Objective To further research the biological functions of PES1,the ovarian SKOV3 cell line with inducible stable PES1 expression is established by using Tet-on system.Methods PES1 was cloned into pTRE-Tight vector via PCR and its expression was identified. After transfected the regulating plasmid pTet-on,SKOV3 cells were screened with G418 and re-transfected pTRE-Tight-PES1.The positive cell clones were screened out with hygromycin and were induced by doxycycline (Dox) to definite the best induction concentration.Growth velocity of SKOV3 cells stably expressing PES1 induced by Dox was detected with viola crystallina.Results The SKOV3 cells with inducible PES1 expression were screened out after the cells were transfected pTRE-Tight-PES1 constructed.Dox could dose-dependently induce the PES1 expression with the concentration under 2 mg/L,and 2 mg/L of Dox induced the highest PES1 expression.Growth velocity of SKOV3 cells transfected pTRE-Tight has no significant difference between the SKOV3 cells transfected nothing induced with Dox.However,the SKOV3 cells transfected pTRE-Tight-PES1 grew faster than the cells transfected pTRE-Tight or without transfection in the fourth day (P =0.001 ).Conclusion The inducible stable PES1 expression SKOV3 cells are successfully established and could be used to be an effective cell model to research the biological functions of PES1.The expression of PES1 could promote the growth of SKOV3 cells.

Objective To study the effect of psychological intervention combined with the analysis of Budesonide and Formoterol Fumarate Powder for Inhalation in treatment of chronic obstructive pulmonary disease. Methods 100 patients with chronic obstructive pulmonary disease treated in our hospital from February 2015 to March 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The control group was treated with the Budesonide and Formoterol Fumarate Powder for Inhalation treatment,the experimental group on the basis of psychological intervention on the mental status of patients and patients,strengthen communication and exchanges, increase confidence in the treatment and the treatment compliance of patients. Results After treatment, the SGRQ score of the experimental group was (57.33±16.81), and the score of the control group was (43.86±12.68) points, with statistical difference (P<0.05). The scores of depression and anxiety in the experimental group were significantly better than those in the control group,with statistical difference(P<0.05). Conclusion Budesonide and Formoterol Fumarate Powder for Inhalation combined with mental intervention in the treatment of chronic obstructive pulmonary disease can significantly improve the patients, improve the quality of life, help patients recover as soon as possible, has clinical significance.

Chronic kidney disease (CKD) is becoming a global social problem. It is important to slow down the progression of CKD for economic and social concerns. In recent years, it has been found that colon is one of the vital organs which produce uremic toxins. And enterogenous uremic toxins are closely related to the prognosis of CKD. Theory of gut-kidney axis for the slowdown of CKD progression was raised by foreign scholars and became the research hot spot. Colon therapy with traditional Chinese medicine (TCM) has been widely used in clinical practice and is believed to slow down the progression of CKD by numerous clinical reports. However, low re-search quality and ambiguous results limited its further application. Under the guidance of senior TCM Professor Huang Chunlin, who emphasized the method of draining turbidity through bowels in the management of CKD, from the Nephrology Center, Guangdong Provincial Hospital of Chinese Medicine, as well as the modern theory of gut-kidney axis, we had carried out a series of exploratory researches which will provide data and methodology support for further confirmatory studies and improve its effectiveness.

Objective To investigate the prevalence and risk factors of chronic kidney disease (CKD) in the general adult population in the Hulunbeir Prefecture, Inner Mongolia Autonomous Region where many minorities of north China live. Methods Sampling surveywas performed in the residents aged 20 years and older in the Hulunbeir Prefecture. All the investigated subjects were tested for urinary albumin to creatinine ratio (ACR); hematuria by microscopy of urinary sediment; and GFR estimated by modified MDRD equation for Chinese adults (eGFR). The related risk factors of CKD were also investigated. Results A total of 4522 subjects were enrolled in the study. The prevalence of albuminuria was 7.11％, hematuria was 2.64％ and reduced eGFR [60 ml-min-1·(1.73 m2)-1] was 2.75％. The prevalence of hypertension was 38.90％; hyperglycemia 6.61％; hyperlipidemia 2.72％; increased waist 24.79％ and metabolic syndrome 15.02％. After the subjects with combined microalbuminuria, hematuria and reduced eGFR were excluded, the prevalence of CKD was 12.95％. Logistic regression analysis and stratified analysis showed increased age, increased waist, elevated systolic pressure, hyperglycemia,hypertriglyceridemia and metabolic syndrome were independently associated with albuminuria;increased age, elevated systolic pressure and hyperglycemia were independently associated with reduced eGFR; increased age was independently associated with hematuria. Conclusions The prevalence of adult CKD is 12.95％ in the Hulunbeir Prefecture, Inner Mongolia Autonomous Region. Independent risk factors of CKD include increased age, increased waist, hypertension,abnormal blood glucose or lipid, and metabolic syndrome.

