Objective To investigate the impact of intermittent porta hepatis occlusion on postoperative intra-hepatic recurrence of hepatocellular carcinoma.Methods We retrospectively reviewed the records of 335 patients who underwent partial hepatectomy.The patients were classified into 2 groups:(1) the study group (n=97):porta hepatis was occluded with intermittent Pringle maneuver with 2-3 cycles of clamp/unclamp time of 15 min/5 min,repeated 2-3cycles; (2) the control group (n=238):including using Pringle maneuver,preconditioning occlusion of porta hepatis and selective occlusion of portal blood inflow.Patients were followed-up in the Outpatient Department once every 2-3 weeks in the 1st year,and once every 3-6 weeks in the 2nd year with US/CT/MRI and serum AFP test.The mean duration of follow-up was 26.5 months.Results The perioperative mortality was 1.8％ (6/335).Tumour recurrence in the study group was 31.6％ and 48.4％ in the 1st and 2nd year,respectively.The recurrence rates were significantly higher,than the 21.4％ and 38.0％ in the control group (P＜0.05).To exclude the miscellaneous factors which were involved in intra-hepatic recurrence of HCC,we set up 3 criteria to include patients for subgroup analysis:tumor ≥5 cm; serum AFP decreased to normal level within 4 weeks; negative intra-operative US scan.The number of patients included were 79 and 155 in the study and the control groups,respectively.There were significant differences in recurrence rate between the study and the control groups in the 1st and 2nd year (29.1％ vs 18.7％,46.8％ vs 35.5％,P＜0.05).There were no significant differences in overall survival rate between the two groups.Conclusions Intermittent porta hepatis occlusion is a risk factor of postoperative intra hepatic recurrence of hepatocellular carcinoma.

The culture medium and cultural conditions of solid-state fermentation of Streptomyces Menmyco-93-63 were tested in this study. The suitable medium which contains rice, sorghum, millet bran, and rice hull with the proportion of 2:2:3:3 was developed for the spore production of Streptomyces Men-myco-93-63 using single substrate screening, mixture substrate screening and orthogonal experiments, and the sporulation was up to 2.52?109 CFU/g. And then, initial charge, initial ratio of water to solid, inoculating quantity, and culture temperature impact to sporulation of Streptomyces Men-myco-93-63 were tested. The favorite cultural conditions are developed as the following: the initial charge is 15 g in 500 mL Erlenmeyer flask; initial ratio of water to solid is 1.7:1.0 (V/W, rice hull excluding), inoculating quantity is 7 mL, culture temperature is 28℃.

OBJECTIVE: To analyze external factors affecting auditory ability of infants and toddlers after cochlear implantation in the first year of switch-on. METHOD: Seventy-five infants and toddlers after cochlear implantation were selected as subjects, using LittlEARS Auditory Questionnaire to assess and analyze the correlations with auditory ability and external factors (including gender, cochlear implanted age, pre-implant hearing aid fitting, caregivers' education background, household income and rehabilitation modes) in different stages (before switch-on, and 3 months, 6 months, 9 months, 12 months after switch-on). RESULT: The mean scores of LittlEARS were significantly different in cochlear implanted age group, pre-implant hearing aid fitting group and rehabilitation modes group (P < 0.05), and there was no significant difference in other groups such as external factor gender, caregivers' education background and household income (P > 0.05). The correlations with the mean scores of LittlEARS and cochlear implantation age or pre-implant hearing aid fitting were significant at 3 months or 6 months after switch-on(/r/ ≥ 0. 3, P < 0.01). However, the correlation with the mean scores of LittlEARS and rehabilitation modes was significant at 12 months after switch-on(/r/ > ≥ 0.3, P < 0.01). CONCLUSION Cochlear implanted age and pre-implant hearing aid fitting were the important factors affecting auditory ability of infants and toddlers after cochlear implantation in the first year of switch-on. The effect of rehabilitation modes on auditory ability of infants and toddlers after cochlear implantation was slow.
Age Factors ; Child, Preschool ; Cochlear Implantation ; Cochlear Implants ; Deafness ; rehabilitation ; Hearing ; Hearing Aids ; Humans ; Infant ; Surveys and Questionnaires

