ObjectiveTo investigate the expression and the clinical significance of diacylglycerol kinase α (DGKα) and protein kinase C (PKC) in human hepatocellular carcinoma (HCC).MethodsDGKα and PKC expressions in the samples from 60 pathologically confirmed HCC patients were analyzed by immunohistochemistry. The relationship between DGKo expression and clinical pathology factors was analyzed.ResultsThe expression positive rates of DGKo and PKC were highest in normal liver tissues [90.0％ (9/10) and 100.0％ (10/10)].The positive rates were 81.7 ％ (49/60) and 71.7 ％ (43/60) in HCC tissues,respectively,and were 58.3 ％ (35/60) and 61.7 ％ (37/60) in carcinoma adjacent tissues,respectively.In three liver tissues,the positive rates of DGKα and PKC were significantly different (P ＜0.05).The location of both kinases in hepatocytes translocated from cytoplasm/nucleus to membrane.The expressions of DGKα and PKC were positively correlation(r =0.495, P ＜ 0.05), The DGKα expression was correlated to differentiation type,portal venous tumor thrombus and TNM staging(all P ＜ 0.05).ConclusionDGKa is expressed with high activity in advanced stage and poorly differentiated HCC. It may be promote the pathological process of HCC.

Objective To analyze clinical outcome of kidney transplantation from elderly livingrelated donors. Methods The clinical data of living-related kidney transplantation between November 2005 to June 2011 in the First Affiliated Hospital of Zhengzhou University were retrospectively analysed.The patients were divided into elderly donor kidney transplantation group (elderly group,36 cases) and non-elderly living related donor kidney transplantation group (nonelderly group,208 cases).The mean recipients' serum creatinines before and 3 days,7 days,1 month,3 month,6 month,12 month,24 month,36 month after surgery,peri-operation complications,the incidence rate of acute rejection,calcineurin inhibitor (CNI)-induced renal toxicity,delayed graft function(DGF),1 year and 3 year recipient/kidney survival were compared respectively between the two groups. Results The serum creatinine levels were higher in elderly group than in non-elderly group at 3 days,7 days,1 month after surgery [(245.2±135.2)μmol/L vs.(185.6±148.4)μmol/L,(150.5±86.8)μmol/L vs.(122.2± 136.8)μmol/L,(140.6±42.5)μmol/L vs.(117.8±33.2)μmol/L,t =84.07,31.90,21.54; all P =0.000].In addition,the incidence rate of CNI induced renal toxicity was higher in the elderly group than in non-elderly group [22.2％(8/36)vs.1.9％(4/208),x2=27.04,P=0.000].Nevertheless,there were no significant differences between the two groups in recipients' serum creatinines before and 3 month,6 month,12 month,24 month,36 month after surgery,in peri-operation complications,the incidence rate of acute rejection,delayed graft function,and in 1 year and 3 year recipient/kidney survival (all P ＞ 0.05). Conclusions With stringent screening and overall assessment of elderly donors,healthy elderly donors should not be barriers to organ donation.Renal toxicity of CNI agents should be carefully monitored in recipients of elderly donor.

Objective To investigate the effect of small interfering RNA (siRNA) suppressing discoidin domain receptor 1 (DDR1) gene on biological behaviour of Kupffer cells (KC) in acute hepatic injury. Methods Male BALB/c mice were randomly divided into control, hepatic injury model, non-silencing siRNA and DDRlsiRNA groups. Hepatic injury model induced by intravenous injection of Con-canavalinA (ConA) 15 mg/kg, with or without hydrodynamic tail intravenous injection of naked siRNA (50 μg,2.0-2.5 mg/kg)/mouse or 1.5 ml normal saline. The expression of DDRI was assayed by West-ern blot and pro-inflammatory cytokine expression analyzed by ELISA. In the meantime, alanine amin-otransferase (ALT) and Kupffer cells'clearance to carbon granules was detected. Results The expres-sion of DDR1 obviously increasod at 6 h after hepatic injury, roached peak at 24 h and began to decrease at 48 h. Pretreatment with DDRisiRNA could obviously inhibit the expression of DDR1 and abrogate the high levels of ALT, expressions of TNF-α and IL-1β as well as phagocytosis of Kupffer cells. Conclu-sions Inhibition of discoidin domain receptor 1 by in vivo delivery of siRNA attenuates ConA-induced hepatic injury. Possible mechanism is that the inhibition of activity of KC inhibits the expression of pro-in-flammatory cytokines and thus alleviates hepatic injury.

