Objective To investigate the expression pattern of carbonic anhydrase 1 (CA1) in different clinical stages of color ectal cancers and the correlation between CA1 expression and pathologic characteristics of colorectal cancer.Methods The expression of CA1 in genetic level was detected by real-time quantitative polymerase chain reaction (PCR) and the expression of CA1 in protein level was detected by Western blot and immunohistochemical staining.Results The expression pattern of CA1 in the protein level was very similar to the genetic level.It had a very low expression level in carcinoma tissue,especially at stages Ⅲ and Ⅳ (P ＜0.01),CA1 had significantly lower expression level in the colorectal patients with metastasis (P ＜0.01).CA1 was gradually decreased from well-differentiation tissue to poorly-differentiation tissue with a significant difference between well-differentiated adenocarcinoma and poorly-differentiated adenocarcinoma (P ＜ 0.01).Kaplan-Meier survival analysis showed that the expression of CA1 was extremely related to colorectal carcinoma (CRC) prognosis.The 5-year survival rate was only 8％ in the CA1 negative expression group,and the 5-year survival rate of the patients with CA1 positive expression was 92.86％ (P ＜ 0.01).Conclusions CA1 had the similar expression patterns at genetic and protein levels.In the colorectal cancer tissue,the expression of CA1 was downregulated and even missing.CA1 had significantly lower expression level in the advanced colorectal cancers with metastasis and poorly differentiated colorectal cancer tissues.The patients with lower CA1 expression level had the worse prognosis.

Objective To study the impact of severe idiopathic pulmonary arterial hypertension (IPAH) on pregnancy outcome and to investigate the effect of multidisciplinary approach during pregnancy on the pregnancy outcome in pregnant woman with severe IPAH.Methods Between March 2007 and November 2013,10 pregnant women with severe IPAH undergoing treatment in Beijing Anzhen Hospital were studied retrospectively.Hemodynamic measurements,medical therapy,manner of delivery,anesthetic administration,multidisciplinary management and outcomes were assessed.Results All 10 cases were first diagnosed at the mean of (24 ± 3) weeks during the pregnancy.The systolic pulmonary artery pressure (sPAP) estimated by transthoracic echocardiography was (95.6 ± 1.3) mmHg (1 mmHg =0.133 kPa).Seven cases of class Ⅲ and 3 cases of class Ⅳ were recorded by World Health Organization functional class.One patient underwent pregnancy termination at gestational age of 21 weeks with no maternal death or complications,nine patients continued pregnancy and all the patients underwent cesarean section.The mean pregnancy length was (31 ± 5) weeks.Nine had cesarean deliveries during continuous epidural anesthesia,and one during general anesthesia.There were three maternal deaths in hospital (5,2,3 days postpartum),and seven patients were alive,and the average hospitalization days was (8 ± 4) days.One fetus lost with cesarean section.Two were term delivery,and seven cases were premature delivery.The average weight is (1 948 ± 731) g and nine were alive and no malformation.Conclusions Because of maternal mortality in patients with severe IPAH remains prohibitively high,patients should continue to be counseled to avoid pregnancy.Women with severe IPAH who become pregnancy should be followed by multidisciplinary approach,and cesarean deliveries during continuous epidural anesthesia are a relatively safe way for pregnancy termination in patients with severe IPAH.

Objective To investigate the effects of liraglutide on the proliferation and differentiation of mouse pre-osteoblasts MC3T3-E1 exposed to higher glucose concentration. Methods MC3T3-E1 cells were cultured and divided into control group and liraglutide group. In liraglutide group, cells were treated with different liraglutide concentrations (10-9 mol/L, 10-8 mol/L, and 10-7 mol/L, respectively) for 48 hours. Cell proliferation was tested with CCK-8. The mRNA expressions of typeⅠcollagen (COL-Ⅰ), osteopontin (OPN), and alkaline phosphase ( ALP) were detected using semi-quantitative RT-PCR. Results ( 1 ) Compared to control group, the proliferation rate of different liraglutide concentration groups (10-9 mol/L, 10-8 mol/L, and 10-7 mol/L) increased significantly (all P<0. 05), the proliferation rate was the highest in 10-8mol/L liraglutide group. (2)The expression of COL-Ⅰ, OPN, and ALP mRNA in liraglutide groups were higher than those in control group (all P<0. 05). The optimal concentration of liraglutide was 10-8 mol/L. Conclusion Liraglutide within a certain concentration range may improve the proliferation and differentiation of mouse pre-osteoblasts MC3T3-E1.