Objective:To investigate the effect of interventional embolization of prostate artery in patients with benign prostatic hyperplasia with prostatic volume>80 ml.Methods:A total of 56 patients with BPH combined with hypertension, diabetesand heart disease with prostate volume>80 ml in Meizhou People′s Hospital from April 2018 to November 2020 were selected. They were divided into the study group and the control group according to a simple random number table, 28 cases in each group. The patients in the study group were performed prostatic arterial embolization, and the patients in the control group were performed transurethral resection of the prostate. The efficacy, perioperative conditions, preoperative and 1 month after operation serum total prostate specific antigen (TPSA) level, free prostate specific antigen (FPSA) level, prostate volume, and international prostate symptom score (IPSS) were compared between the two groups. The sexual life quality after operation for 6 months was compared between the two groups.Results:The efficacy of the two groups had no significant difference ( P>0.05). The intraoperative blood loss, postoperative catheterization, postoperative hospital stay in the study group were less than those in the control group: (10.65 ± 1.89) ml vs. (119.64 ± 23.60) ml, (2.16 ± 0.39) d vs. (3.05 ± 0.61) d, (3.03 ± 1.82) d vs. (7.10 ± 2.39) d, the differences were statistically significant( P<0.05). The levels of serum TPSA, FPSA and prostate volume, IPSS at the first month after surgery in the two groups had no significant differences ( P>0.05). After operation for 6 months, the scores of Chinese Index of Sexual Function for Premature Ejaculation-5 (CIPE-5) and International Index of Erectile Function (IIEF-5) in the study group were higher than those in the control group: (18.63 ± 2.51) scores vs. (15.71 ± 2.29) scores, (16.38 ± 4.14) scores vs. (13.98 ± 3.82) scores, the differences were statistically significant ( P<0.05). Conclusions:Prostate arterial embolization is effective in BPH patients with prostate volume>80 ml and underlying diseases. Compared with transurethral prostatectomy, it has the advantage of faster recovery after surgery, and it has an ideal effect in controlling diseases, improving urination function, and quality of sexual life.

Objective:To investigate the success rate, operation time and complications of ultrasound combined with X-ray-guided precise implantation of totally implantable access port (TIAP) in the chest wall.Methods:A total of 623 patients who underwent implantation of totally implantable venous access ports in the chest wall in Meizhou People's Hospital, China between January 2015 and August 2018 were included in this study. In group A ( n = 320), jugular or subclavian access ports were precisely implanted in the chest wall under the guidance of ultrasound combined with X-ray. During the surgery, color Doppler ultrasound was used to guide the puncture and a C-arm machine was used to locate the position of catheter tip. In group B ( n = 303), venous access ports were implanted using the conventional method. Subclavian vein puncture was performed using anatomic landmarks and the depth of catheterization was estimated by experience. The success rate of the first implantation, operation time, and complications (pneumothorax, hemothorax, catheter displacement, poor position of catheter tip, skin infection, and thrombosis) were compared between the two groups. Results:There were no statistical differences in baseline data between the two groups ( P > 0.05). The success rate of the first implantation in the group A was significantly higher than that in the group B [100% (320/320) vs. 93.06% (282/303), χ2 = 22.95, P < 0.01]. The operation time in the group A was significantly shorter than that in the group B [(26.48 ± 5.49) minutes vs. (35.51 ± 14.37) minutes, t = -10.25, P < 0.01]. In group A, 2 patients developed pneumothorax and healed after conservative treatment, 6 patients had thrombosis, and the incidence of complications was 2.5% (8/320). In group B, complications occurred in 67 patients, including pneumothorax in 9 patients, poor catheter tip position in 17 patients, thrombosis in 36 patients, and skin infection in 1 patient, and the incidence of complications was 22.11% (67/303). There was significant difference in the incidence of complications between the two groups ( χ2 = 56.53, P < 0.01). In group B, 6 out of 9 patients developing pneumothorax were healed after closed thoracic drainage, and 4 patients underwent a secondary surgery because of catheter displacement into the internal jugular vein. Conclusion:Precise implantation of venous access ports in the chest wall guided by ultrasound combined with X-ray has the advantages including 100% success rate of first precise implantation, few complications, short operation time, high comfort, safety and efficacy.

