Objective To investigate the harmonization of results of Prothrombin time(PT),International Normalized Ratio(INR),activated partial thromboplastin time(APTT),fibrinogen(FIB)and thrombin time(TT)with different coagulation analyzers in different or sanle clinical laboratory.Methods PT,INR,Am,FIB and TT for the same quality control material were detected with 14 different coagulation analyzers,which are distributed in 12 clinical laboratories and classified into A,B and C group.MeaJlwhile,PT,INR,APTT,FIB of 139 samples were detected with two different coagulation aJlalyzers in the same laboratory.Results There was no significant difference for detection of level 3 of both INR and TT among the three group analyzers(P＞0.05),but there was significant difference for other tests (P＜0.05).The comparison between groups showed that there was high percentage(66.7%)of consistency for detection of INR,FIB-C and TT between group B and C.The results of two different coagulation analvzers ( ACL Futura and CA 510)in same laboratory showed that there was no significant difference(P＞0.05)for detection of PT,INR,PT-FIB and FIB-C between them,and there was good eorrelation for them in detecting PT,INR,APTT,PT-FIB and FIB-C(r＞0.975).Analysis of bias showed that the bias of PT,INR,PT-FIB and FIBC between the two different coagulation analyzers was acceptable according to CLIA'88.Conclusion There are good agreement for the results between different coagulation analyzers based upon the similar Drinciple in coagulation analysis.

Objective To compare efficacy of procedure for prolapse and hemorrhoids (PPH) and rubber band ligation (RBL) in treatment of Ⅲ degree internal hemorrhoids.Methods One hundred patients with Ⅲ degree internal hemorrhoids were randomly divided into two groups and received PPH (42 cases) and RBL (58 cases) respectively.At once and after two weeks and two and six months the efficacy were compared.Results PPH and RBL were equally effective in controlling symptomatic prohpse (P>0.05),but RBL was associated with an increased incidence of recurrent bleeding (PPH 8/42 vs RBL 30/58,P<0.05);there was no difference in scores of patient satisfaction (P>0.05); PPH was associated with increased pain and analgesia usage at both at once and 2-week follow-up (P<0.05);the rate of complications in PPH was higber than in RBL (7/42 vs 0/58,P<0.05).Conclusion RBL can be used as treatment of first-line treatment of Ⅲ degree internal hemorrhoids.

Liver cancer is the second leading cause of cancer-related death worldwide,so early detection and prediction for response to treatment is of great benefit to hepatocellular carcinoma (HCC) patients.Currently,needle biopsy and conventional medical imaging play a significant and basic role in HCC patients' management,while those two approaches are limited in sample error and observerdependence.Radiomics can make up for this deficiency because it is an emerging non-invasive technic that is capable of getting comprehensive information relevant to tumor situation across spatial-temporal limitation.The basic procedure for radiomics includes image acquisition,region of interest segmentation and reconstruction,feature extraction,selection and classification,and model building and performance evaluation.The current advances and potential prospect of radiomics in HCC studies are involved in diagnosis,prediction for response to treatment,prognosis evaluation and radiogenomics.

Objective:To establish a radiomics signature based on CT images of non-small cell lung cancer (NSCLC) to predict the expression of molecular marker P63.Methods:A total of 245 NSCLC patients who underwent CT scans were retrospectively included.All patients were confirmed by histopathological examinations and P63 expression were examined within 2 weeks after CT examination.Radiomics features were extracted by MaZda software and subjective image features were defined from original non-enhanced CT images.The Lasso-logistic regression model was used to select features and develop radiomics signature,subjective image features model,and combined diagnostic model.The predictive performance of each model was evaluated by the receiver operating characteristic (ROC) curve,and compared with Delong test.Results:Of the 245 patients,96 were P63 positive and 149 were P63 negative.The subjective image feature model consisted of 6 image features.Through feature selection,the radiomics signature consisted of 8 radiomics features.The area under the ROC curves of the subjective image feature model and the radiomics signature in predicting P63 expression statue were 0.700 and 0.755,respectively,without a significant difference (P＞0.05).The combined diagnostic model showed the best predictive power (AUC=0.817,P＜0.01).Conclusion:The radiomics-based CT scan images can predict the expression status of NSCLC molecular marker P63.The combination of the radiomics features and subjective image features can significantly improve the predictive performance of the predictive model,which may be helpful to provide a non-invasive way for understanding the molecular information for lung cancer cells.