[Abstrict]Objective To explore the key points and clinical value of combined direct and indirect extracranial-in?tracranial (EC-IC) bypass in patients with adult moyamoya disease. Methods Retrospective analysis of combined revas?cularization surgery in 25 adult patients with moyamoya disease. The frontal branch and parietal branch of the superficial temporal artery (STA) were dissected. Combined revascularization surgery consisted of direct (anastomosis between the su?perficial temporal artery and cortical branch of the middle cerebral artery) and indirect (encephalodurogaleosynan-giosis EDAS) surgeries. Clinical status was evaluated using the modified Rankin Scale and NIHSS score at 1 day before, 1 week and 3 months after surgery. Results Thirty lateralities were successfully performed on 25 patients. Postoperative angiogra?phy or CTA and cranial computer tomography perfusion imaging(CTP) were conducted to examine the patency of the di?rect anastomosis and cerebral blood flow in 23 patientswithin 1 weeks after surgery . The results showed that the anasto?motic vascular patency was excellent and the cerebral blood flow increased in parallel to the relief of the patients’s isch?emic symptoms. The median mRS scores were 3 (1,3) before surgery, 2 (1,3) 1 week and 1 (0,3) 1 month after surgery.The median mRS scores were significantly improved (Z=15.14, P<0.01). The median NIHSS scores was 5 (4,8) preopera?tively and 4(2,7) postoperation 1 week and 3(1,4) 3 months. The median NIHSS scores were also significantly improved (Z=11.36, P<0.01). Unfortunately, two patients had complication and left hemiparesis. One patient complicated with con?tralateral hemisphere infarction and the another one complicated with ipsilateral hemispheric hemorrhage after operation. Conclusions Combined revascularization surgery may result in satisfying improvement in clinical, angiographic, and he?modynamic states and prevention of recurrent stroke. The stabilized hemodynamic is the key point in peroperative period for moyamoya patients.

OBJECTIVETo evaluate the effect of additives on absorption of Coptis chinensis total alkaloid and their pharmacokinetics in mice.

METHODThe mice were fed with the mixture of C. chinensis total alkaloids and additives (1:1). And then the feces and orbital blood were taken to detect the content of total alkaloids by HPLC and their pharmacokinetics.

RESULTGlutin could make the absorption of jatrorrhizine, coptisine, berberine and total alkaloids increased by 30%. Tween 80 and arabic gum did not affect the absorption of berberine, but inhibit that of other alkaloids. There had no influence of lecithin on the absorption of alkaloids. The peak time of total alkaloids in blood were 2 h (Cmax 1=5.9 mg x L(-1)) and 5.0 h (Cmax 2=3.4 mg x L(-1)), respectively, AUC was 17.6 mg x h x L(-1), the elimination of Half-life t1/2 was 5.2 h. After addition of glutin, the peak time of total alkaloids in blood were 1.5 h (Cmax 1=7.6 mg x L(-1)) and 4.8 h (Cmax 2=8.5 mg x L(-1)), AUC was up to 31.1 mg x h(-1) x L(-1), the elimination of Half-life t1/2 was 6.2 h.

CONCLUSIONGlutin could accelerate the mice on the absorption of C. chinensis total alkaloids, to extend the elimination half-life, increase the blood concentration and bioavailability.

Absorption ; drug effects ; physiology ; Alkaloids ; blood ; pharmacokinetics ; Animals ; Berberine ; analogs & derivatives ; blood ; Chromatography, High Pressure Liquid ; Coptis ; chemistry ; Diterpenes ; pharmacology ; Drug Interactions ; Female ; Food Additives ; pharmacology ; Half-Life ; Male ; Mice

Acute Disease ; Fatty Liver/diagnosis* ; Female ; Humans ; Liver ; Pregnancy ; Pregnancy Complications/diagnosis*

