Objective:To study the prognostic factors in patients with occult ruptured hepatocellular carcinoma (HCC) after hepatectomy.Methods:The clinical data of 31 patients with occult ruptured HCC who underwent hepatectomy at the Heze Multiple Hospital from January 2001 to December 2014 were retrospectively analyzed. There were 27 males and 4 females, with ages ranging from 29 to 73 years. Kaplan-Meier survival analysis was carried out for survival analysis, and compared by the log-rank test. Multivariate analysis was conducted using the Cox proportional hazards regression model.Results:Of 31 patients in this study, 27(87.1%) had died, and 25(80.6%) had developed tumor recurrence and metastasis. The median overall survival was 8 months and the median tumor-free survival was 4 months. On Cox regression analysis, non-R 0 resection was an independent risk factor of overall survival ( RR=2.816, 95% CI: 1.006-7.887) and disease-free survival ( RR=3.295, 95% CI: 1.215-8.940). Poor tumor differentiation was an independent risk factor of overall survival ( RR=3.120, 95% CI: 1.193-8.160). Conclusions:The prognosis of patients with occult rupture HCC who underwent no R 0 resection was poor. However, the prognosis of patients who underwent non-R 0 resection was even poorer.

Objective To study the impact of regional lymph node metastasis on the prognosis of patients with hepatocellular carcinoma (HCC) after hepatectomy.Methods Three hundred and twenty-two HCC patients who underwent elective hepatectomy in the Heze Municiple Hospital were retrospectively studied from January 1999 to December 2013.The clinical data and follow-up results were analyzed.The diagnosis of lymph node metastasis was based on preoperative imaging data and intraperative findings.Results There were 16 patients (5.0％) with lymph node metastasis (the metastasis group) and 306 patients (95.0％) without lymph node metastasis (the no-metastasis group).On Kaplan-Merier analysis,the overall survival (OS) rates at 1,2,5 years were 43.8％,31.3％,7.5％ in the metastasis group and 83.7％,70.9％,46.1％ in the no-metastasis group,respectively (Log-rank test:P ＜ 0.05).The corresponding disease-free survival (DFS) rates were 30.0％,22.5％,6.3％ in the metastasis group and 69.8％,52.8％,34.5％ in the no-metastasis group,respectively,(P ＜0.05).On follow-up,the mid-and shortterm HCC recurrence rates (≤6 months) were 71.4％ in the metastasis group (10 patients) and 31.6％ in the no-metastasis group (142 patients,x2 =9.754,P ＜ 0.05),respectively.Absence of cirrhosis,hepatectomy extent of ＞ 1 Section,max-diameter of tumor ＞ 5 cm,poor differentiation and absence of tumor encapsulation were significant factors of DFS in the metastasis group (P ＜ 0.05).On COX regression analysis,absence of tumor encapsulation was the only independent risk factor of DFS.Conclusions Regional lymph node metastasis was one of the significant factors for OS and DFS in HCC patients who underwent hepatectomy.Resection of metastatic lymph nodes and post-operation adjuvant treatment should be helpful to improve patients' prognosis.

The epidemic of 2019 novel coronavirus, later named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is still gradually spreading worldwide. The nucleic acid test or genetic sequencing serves as the gold standard method for confirmation of infection, yet several recent studies have reported false-negative results of real-time reverse-transcriptase polymerase chain reaction (rRT-PCR). Here, we report two representative false-negative cases and discuss the supplementary role of clinical data with rRT-PCR, including laboratory examination results and computed tomography features. Coinfection with SARS-COV-2 and other viruses has been discussed as well.

Objective To explore the value of axis shift between the baseline normal sinus rhythm (NSR) and WCT in diagnosis of wide QRS-complex tachycardia (WCT). Methods 390 surface ECGs of 186 patients with WCT were obtained from April 2012 to April 2018 at Ningbo Medical Center Lihuili Hospital at which the arrhythmia diagnosis was proven by intracardiac electrophysiological study. The axis shift between the baseline NSR and WCT was calculated by table lookup method. Then we analyzed the role of axis shift in diagnosis of WCT. Results Among the 186 patients with WCT, 147 (79.03％) were ventricular tachycardia (VT) , and 39 (20.97％) were supraventricual tachycardia (SVT) with conduction abnormalities. In the 95％ confidence interval, the axis shift showed an outstanding discrimination performance. The area under the ROC curve is 0.708 (0.579-0.817, P =0.007). Compared with left axis deviation, right axis deviation, the right axis deviation of LBBB morphology, the axis shift> 68 degree is more sensitive (53.06％) , and the specificity (91.43％) is also more desirable. Moreover, if the axis shift set> 130 degree, the specificity can reach 100％, and the sensitivity (12.24％) is equivalent to northwestern axis. Conclusion A significant axis shift between the baseline NRS and WCT can distinguish WCT accurately. Given the ease of grasping, it can probably be feasible to popularize as a routine diagnosis method for WCT in primary hospitals.

The intestinal absorption properties of four main effective components(gallic acid, ocinolglucoside, ethyl gallate and penta-O-galloyl-β-D-glucose) in Rhus chinensis extracts were investigated by in situ single-pass intestinal perfusion model in rats. The liquid accumulation of perfusion was corrected by gravimetry. The HPLC method was established to determine the concentration of the four effective components in the intestinal perfusion. It showed significant differences(P<0.05) in absorption rate constant(K_a) and effective permeability(P_(eff)) among the three concentrations of components, and the absorption of the four effective components in different intestinal segments was saturated at high concentrations. At the same concentration, there were significant differences in K_a and P_(eff) of the four components in each intestinal segment(P<0.05). The order of K_a and P_(eff) of the four components in the intestine was penta-O-galloyl-β-D-glucose>ethyl gallate>gallic acid>ocinolglucoside, with significant differences between them(P<0.05). In conclusion, gallic acid, orpheolglucoside, ethyl gallate and pentacyl-glucose could be absorbed in the whole intestine. Their absorption rate and permeation ability were related to the intestinal section and the perfusate concentration. These results indicated potential active transport or facilitated diffusion in the intestinal transport process of the four effective components.
Animals ; Chromatography, High Pressure Liquid ; Hydroxybenzoates ; metabolism ; Intestinal Absorption ; Perfusion ; Phytochemicals ; metabolism ; Rats ; Rhus ; chemistry