Objective To evaluate the imaging features,pathologic characteristics and diagnostic methods of gastrointestinal stromal tumor(GIST).Methods A retrospective study was performed to analyze the clinical pathological and imaging data of 14 GIST patients diagnosed by surgery and pathology.Results 14 cases of GIST were all solitary.10 cases were located in stomach and 4 cases in small intestine.Tumors were mostly round or oval,and a few of them were irregular lobulated.Immunohistochemistry analysis:12 cases were CDll7 positive and 9 cases were CD34 positive.Conclusion The imaging examination was important to the diagnosis and localization of GIST,but the final diagnosis of GIST depended on histopathological and immunohistochemical examination.

Liver fibrosis is a major cause of morbidity and mor-tality worldwide which poses a great threat to public health. Con-siderable evidence suggests that the immune system is closely re-lated to the development of hepatic fibrosis especially the dendrit-ic cells ( DCs) . In recent years, many studies have showed that DCs play a key role in regulating the immune function of liver, which not only mediate the activation of the immune system and inflammation reaction in liver, but influence the occurrence and development of liver fibrosis. Further study has found that DCs exert different effects on liver fibrosis at different stages of the disease, and it exerts anti-fibrosis in early stages and recession period, while plays opposite effect in the middle of the disease. This article reviews the research progress of the role of DCs in liver fibrosis and discusses the underlying mechanisms of DCs in regulation of liver fibrosis, which may provide references for bas-ic and clinical studies of liver fibrosis.

Liver sinusoidal endothelial cells (LSECs) are the highest proportion of liver non-parenchymal cells with fenestrae structure and high endocytic ability maintaining liver homeostasis and playing an indispensable role in the physiology and patholo-gy of the liver.LSECs are involved in the regulation of patholog-ical process in nonalcoholic fatty liver disease(NAFLD),alco-holic fatty liver(AFL),hepatocellular carcinoma(HCC),liverregeneration and liver fibrosis mainly via antiinflammation,endocytosis,secretion of angiocrine signals and maintaining thequiescence phenotype of HSCs.This review highlights the physiological function of LSECs and the different roles in different pathological conditions,which aims to provide a new perspectivefor the treatment of liver diseases through targeting LSECs.

In this paper, the pharmacokinetics of ferulic acid loaded liposome-in-chitosan-microspheres was investigated. Eighteen Sprague-Dawley rats were divided into 3 groups randomly. Each group was administered orally of ferulic acid, ferulic acid loaded chitosan microspheres and ferulic acid loaded liposome-in-chitosan-microspheres, respectively. Then blood samples were obtained from fossa orbitalis at different time points. The concentration of ferulic acid in blood was analyzed by a HPLC method using coumarin as internal standard. The data were analyzed by DAS program. The t(max), MRT and t(1/2beta) of liposome-in-chitosan-microspheres were 2.500, 7.487 and 7.818 h, respectively, which were much longer than crude drug and chitosan microspheres. This results demonstrated that liposome-in-chitosan-microspheres had better sus-tained-releasing property. The AUC of liposome-in-chitosan-microspheres was 6.08 times higher than crude drug and 1.21 times higher than chitosan microspheres, which verified that liposome-in-chitosan-microspheres could enhance oral absorption.
Absorption ; Administration, Oral ; Animals ; Anticoagulants ; administration & dosage ; blood ; pharmacokinetics ; Biocompatible Materials ; Chitosan ; Coumaric Acids ; administration & dosage ; blood ; pharmacokinetics ; Delayed-Action Preparations ; Liposomes ; Male ; Microspheres ; Orbit ; blood supply ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Time Factors

Background and objective The aim of this study is to determine the effcacy and feasibility of a novel folate receptor (FR)-based circulating tumor cell (CTC) detection method in the diagnosis of lung cancer. CTCs were col-lected from 3 mL of blood based on negative enrichment by immunomagnetic beads and then labeled by a conjugate of a tumor-speciifc ligand folate and an oligonucleotide.Methods Atfer washing off redundant conjugates, the bound conjugates were removed and analyzed by quantitative polymerase chain reaction.Results The CTC levels of 97 patients with lung cancer were signiifcantly higher than that of the controls (18 patients with benign lung diseases;P<0.001). With a threshold of 8.7 Folate units, the method showed a sensitivity of 82.5% and a speciifcity of 72.2% in the diagnosis of lung cancer, especially a sensitivity of 86.8% in stage I disease. Compared with the existing clinical biomarkers such as neuron-speciifc enolase (NSE), carcinoembryonic antigen (CEA), and CYFAR21-1, the method showed the highest diagnostic effciency in lung cancer (area under the curve, 0.859; 95%CI: 0.779-0.939) and stage I lung cancer (area under the curve, 0.912; 95%CI: 0.829-0.994). For future work, the CTC levels of 5 lung cancer patients higher than 8.7 Folate units/3 mL in their postoperation.Conclusion FR-positive CTCs were feasible diagnostic biomarkers in patients with lung cancer, as well as in early-stage tumors.