Objective:To construct and validate a machine learning model for preoperative prediction of perineural invasion (PNI) status in intrahepatic cholangiocarcinoma (ICC).Methods:Clincial data of 329 patients, including 245 admitted to Zhengzhou University People's Hospital from January 2018 to June 2023 and 84 admitted to the Affiliated Cancer Hospital of Zhengzhou University from January 2013 to January 2020 were retrospectively analyzed. Patients were divided into a training set ( n=231) and a validation set ( n=98). Clinicopathological data including age, gender, hepatitis B virus (HBV) infection status were collected. Predictive variables were determined using least absolute shrinkage and selection operator (LASSO) regression analysis. Six machine learning algorithms including random forest (RF), logistic regression, and linear kernel-based support vector machine were selected to construct the preoperative prediction model for PNI in ICC. Performance metrics of the model were calculated using a confusion matrix, and the final model was selected. The model performance was evaluated in the validation set. Calibration curves were plotted to evaluate the final model, and a Pareto chart was used to visualize the importance of predictive variables. Results:LASSO regression identified nine predictive variables included in the prediction model, including carbohydrate antigen 19-9 (CA19-9), HBV infection status, alkaline phosphatase, alanine aminotransferase, prothrombin time, total bilirubin, albumin, neutrophil times gamma-glutamyl transferase to lymphocyte ratio, and tumor burden score. Among the trained six models, the area under the curve (AUC) of the RF model was 0.909, with a sensitivity of 0.842 and an accuracy of 0.870. Compared with the AUC of the RF model, the AUCs of the other 5 models were lower (all P<0.05). The AUC of the RF model for predicting PNI in ICC in validation set was 0.736. Calibration curves showed good fit of the RF model's prediction of PNI in ICC in both training and validation sets. The Pareto chart showed that CA19-9 was the most important predictive variable in the model, followed by HBV infection status. Conclusion:The machine learning model based on the RF algorithm has a high accuracy in preoperative prediction of PNI status in ICC.

Objective:To explore the clinical features of chronic atrophic gastritis (CAG) without Helicobacter pylori ( H. pylori) infection and its correlation with metabolic syndrome. Methods:From June 1, 2022 to March 31, 2023, a total of 966 patients diagnosed with CAG at Army Medical Center of PLA (Chongqing Daping Hospital) were enrolled. All the patients underwent 14C-urea breath test and gastroscopy. The patients were divided into infected group (461 patients with H. pylori-positive CAG) and uninfected group (505 patients with H. pylori-negative CAG). Relevant data including age, body mass index, degree of gastric atrophy (Kimura-Takemoto classification), metabolic syndrome, diabetes mellitus, and hyperlipidemia were collected and compared between the 2 groups. Independent sample t-test and chi-square test were used for statistical analysis. Multiple linear regression analysis was performed to investigate the correlation between relevant indicators and the degree of gastric atrophy in the uninfected group patients. Results:The proportion of patients aged 71 to 80 years old in the uninfected group was higher than that in the infected group (17.0%, 86/505 vs.10.4%, 48/461), and the difference was statistically significant ( χ2=9.62, P=0.002). The degree of gastric atrophy was compared between the 2 groups, the proportions of C1 and C2 patients in the uninfected group were higher than those in the infected group (53.5%, 270/505 vs. 46.4%, 214/461; 34.1%, 172/505 vs. 26.24%, 121/461), and the differences were statistically significant ( χ2=4.78 and 6.96, both P<0.05). The proportions of patients with metabolic syndrome, diabetes mellitus, hyperlipidemia and obesity in the uninfected group were higher than those in the infected group (31.2%, 20/64 vs.14.8%, 9/61; 33.5%, 62/185 vs. 21.5%, 34/158; 31.3%, 67/214 vs. 7.8%, 36/461; 36.7%, 22/60 vs.19.7%, 12/61), and the differences were statistically significant ( χ2=4.77, 6.08, 4.95, and 4.32, all P<0.05). The results of multiple linear regression analysis showed that high density lipoprotein-cholesterol, blood glucose, and body mass index were all correlated with the degree of gastric atrophy ( r=-0.15, 0.20, and 0.31, all P<0.05). Conclusion:CAG without H. pylori infection may be related to physiological aging, and the degree of gastric atrophy is C1 and C2, which is related to metabolic syndrome.