Objective To investigate the clinical features,diagnosis and treatment of von Hippel-Lindau (VHL) disease in order to improve the understanding of this disease.Methods The clinical features,imaging features,pathological data and treatments of 7 patients in 3 families admitted to our hospital from December 2005 to August 2017 were retrospectively analyzed.Results Ten oprations were performed under the guidance of neural navigation system for the 7 patients.There were 4 enjoying total resection at once;one achieved primary surgical resection of the primary lesions,and residual lesions grew up and the patient accepted surgical treatment at the 7th and 9th years;one patient achieved primary surgical resection of the primary lesion,the residual lesions grew up and surgical treatment was performed 8 months later;another one underwent surgical resection of the primary lesion,and the residual lesion was treated with gamma knife therapy 3 months after surgery.The pathological results of the 10 operations of the 7 patients were proved to be hemangioblastoma.No operative deaths were noted.The symptoms of these patients when they were discharged from the hospital were significantly better than those when they were on admission.The 10 patients were followed up so far,no symptoms of neurological impairment were noted,and they could work and live a normal life.Conclusions Surgical treatment is still the preferred method of VHL,and radiotherapy is effective for small lesions.

OBJECTIVETo investigate the clinical characteristics, diagnosis and treatment as well as prognostic factors of the giant gastrointestinal stromal tumor (GIST).

METHODSClinical data of 235 patients with high risk GIST treated in the Union Hospital, Tongi Medical College, Huazhong University of Science and Technology between January 2005 and July 2015 were retrospectively analyzed. Patients were divided into giant GIST group (diameter equal to or larger than 10 cm, 119 cases) and high risk group (diameter less than 10 cm, 116 cases) according to tumor size. Clinical characteristics and prognosis of two groups were compared and the clinical features of giant GIST were summarized. Multivariate analysis was performed to evaluate the prognostic factors of giant GIST with Cox regression model.

RESULTSOf the 119 patients with giant GIST, which accounted for 50.6%(119/235) of all the high risk patients, there were 63 male and 56 female patients with a median age of 53(20-82) years. Primary giant GIST of 43(36.1%) located in the stomach, of 39(32.8%) in the small intestine, 5(4.2%) in the colon and rectum, and of 32 (26.9%) outside the gastrointestinal tract (mesentery, retroperitoneum, abdominal cavity, etc) and pelvic. Compared to high risk group, age of onset was younger [ratio of ≤50 years, 44.5%(53/119) vs. 31.9%(37/116), P = 0.046] and incidence of outside the gastrointestinal tract was significantly higher [26.9%(32/119) vs. 9.5%(11/116), P=0.000] in giant GIST group. All the giant GIST patients underwent surgical resection, including 115 cases(96.6%) of R0 resection, 3 cases(2.5%) of R1 resection and 1 case(0.9%) of R2 resection, besides, 32 cases(26.9%) underwent expanded resection (namely, underwent lymphadenectomy or combined organ resection simultaneously). Thirty-nine giant GIST cases(32.8%)accepted imatinib 400 mg/d for targeted therapy after operations, which was not significantly different with high risk group (46 cases, 39.6%, P=0.232). Relapse and metastasis occurred in 8 cases in giant GIST group. The 1-, 3-, 5-year overall survival rates of giant GIST group were 94.5%, 89.3%, 79.4% respectively and of high risk group were 99.1%, 92.9%, 85.1% respectively, and no significant difference was found (P=0.788). The 1-, 3-, 5-year recurrence-free survival rates of giant GIST group were 93.6%, 85.1%, 72.8% respectively and of high risk group were 99.1%, 91.7%, 84.2% respectively, and no significant difference was found as well (P=0.932). Multivariate analysis revealed that gender (P=0.047, RR=0.383, 95%CI:0.149-0.987), mitotic count (P=0.001, RR=0.216, 95%CI:0.087-0.538) and targeted therapy(P=0.019, RR=5.719, 95%CI:1.324-24.695) were prognostic risk factors of overall survival (OS), moreover, tumor size (P=0.024, RR=0.368, 95%CI:0.155-0.875) and mitotic count(P=0.007, RR=0.357, 95%CI:0.169-0.755) were prognostic risk factors of RFS.