OBJECTIVETo study the effect of catalpol and puerarin freeze-dried powder for injection (CPFPI), a new compound traditional Chinese medicine (TCM) preparation, on coagulability, hemorheology and NO in rats with qi-deficiency and blood-stasis syndrome.

METHODThe model of rats with qi-deficiency and blood-stasis syndrome was established by hunger, fatigue, cold-dampness, panic and high fat diet. Coagulation time (CT) was observed by the glass method, and bleeding time (BT) was measured by tail-cutting method. The effects of CPFPI were also evaluated with prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT). HCT was measured by the electric tesistance method, hemorheology indicators were observed by auto-hemorheological instrument. The level of NO in blood serum was measured by NO assay kit.

RESULTCPFPI 65.40 mg x kg(-1) significantly prolonged CT, BT, PT, APTT and TT in rats. The viscosity of whole blood and plasma, hematocrit, erythrocyte aggregation and rigidity index, and reduced viscosity of whole blood in 65.40 mg x kg(-1) groups were lower than model group. CPFPI 65.40 mg x kg(-1) can raise the level of NO in blood serum. 32.70 mg x kg(-1) markedly prolonged CT, PT and APTT and decreased whole blood viscosity, erythrocyte aggregation index and whole blood reduction viscosity.

CONCLUSIONCPFPI has a significant effect in improving coagulability and hemorheology index and enhancing NO content in blood serum.

Animals ; Blood Coagulation ; drug effects ; Blood Coagulation Disorders ; blood ; drug therapy ; Blood Viscosity ; drug effects ; Freeze Drying ; Iridoid Glucosides ; pharmacology ; Isoflavones ; pharmacology ; Male ; Medicine, Chinese Traditional ; Nitric Oxide ; blood ; Powders ; Qi ; Rats ; Rats, Sprague-Dawley

Objective To investigate the clinical efficacy of levothyroxine replacement therapy in children with hypothyroidism.Methods 45 children with hypothyroidism admitted from Apr.2015 to Dec.2016 were selected as observation group,and 45 healthy children in the same period were selected as the control group.Children in the control group received regular diet and were paid attention to nutritional balance.Children in the observation group were given levothyroxine sodium on the basis of dietary guidance.The two groups were treated continuously for 6 months.The levels of thyroid function,insulin-like growth factor,indicators for growth and development and inflammatory factors were measured before and after treatment in both groups.Results After treatment for 3 months and 6 months,the levels of FT3,FT4,IGF-1,IGFBP-3 and IGF-1/IGFBP-3 in the observation group increased significantly compared with those before treatment,and the levels of TSH in the observation group decreased significantly(P＜0.05).The levels of FT3,lFT4,TSH,IGF-1,IGFBP-3 and IGF-1/IGFBP-3 in the observation group after treatment for 6 months were (7.17±0.06)pmol/L,(2.74±0.07)mU/L,(207.67±9.06)μg/L,(0.46±0.02) mg/L and(34.59±1.97).The difference was not statistically significant (P＞0.05).After 3 months and 6 months of treatment,the height,body weight,osteocalcin and 25-(OH)2D3 levels in the observation group were significantly higher than those in the control group (P＜0.05),and there was no significant difference between the two groups after 6 months (P＞0.05).The difference was statistically significant (P＜0.05).Conclusion Left thyroid hormone replacement therapy can significantly improve the thyroid function of children with hypothyroidism,increase the level of thyroid-associated hormone and insulin-like growth factor,promote the growth and development of children,which is worthy of clinical application.

Objective:To evaluate the lung protection of pressure-controlled ventilation volume guaranteed (PCV-VG) in elderly patients undergoing laparoscopic surgery in Trendelenburg position.Methods:Sixty patients of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, aged 65-80 yr, with body mass index of 19-27 kg/m 2, scheduled for elective laparoscopic radical prostatectomy or laparoscopic radical cystectomy, were allocated into 2 groups ( n=30 each) by a random number table method: VCV group (group V) and PCV-VG group (group P). Tracheal intubation was performed after induction of anesthesia.The anesthesia machine was connected to perform mechanical ventilation with tidal volume of 7 ml/kg (corrected body weight), positive end-expiratory pressure at 5 cmH 2O, inspiratory/expiratory ratio 1∶2, fraction of inspired oxygen 50%, fresh gas flow at 2 L/min and respiratory rate 12-15 breaths/min in two groups.Recruitment maneuver was performed with a pressure of 30 cmH 2O, lasting for 30 s, starting from 5 min before the end of administration.The airway peak pressure (P peak), airway plateau pressure (P plat), driving pressure (DP), and dynamic lung compliance (Cdyn) were measured at 5 min after intubation (T 1), 5 min after changing position (T 2), 5, 30, 60, 90 and 120 min of pneumoperitoneum (T 3-7) and 5 min after restoring the supine position and after the end of pneumoperitoneum (T 8). Blood samples were collected from the radial artery for blood gas analysis at T 1, T 4 and T 6 and when modified Aldrete score reached 10 in postanesthesia care unit, and pH value, partial pressure of arterial oxygen (PaO 2), partial pressure of arterial carbon dioxide (PaCO 2), arterial oxygen saturation (SaO 2) and alveolar-arterial oxygen gradient (P A-aO 2) were recorded.Blood samples were collected from the radial artery before induction of anesthesia and at the end of surgery for determination of concentrations of Clara cell protein (CC-16), interleukin-6 (IL-6) and neutrophil elastase (NE) in serum by enzyme-linked immunosorbent assay.The development of pulmonary complications was recorded within 7 days after surgery. Results:Compared with group V, P peak was significantly decreased at T 1-8, P plat and DP were decreased at T 5-7, Cdyn was increased at T 2-7, P A-aO 2 was decreased at T 1, 4, 6, serum CC-16, IL-6 and NE concentrations were decreased at the end of surgery ( P<0.05), and no significant change was found in the incidence of pulmonary complications within 7 days after surgery in group P ( P>0.05). Conclusion:PCV-VG can produce lung protection to some extent in elderly patients undergoing laparoscopic surgery in Trendelenburg position.

