Humans ; Liver Failure ; Lymphohistiocytosis, Hemophagocytic

Spontaneous cerebellar hemorrhage accounts for about 10% of all cases of cerebral hemorrhage and 15% of all cases of cerebellar stroke. The mortality is about 30%-50% in 30 d after onset. Patients with cerebellar hemorrhage can rapidly deteriorate due to enlarged hematoma and/or brain stem compression, leading to coma and death. Therefore, hematoma evacuation is the preferred treatment for spontaneous cerebellar hemorrhage, especially in patients with hematoma diameter >3 cm and accompanied by brainstem compression or hydrocephalus.

Objective To investigate the effect of Mucin 3A (Muc3A) gene silencing by shRNA mediated with lentivirus vector on human extrahepatic cholangiocarcinoma.Methods Short hairpin RNA (shRNA) interference sequence targeting Muc3A gene was designed and synthesized.Recombinant lentiviral plasmids were packaged to produce virus venom and their titers were determined.After transfected with QBC939 cells of extrahepatic cholangiocarcinoma,stable positive cell lines were obtained by optimal drug screening concentration.QBC939 cells were divided into three groups:lentivirus mediated shRNA transfected cells (transfected group),empty virus transfected cells (negative control group),and untransfected cells (blank group).ShRNA silencing efficiency of Muc3A gene was detected with Western blot.Cell growth was assessed by MTS assay,cell colony formation was detected with plate clonogenesis assay,and cell cycle distribution were detected by flow cytometry.Results Lentivirus was successfully packaged and titer of virus suspension was 1 × 108 TU/ml.Western blot confirmed that shRNA worked well in QBC939 cells.3 μg/ml puromycin concentration was added for table cell lines selection.Western blot results showed that the expression of Muc3A in the transfection group was significantly decreased comparing with negative control group and the blank group (P ＜ 0.05).The MTS results showed that the value of OD490nm in the transfected group was significantly lower than that in the negative control group and the blank group,and the differences were statistically significant (P ＜ 0.05).The number of clone formation in the transfection group was significantly lower than that in the negative control group and the blank control group,and the differences were statistically significant (P ＜ 0.05).Cell cycle of the experimental group was in G2/M is more,but S phase is less,but there is no statistical difference compared with blank group (P ＞ 0.05).Conclusion Lentivirus mediated shRNA transfection can significantly inhibit the growth,proliferation and colony formation of QBC939 cells of extrahepatic cholangiocarcinoma after interfering with Muc3A gene expression,which sugests that Muc3A can promote the growth of cholangiocarcinoma cells.

Objective:To analyze the status of extracorporeal membrane oxygenation (ECMO) for poisoned patients in China, and prognosis, complications and risk factors for death in poisoned patients supported with ECMO.Methods:The data of adult poisoned patients registered in Chinese Society of Extracorporeal Life Support (CSECLS) database were collected. Patients were divided into the survival group and death group according to the conditions at discharge. The type of poisoning, patient prognosis, hemodynamic parameters and complications before and after ECMO were retrospectively analyzed.Results:A total of 96 poisoned patients supported with ECMO were included in the database from 2017 to 2022, including 77 adult patients. The use of ECMO for poisoning was more common in Henan Province (28 cases, 36%), Guangdong Province (11 cases, 14%) and Zhejiang Province (9 cases, 8%). The number of adult poisoned patients registered in the database increased over time from 2017 to 2022, but the survival rate showed no significant difference ( P = 0.794). Agricultural poisoning was the most common indication (43%). Veno-arterial (V-A) ECMO was used in 60 patients (78%) and venovenous (V-V) ECMO in 27 patients (22%). Thirty-two patients (42%) survived to hospital discharge. The mean duration of ECMO support was 57 (34, 123) h, the mean duration of mechanical ventilation was 88 (33, 211) h, the mean length of hospital stay was 10 (2, 21) days, and the mean length of ICU stay was 9 (2, 18) days. Multivariate analysis showed that 24-h lactic acid level was significantly associated with mortality ( OR = 0.378, 95% CI: 0.183-0.779, P = 0.008). Conclusions:ECMO can be used as a salvage strategy to treat various types of severe poisoning. Although the application of ECMO is expanded rapidly in China, it is still necessary to optimize intervention indications and treatment timing, and adopt standardized ECMO management and monitoring strategies to improve the prognosis of patients.