Objective: To evaluate the relationship between serum mRNA level of heparin binding epidermal growth factor (HB-EGF) and acute coronary syndrome (ACS) occurrence. Methods: Our research included in 2 groups: ACS group,n=50 patients and Control group,n=100 normal subjects. Serum HB-EGF mRNA level was examined by RT-PCR and the relationship between HB-EGF mRNA and ACS occurrence was assessed by Logistic regression analysis. Results: Compared with Control group, the serum HB-EGF mRNA level of ACS group was higher (0.22±0.73) vs (0.46±0.14),P<0.05. With adjusted meaningful factors of hypertension, smoking, TG, TC, LDL-C, HDL-C and BMI by single factor analysis, multi Logistic regression analysis indicated that serum HB-EGF mRNA was related to ACS occurrence (OR=5.813, 95% CI 2.342-14.426,P<0.001) which meant that upon 0.1 grey value of HB-EGF mRNA elevation, the risk of ACS occurrence may increase 4.813 folds accordingly. Conclusion: Serum HB-EGF mRNA level was related to ACS occurrence.

Objective:To discuss the causes and effective measures of prevention and treatment of chylous fistula after central lymph node dissection (CLND) of thyroid cancer. Methods:A total of 6 127 patients who underwent CLND of thyroid cancer in the Tianjin Medical University Cancer Institute and Hospital between July 2013 and June 2015 were analyzed;of which, 14 patients acquired the complication of postoperative chylous fistula. The following conservative treatments were initially performed:systemic therapy, local pressure bandaging, normal pressure drainage, 50%glucose injection, or pingyangmycin injection through a drainage tube. Surgical op-eration was then conducted when the efficacy of the treatment was poor. Results:After the conservative treatment of the 14 patients, the drainage volume gradually decreased in 12 patients, and surgery was performed on the remaining two patients. Conclusion:The CLND of thyroid cancer must be carefully conducted to prevent postoperative chylous fistula. An active conservative treatment must be the first option when chylous fistula occurs. Surgery must only be performed if the treatment is invalid.

BACKGROUND:To investigate the prognostic value of the peripheral perfusion index(PPI)in patients with septic shock. METHODS:This prospective cohort study,conducted at the emergency intensive care unit of Peking University People's Hospital,recruited 200 patients with septic shock between January 2023 and August 2023.These patients were divided into survival(n=84)and death(n=116)groups based on 28-day outcomes.Clinical evaluations included laboratory tests and clinical scores,with lactate and PPI values assessed upon admission to the emergency room and at 6 h and 12 h after admission.Risk factors associated with mortality were analyzed using univariate and multivariate Cox regression analyses.Receiver operator characteristic(ROC)curve was used to assess predictive performance.Mortality rates were compared,and Kaplan-Meier survival plots were created. RESULTS:Compared to the survival group,patients in the death group were older and had more severe liver damage and coagulation dysfunction,necessitating higher norepinephrine doses and increased fluid replacement.Higher lactate levels and lower PPI levels at 0 h,6 h,and 12 h were observed in the death group.Multivariate Cox regression identified prolonged prothrombin time(PT),decreased 6-h PPI and 12-h PPI as independent risk factors for death.The area under the curves for 6-h PPI and 12-h PPI were 0.802(95%CI 0.742-0.863,P<0.001)and 0.945(95%CI 0.915-0.974,P<0.001),respectively,which were superior to Glasgow Coma Scale(GCS),Sequential Organ Failure Assessment(SOFA)scores(0.864 and 0.928).Cumulative mortality in the low PPI groups at 6 h and 12 h was significantly higher than in the high PPI groups(6-h PPI:77.52%vs.22.54%;12-h PPI:92.04%vs.13.79%,P<0.001). CONCLUSION:PPI may have value in predicting 28-day mortality in patients with septic shock.

OBJECTIVETo identify the relationship between genetic polymorphisms of peroxisome proliferator-activated receptor alpha (PPARalpha) intron 1A/C and metabolic syndrome (MS) in a Chinese population.

METHODSA population-based case-control study was conducted in Suzhou city, Changshu County and Ganyu County in Jiangsu Province China, on the basis of an ongoing cohort study and 2348 cases were investigated. After the exclusion of the known MS cases, 1847 eligible subjects were successfully followed-up and their waist circumference (WC), body mass index, blood pressure, total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglycerides (TG) and fasting plasma glucose were measured. Newly diagnosed MS patients were recruited as cases, controls were individual matched with each case. TaqMan fluorescence probe method was used to detect the genetic polymorphism of PPARalpha intron 1A/C.