Objective To determine the median effective dose (EDs0) of etomidate inducing electroencephalogram (EEG) burst suppression (BS) in the patients with non-intracranial diseases.Methods American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,with body mass index of 19-27 kg/m2,scheduled for elective non-intracranial surgery,were enrolled in this study.ED50 of etomidate was determined by Dixon's up-and-down sequential method.Etomidate was intravenously injected for 30 s at an initial dose of 0.30 mg/kg.The BS ratio was recorded within 6 min following the end of injection.Each time ED50 increased/decreased in the next patient depending on whether or not BS occurred.The difference between the two successive doses was 0.05 mg/kg.Successful induction of BS was defined as BS ratio＞ 10％,lasting more than 1 min.Probit analysis was used to calculate the ED50 and 95％ confidence interval of etomidate inducing EEG BS in the patients with non-intracranial diseases.Results The ED50 of etomidate inducing EEG BS was 0.70 mg/kg,and the 95％ confidence interval was 0.65-0.81 mg/kg in the patients with non-intracranial diseases.Conclusion The ED50 of etomidate inducing EEG BS is 0.70 mg/kg in the patients with non-intracranial diseases.

Objective:To explore and analyze the value of CT texture combined with baseline data in lymph node metastasis of cN0 papillary thyroid microcarcinoma (PTMC), in order to provide evidence for the evaluation of lymph node metastasis of PTMC.Methods:106 patients with single stage cN0 papillary PTMC confirmed by operation and pathology in Department of Radiology and Hernia Department of Huzhou First People’s Hospital from Aug. 2020 to Aug. 2022 were selected for retrospective analysis. Metastatic lymph nodes and non-metastatic lymph nodes were delineated in CT images, and they were divided into a lymph node metastasis group (22 cases) and a group without lymph node metastasis (84 cases). At the same time, lymph node CT texture feature images were obtained in both groups. Logistic regression was used to analyze the relationship between CT texture and lymph node metastasis, and ROC curve was drawn to evaluate the predictive value of CT texture for lymph node metastasis in cN0 stage PTMC patients. The patients were divided into<1/4 group (51 cases), 1/4-<1/2 group (36 cases), and ≥1/2 group (19 cases) according to the different contact range between tumor and thyroid margin in CT signs. The baseline data and lymph metastasis distribution of each group were analyzed.Results:The results of single factor analysis showed that there were no differences in tumor location, tumor calcification or thyroglobulin in CT texture between LNM group and non-LNM group ( P>0.05). The incidence of tumor contact with thyroid margin, tumor diameter ≥7 mm, age<45 and male ratio of sex in LNM group were higher than those in non-LNM group ( P<0.05). Multivariate Logistic regression analysis showed that tumor was in contact with thyroid margin ( OR=6.080, 95% CI: 1.738-21.273), tumor diameter ≥7 mm ( OR=2.779, 95% CI: 1.135-6.805), age<45 years old ( OR=6.074, 95%CI: 1.980-18.636) and gender male ( OR=12.642, 95% CI: 3.125-51.136) were independent risk factors for lymph node metastasis in cN0 stage PTMC patients ( P<0.05). There were no significant differences in gender, age, tumor diameter, tumor location, tumor calcification or thyroglobulin among<1/4 group, 1/4-1/2 group and ≥1/2 group ( P>0.05). The incidence of LNM in ≥1/2 group was higher than that in<1/4 group and 1/4-1/2 group, and pairwise comparison between groups had statistical significance ( P<0.05) . Conclusions:It is an independent risk factor for lymph node metastasis in cN0 stage PTMC patients with tumor and thyroid boundary contact, tumor diameter ≥7 mm, age<45 years old, male, and the wider the tumor and thyroid boundary contact, the higher the risk of lymph node metastasis. CT texture analysis combined with baseline data has important reference value in predicting lymph node metastasis of cN0 TMPC.