Objective To investigate the relationship of changes in serum chromogranin A(CgA)and heat shock transcription factor 1(HSF1)levels with cardiac remodeling and myocardial injury in elderly patients with chronic heart failure(CHF).Methods A total of 165 elderly CHF patients admitted to our hospital from January 2019 to May 2022 were selected as the disease group,and according to NYHA classification,they were divided into Class Ⅰ(28 patients),Ⅱ(29 patients),Ⅲ(65 patients)and Ⅳ(43 patients)subgroups.Another 80 healthy individuals taking physical examination in our hospital during the same period were enrolled as the control group.The serum CgA and HSF1 levels were detected,and the indicators of cardiac remodeling and myo-cardial injury were collected at admission in the two groups.The correlation of serum CgA and HSF1 levels with cardiac remodeling and myocardial injury was determined with Pearson correla-tion analysis.During 1 year's follow-up,6 cases were lost,and the left 159 patients were divided into MACE group(51 cases)and non-MACE group(108 cases)according to whether MACE occurred.Univariate and multivariate logistic regression analyses were used to analyze the influen-cing factors of MACE,and ROC curve was plotted to analyze the predictive value of serum CgA and HSF1 levels for MACE.Results The disease group had significantly higher left ventricular mass index(LVMI),left ventricular end-systolic volume(LVESV),left ventricular posterior wall thickness(LVPWT),serum levels of CgA,cardiac troponin Ⅰ(cTnⅠ),creatine kinase isoenzyme(CK-MB)and N-terminal B-type natriuretic peptide precursor(NT-proBNP),and obviously lower HSF1 level and left ventricular ejection fraction(LVEF)when compared with the control group(P＜0.01).Pearson correlation analysis showed that serum CgA level was negatively correlated with LVEF and positively with LVMI,LVESV,LVPWT,and serum levels of cTnⅠ,CK-MB and NT-proBNP(P＜0.01);serum HSF1 level was positively correlated with LVEF and negatively with LVMI,LVESV,LVPWT,and serum cTnⅠ,CK-MB and NT-proBNP levels(P＜0.01).Multi-variate logistic regression analysis showed that CgA,HSF1,LVEF,LVMI,LVESV,LVPWT and cTnⅠ were influencing factors for MACE in elderly CHF patients(P＜0.05,P＜0.01).ROC curve analysis indicated that the cut-off value of CgA was 387.55 μg/L,the sensitivity was 74.51％,the specificity was 71.30％,and the AUC value was 0.802(95％CI:0.751-0.855);the cut-off value of HSF1 was 2.34 ng/L,the sensitivity was 74.51％,the specificity was 69.44％,and the AUC value was 0.760(95％CI:0.707-0.812).Conclusion In elderly CHF patients,serum levels of CgA and HSF1 are closely associated with cardiac remodeling and myocardial injury,and the two indicators can be used as prognostic indicators for MACE.