Objective:To analyze the clinical data of pregnant women complicated with cardiovascular disease in our center in the past 10 years, and to explore the trend of incidence, clinical diagnosis, and treatment of the disease.Methods:Clinical data of pregnant women with cardiovascular disease who delivered in Beijing Anzhen Hospital, Capital Medical University from 2010 to 2019 were collected and analyzed retrospectively. According to the time of the establishment of multidisciplinary team (MDT) in the center, the pregnant women were divided into the first 5-year group (2010-2014) and the second 5-year group (2015-2019). The general data, the composition of pregnancy complicated with cardiovascular disease and the changes of maternal and infant outcomes of the two groups were analyzed.Results:(1) During 2010-2019, there were 2 267 cases of pregnancy complicated with cardiovascular disease (836 cases in the first 5-year group and 1 431 cases in the second 5-year group), with a total incidence of 10.2% (2 267/22 334). Among all kinds of cardiovascular diseases, arrhythmia (41.0%, 930/2 267) and congenital heart disease (38.2%, 865/2 267) were more common. (2) There were 212 cases (25.4%, 212/836) and 426 cases (29.8%, 426/1 431) classified as Ⅲ or Ⅳ by modified WHO cardiovascular risk classification in the first 5-year group and the second 5-year group, respectively, and the difference was statistically significant ( χ2 =5.076, P=0.024). Among all kinds of cardiovascular diseases, there were 111 cases (13.3%, 111/836) and 159 cases (11.1%, 159/1 431) with valvular disease in the first 5-year group and the second 5-year group, respectively. The change of the component ratio was -16.5% (the difference was significant when the absolute value of change>10%), showing a significant decreasing trend. Aortic disease was found in 16 cases (1.9%, 16/836) and 56 cases (3.9%, 56/1 431), respectively, with a significant upward trend of 105.3%. (3) The mortality rate of pregnant women with cardiovascular disease was 1.0% (22/2 267), and 1.2% (10/836) and 0.8% (12/1 431) in the first 5-year grouop and the second 5-year group, respectively. There was no significant difference between the two groups ( χ2=0.702, P=0.402). ICU occupancy rates in the first 5-year group and the second 5-year group were 25.6% (214/836) and 20.7% (296/1 431), respectively, and the difference between the two groups was statistically significant ( χ2=7.306, P=0.007). There were no significant differences in cesarean section rate, mortality rate and incidence of adverse events between the two groups of pregnant women, and there were no significant differences in birth weight, preterm birth rate, mortality rate and asphyxia rate between the two groups of newborns (all P>0.05). Conclusions:Pregnancy complicated with cardiovascular disease is a common cause of adverse obstetric outcomes. There are various types of specific cardiovascular diseases, and the prognosis varies greatly. In recent years, the disease composition ratio has changed, and the severity and complexity of diseases have increased. Hierarchical management, MDT and individual management could improve the treatment level and reduce adverse outcomes.

Objective:To study the factors influencing survival after radical resection in patients with intrahepatic cholangiocarcinoma (ICC), and to construct a nomogram on survival prediction.Methods:The clinical data of 139 patients with ICC who underwent radical resection at the People's Hospital of Zhengzhou University from June 2018 to December 2021 were retrospectively analyzed. There are 69 males and 70 females, aged (59.5±10.2) years old. These patients were divided into two groups based on a 3: 1 ratio by using the random number method: the test group ( n=104) and the validation group ( n=35). Data from the test group was used to construct a nomagram and data from the validation group was used to validate the predictive power of the nomagram. Univariate and multivariate Cox regression analyses were used to analyse factors influencing survival on the test group patients and to construct a nomogram. The predictive accuracy of the nomogram was determined by receiver operating characteristic (ROC) curves, concordance index (C-index) and calibration curves. Results:The results of the multivariate regression analysis showed that a combined hemoglobin, albumin, lymphocyte and platelet immunoinflammation (HALP) score <37.1 ( HR=1.784, 95% CI: 1.047-3.040), CA19-9 > 35U/ml ( HR=2.352, 95% CI: 1.139-4.857), poorly differentiated tumor ( HR=2.475, 95% CI: 1.237-4.953) and vascular invasion ( HR=1.897, 95% CI: 1.110-3.244) were independent risk factors that affected prognosis of patients with ICC after radical resection (all P<0.05). The AUCs of the nomogram in the test group in predicting the overall survival at 1, 2 and 3 years of patients with ICC after radical resection were 0.808, 0.853 and 0.859, respectively. There was good consistency between the prediction of the nomogram and actual observation. The predicted C-index of the total survival period of the test group was 0.765 (95% CI: 0.704-0.826), and the C-index of the validation group was 0.759 (95% CI: 0.673-0.845). Conclusion:A HALP score <37.1, CA19-9>35 U/ml, poorly differentiated tumour and vascular invasion were independent risk factors for prognosis of ICC patients after radical resection. The nomogram was established based on the above factors and showed good performance in predicting overall survival after radical resection in patients with ICC.