from December to March in 2015-2019, also peaked from December 2019 to January 2020, but decreased to 0 in March. ILI% was positively correlated with the positive rate of influenza virus ( r=0.682, P<0.05). The growth rates of ILI% from January to July 2020 were 4.75%, -11.27%, 0.68%, 19.84% and 0.92%, compared with the same period of 2015-2019, respectively. The growth rates of ILI% in January 2020 were much higher ( >57.00% ) and from April to July were much lower ( <-33.00% ) . The growth rates of influenza virus positive rate from January to July 2020 were -47.96%, -36.53%, -3.44%, -35.92% and -39.37%, compared to the same period of 2015-2019, respectively. The growth rates of influenza virus positive rate in January 2020 were much higher ( >11.00% ) and from February to March were much lower ( <-61.00% ). Conclusion Since COVID-19 prevention and control measures were implemented in January 2020 in Huzhou, the ILI% and the positive rate of influenza virus in sentinel hospitals decreased significantly.

OBJECTIVETo evaluate therapeutical effect of combined hepatic resection and fenestration on patients with severe adult polycystic liver disease (APLD).

METHODSPreoperative clinical symptoms, postoperative complications and prognoses from 33 patients with severe adult polycystic liver disease (APLD) treated with combined hepatic resection and fenestration were recorded. According to the number and location of cysts before surgery and the remnant liver parenchyma after operation, all patients were classified into two types: class A and B. And patients in each type were further classified into three grades: Grade I, II and III. The frequency of postoperative complications of two types patients was compared.

RESULTSThe mean follow-up time was 57 months. There were three patients with recurrence of symptoms at 81, 68 and 43 mouths after operation. Two patients died of renal failure due to polycystic kidney disease at 137 and 85 mouths after operation. And one patient with postoperative hepatic inadequacy received an orthotopic liver transplantation. The total number of patients with postoperative complications was 26 cases, including one patient with bleeding, two patients with bile leakage, fourteen patients with mild ascites, twelve patients with severe ascites and eighteen patients with pleural effusion, and the overall incidence was 78.8%. There were 22 patients with imaging data, including 6 patients within A type and sixteen patients within B type. The frequencies of postoperative complications were 4 and 31, respectively, and the difference was statistically significant (Chi-square test = 4.99, P less than 0.05).

CONCLUSIONCombined hepatic resection and fenestration is a safe and acceptable procedure for the treatment of severe APLD.

Adult ; Aged ; Ascites ; epidemiology ; etiology ; Cysts ; diagnostic imaging ; pathology ; surgery ; Female ; Follow-Up Studies ; Hepatectomy ; methods ; Humans ; Liver ; diagnostic imaging ; pathology ; surgery ; Liver Diseases ; diagnostic imaging ; pathology ; surgery ; Male ; Middle Aged ; Pleural Effusion ; epidemiology ; etiology ; Postoperative Complications ; epidemiology ; prevention & control ; Prognosis ; Recurrence ; Retrospective Studies ; Severity of Illness Index ; Tomography, X-Ray Computed ; Treatment Outcome