CONCLUSIONSGiant GIST is not unusual in GIST and more likely occurs outside gastrointestinal tract. Complete surgical excision combined with targeted therapy can improve the prognosis significantly. The prognosis of giant GIST and common high risk GIST is similar. Mitotic count is the most important prognostic factor.

Abdominal Cavity ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; therapeutic use ; Female ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; drug therapy ; pathology ; Humans ; Imatinib Mesylate ; therapeutic use ; Intestine, Small ; Lymph Node Excision ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Risk Factors ; Survival Rate ; Young Adult

Objective To study the value of serum prealbumin-bilirubin score (PALBI) in predicting posthepatectomy liver failure (PHLF) for patients with HBV related hepatocellular carcinoma (HCC).Methods A retrospective study was conducted on 919 HBV-related HCC patients who underwent hepatectomy from September 2013 to December 2016 at the Affiliated Tumor Hospital of Guangxi Medical University.These patients were divided into a training cohort (n =689) and a validation cohort (n =230) using the 3 ∶ 1 matching principle.The training cohort was divided into the control group (n=546) and the PHLF group (n=143) according to whether PHLF occurred.The multivariate logistic regression model was used to analyze the factors related to PHLF in the training cohort,and then the PALBI score was established.The ability of the PALBI score to predict PHLF was evaluated by the area under the receiver operating characteristic curve (AUC) and compared with the Child-Pugh,model for end-stage liver disease (MELD),and albumin-bilirubin (ALBI) scores.Results Univariate and multivariate logistic regression analyses showed the factors including HBV-DNA≥ 103 IU/ml,total bilirubin,prealbumin,platelet count,AST,prothrombin time,intraoperative blood loss ≥400 ml and major liver resection were closely related to PHLF.The ability of the PALBI score (AUC =0.733) to predict PHLF preoperatively was superior to the ChildPugh score (AUC =0.562),the MELD score (AUC =0.652) and the ALBI score (AUC =0.683) in the entire training cohort.Similar results were obtained in the entire validation cohort (AUC:0.752 vs.0.599 vs.0.641 vs.0.678).To eliminate the effect of a small residual liver volume on PHLF,the ability of each of these scores in the training and validation cohorts to predict PHLF was calculated respectively in these 2 cohorts of patients who underwent only minor liver resection,and similar results were obtained.Conclusion The PALBI score was significantly superior to the Child-Pugh,MELD and ALBI scores in predicting PHLF in patients with HBV-related HCC who underwent liver resection.The PALBI score is a simple,non-invasive and reliable novel model in predicting PHLF.

Objective To establish and evaluate a novel and non-invasive diagnostic model using routine laboratory serological indexes in cirrhotic patients.Methods A retrospective study was conducted on 1044 consecutive patients with hepatocellular carcinoma (HCC) treated by hepatectomy in the Affiliated Tumor Hospital of Guangxi Medical University from September 2013 to December 2016.These patients were divided into a training cohort (n =783) and a validation cohort (n =261) using the 3 ∶ 1 matching principle.Logistic regression analysis was used to identify independent risk factors related to occurrence of cirrhosis in the training cohort,and then a PPH score was established.The accuracy of the model in predicting cirrhosis in two groups was evaluated respectively by the area under the receiver operating characteristic curve (AUC) and goodness of fit,and compared with the following commonly used predictive systems:the model for endstage liver disease (MELD) score,fibrosis index based on 4 factor score (FIB-4),Forns score and aspartate aminotransferase to platelet ratio index score (APRI).Results Univariate and multivariate Logistic regression analysis in the training cohort showed prothrombin time,platelet count and hepatitis B surface antigen positivity were closely related to occurrence of cirrhosis.The accuracy of the PPH score (AUC =0.705) in diagnosing cirrhosis in the training cohort was significantly better than the MELD score (AUC =0.557),APRI score (AUC =0.598),FIB-4 score (AUC =0.597) and Forns score (AUC =0.665).Similar results were obtained in the validation cohort (AUC:0.702 vs 0.554 vs 0.624 vs 0.634 vs 0.580).The goodness of fit indicated that there was no significant difference between the actual and predicted values of cirrhosis in the two cohorts,and the model was in good agreement.Conclusions A novel and non-invasive model for the diagnosis of cirrhosis was successfully established.The accuracy of this model in diagnosing cirrhosis was better than the MELD,APRI,Fib-4 and Forns scores.This model has significance in guiding clinical treatment decision in HCC patients with cirrhosis.