OBJECTIVES: Heparin is mainly used as an anticoagulant in clinic, and it also has a certain anti-inflammatory effect. At present, after portal vein islet transplantation in diabetic patients, heparin is mainly infused through the peripheral veins of the limbs to achieve the purpose of anticoagulation and protection of the graft, rather than through the portal vein. In this study, animal experiments were conducted to investigate the effect of heparin infusion via the portal vein and marginal ear vein on the instant blood-mediated inflammatory reaction (IBMIR) after portal vein islet transplantation, which is the choice of anticoagulation methods for clinical islet transplantation to provide a basis for decision-making. METHODS: A total of 50 neonatal pigs (Xeno-1 type, 3-5 days) were selected. Islets were isolated and purified from the pancreas of neonatal pigs. Ten non-diabetic Landrace pigs (1.5-2.0 months) served as recipients, and 12 000 IEQ/kg neonatal porcine islets were transplanted into the liver through the portal vein. All recipients received bolus injection of 50 U/kg of heparin 10 minutes before transplantation. After the bolus injection of heparin, the experimental group received heparin via the portal vein [10 U/(kg·h), 5 recipients], and the control group received heparin via the marginal ear vein [10 U/(kg·h), 5 recipients]. The superior vena cava blood was collected from the 2 groups pre-operation at 1, 3, 24 h post-operation of the transplantation. The portal vein blood was collected from the experimental group at 1 and 3 h after the transplantation as well. The levels of complement C3a, C5a, thrombin-antithrombin complex (TAT), β-thromboglobulin (β-TG), and D-dimer as well as activated partial thromboplastin time (APTT) in superior vena cava blood from 1 and 3 h post-transplantation were detected in the 2 groups, and the levels of anti-Xa and anti-IIa in the portal vein and superior vena cava blood from 1 and 3 h post-transplantation in the experimental group were detected. Twenty four hours after the transplantation, the liver tissues in the 2 groups were collected for pathological examination to observe the inflammatory cell infiltration and peripheral thrombosis around the islets graft in liver. RESULTS: Before transplantation, there was no statistically significant difference in C3a, C5a, TAT, β-TG, D-dimer levels and APTT between the 2 groups (all P>0.05). At 1 and 3 h after transplantation, the C3a, TAT, and D-dimer levels in the experimental group were significant decreased than those in the control groups (all P<0.05), and at 3 h after transplantation the C5a was significant decreased than that in the control group (P<0.05). At 1 and 3 h after transplantation, the anti-Xa and anti-IIa levels in the portal vein blood were significantly increased than those in the superior vena cava blood in the experimental group (all P<0.05). Pathological results showed the presence of islet cell clusters in the liver blood vessels. The thrombus formation and neutrophil infiltration around islet graft was not obvious in the experimental group, while massive thrombus formation and neutrophil infiltration in the control group. CONCLUSIONS Compared with marginal ear vein infusion of heparin, the direct infusion of heparin in the portal vein has a certain inhibitory effect on complement system, coagulation system activation and inflammatory cell infiltration in portal vein islet transplantation, which may attenuate the occurrence of IBMIR.
Animals ; Anticoagulants/therapeutic use* ; Heparin/therapeutic use* ; Humans ; Islets of Langerhans/pathology* ; Islets of Langerhans Transplantation/physiology* ; Portal Vein ; Swine ; Vena Cava, Superior

To establish a three-dimensional finite element model (FEM) of the neck, to analyze the differences in neck biomechanics between patient with cervical spondylotic myelopathy (CSM) and healthy subject and to provide biomechanics basis for the pathogenesis of CSM.
 Methods: A patient with CSM was enrolled in a mechanical simulation experiment. Three-dimensional CT scan was performed, and three-dimensional FEM of the neck was constructed. A heathy subject was selected as a control according to the patient's age, gender, height, and weight. Three-dimensional FEM was used to compare the stress differences in the vertebral body, intervertebral disc, ligament and spinal cord under the normal stress of the cervical spine and the maximum stress of the posterior reclining motion.
 Results: Successfully constructed FEM model of CSM patient and control, and performed mechanical analysis, the most obvious difference in cervical vertebral body force was at C5-C6 segment in CSM patients. The maximum stress site of control and patient was at the anterior edge of the vertebral body. The maximum stress of the vertebral body in the CSM patient was less than that of the control. The stress distribution of the intervertebral disc was irregular in the CSM patient, and the maximum stress was concentrated on both sides of the posterior edge of the intervertebral disc. The stress distribution of the ligaments of the CSM patient was uneven. The maximum stress was in the posterior longitudinal ligament. The range of neck movement in extension of the CSM patient was restricted.
 Conclusion: Compared with the healthy subject, the balance of the vertebral body, intervertebral disc, ligament and limited range of motion of the CSM patient has been changed, which may be related to the mechanical pathogenesis of cervical spondylotic myelopathy.
Cervical Vertebrae ; Finite Element Analysis ; Humans ; Intervertebral Disc ; Spinal Cord Diseases