RESULTSThe current analysis consisted of 389 MS patients and 389 matched controls. The C allele gene frequency of PPARalpha intron 1A/C in the case group was 22.24% (173/778), lower than that in the control group, which was 24.68% (192/778); whereas the difference was not statistically significant (chi(2) = 1.29, P > 0.05). In the genotypes AA + AC and CC, MS patients were accounted for 50.70% (363/716) and 41.94% (26/62) and hyperglycemia accounted for 21.37% (153/716) and 11.29% (7/62). Compared to the genotypes AA + AC, genotype CC was observed to be inversely associated with hyperglycemia (the adjusted OR = 0.39; 95%CI: 0.17 - 0.90) but not related to the occurrence of MS (OR = 0.75; 95%CI: 0.44 - 1.28) and other components of MS e.g., abdominal obesity (the adjusted OR = 0.67; 95%CI: 0.38 - 1.17), hypertriglyceridemia (the adjusted OR = 0.97; 95%CI: 0.53 - 1.76), low HDL-C (the adjusted OR = 0.72; 95%CI: 0.41 - 1.25) and hypertension (the adjusted OR = 0.72; 95%CI: 0.42 - 1.25) all P values > 0.05.

CONCLUSIONC allele of PPARalpha intron 1A/C is not found to be associated with MS in the Chinese population. But comparing with the genotypes AA + AC, there is an inverse association between CC genotype and hyperglycemia.

Adult ; Aged ; Alleles ; Asian Continental Ancestry Group ; genetics ; Case-Control Studies ; Cohort Studies ; Female ; Gene Frequency ; Genotype ; Humans ; Hyperglycemia ; etiology ; genetics ; Introns ; Male ; Metabolic Syndrome ; etiology ; genetics ; Middle Aged ; PPAR alpha ; genetics ; Polymorphism, Genetic

Objective To investigate the diagnostic accuracy of 64-slice spiral computed tomography(MSCT)in detecting coronary artery lesions and to analyze the impacts of coronary artery calcium on its diagnostic accuracy.Methods Sixty patients underwent 64-MSCT coronary angiography and conventional coronary angiography(CCA).Calcium scoring was estimated on plain scans.The diagnostic accuracy of MSCT to detect significant lesions(≥50%)was evaluated referring to quantitative coronary angiography(QCA).The impacts of coronary artery calcium on the diagnostic accuracy was analyzed.Results A total of 797 segments were diagnositc.The overall sensitivity,specificity,positive predictive value and negative predictive value of 64-MSCT were 96%(174/182),98%(601/615),93% (174/188),and 99%(601/609),respectively.When calcium score ≥100(Agatston score),the specificity and positive predictive value of 64-MSCT was 63%(12/19)and 81%(30/37), respectively.Conclusion In patients with no or mild coronary calcification,the 64-MSCT coronary angiography had a reliable detection of coronary artery stenoses.But severe calcification in coronary artery may degrade diagnostic specificity and positive predictive value of MSCT coronary angiography.

Objective To examine the associations between occupational physical activity,heredity factors and metabolic syndrome (MS) in a Chinese population.Methods Based on the MS cohort study in Jiangsu province,subjects were followed-up,and blood samples were collected at the same time for biochemical indicators measurement.Newly confirmed MS patients according to US.National Cholesterol Education Program Adult Treatment Guidelines Ⅲ (NCEP-ATP Ⅲ ) were recruited as eases.Controls were 1 :1 matched with eases by region,gender and age (±2 years).In total,389 MS patients and 389 eontrols were recruited as study subjects.Nested ease-control study was applied for the present analysis.TaqMan fluorescence probe method was used to detect the genetic polymorphism of PPARα intron 1A/C (rs135539).Results (1)Compared to low physical activity group,the subjects with heavy physical activity were positively associated with MS (OR=2.18,95%CI:1.08-4.38).(2)The subjects,with a family history of hypertension (OR= 1.44,95% CI:1.02-2.03 )or type 2 diabetes (OR=3.25,95CI:1.28-8.20),were significantly indreased the occurrence of MS.(3)The genotype(AA,AC,CC) of PPARα intron 1A/C was not found to be related to MS.The OR of AC and CC genotype (compared to the genotype AA) were 0.98(95%CI:0.70-1.36) and 0.75 (95% CI:0.44-1.29) ,respectively.(4) Effect modifications were observed between family history of hypertension and moderate physical activity (OR=2.47,95% CI:1.00-6.06 ) or heavy physical activity (OR=3.82,95%CI:1.31-11.15) on the development of MS.Conclusion Heavy physical activity,with family history of hypertension or type 2 diabetes,seemed to be positively correlated with the risk of MS.Effect modifications were observed between occupational physical activity and family history of hypertension which might be associated with an increased risk of MS.