Objective Surgical approech differs between China and western countries in the treatment of middle/lower aegment thoracic esophageal cancer. This study was designed to compare the effects of different surgical modalities on traumatic reaction, heal-ing process and lymph node dissection.Methods Fifty-nine petients,diagnosed with middle/lower segment of thoracic esophageal cancer, were enlisted and had undergone curative RO esophagectomy.The patients were categorized based on different approaches as the following three groups:group of Ivor-Lewis operation,group of McKeown operation and group of esophagectomy through left tran-sthoracic approach.Clinical data was summarized and malyzed.Results (1)No surgical death was reported in this study.(2)There were no statistical difference among the three groups in tenms of postoperative hospital stay,diration of systemic inflammatory re-sponse syndrome and total body fluid loes (P=0.287,0.641,0.355).(3) The number of total lymph nodes harvested from the above three groups was 22.5(11-39),26(14-56).and 17(7-44)(P=0.005),respectively.The number of abdominal lymph nodes harvested from the above three groups was 10(5-26),12(4-32),and 8(3-19)(P=0.021),respectively.No statistical difference was found to the number of thoracic lymph nodes among three groups.(4)Lymph node metastasis occurred most frequently in the station of pericardial lymph nodes,followed by middle thoracic paraesophageal nodes along the left gastric ar-tery.The range of metastasized lymph nodes dissected through left transthoracic approach was much limited compated with right tran-sthoracic approach.Conchuslon The was no difference between left and right transthoracic approach in terms of surgical trauma and overall rehabilitation.The number of lymph nodes harvested from right transthoracic approach surpassed that from the left approach, which might be due to the extent of abdoominal lymphadenectomy.Considering wide range of lymph node metastasis,We recommedn a more extended lymph node dissection for middle/lower segment of thoracic esophageal cancer for the purpose of better local control control and survival benefit.

OBJECTIVE: To explore the changes of serum interleukin-6 (IL-6) level in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and OSAHS associated type 2 diabetes mellitus (T2DM) and their significance. METHOD: All observed subjects were divided into 3 groups: 20 cases of normal subjects, 35 cases of simple OSAHS patients, 48 cases of OSAHS associated T2DM patients, IL-6 concentrations of serum were measured by the enzyme-linked immunosorbent. RESULT: IL-6 level was higher in the group of OSAHS with T2DM than the group of OSAHS and the healthy control group (P < 0.05); IL-6 level was higher in the simple OSAHS group than the healthy controls. CONCLUSION IL-6 and other inflammatory factors may involved pathological physiological process in OSAHS patients sugar metabolic abnormalities; and is associated with the development of OSAHS associated with type 2 diabetes.
Case-Control Studies ; Diabetes Mellitus, Type 2 ; blood ; complications ; Humans ; Interleukin-6 ; blood ; Sleep Apnea, Obstructive ; blood ; complications

OBJECTIVE: To investigate the significance of tumor necrosis factor-alpha (TNF-α) and plasma endothelium (ET) in pathophysiologic process of patients with obstructive sleep apnea hypopnea syndrome(OSAHS) with type 2 diabetes mellitus (T2DM). METHOD: All observed subjects were divided into 4 groups. A number of 80 patients with OSAHS, 65 cases of OSAHS with T2DM patients, 20 patients with T2DM, and 32 cases of healthy control group were observed in this study. The serum levels of TNF-α and ET were detected by double antibody sandwich ELISA, the content of TNF-α and ET were compared between OSAHS group and OSAHS + T2DM group. It were also compared before and after treatment of CPAP or surgery. RESULT: TNF-α level is higher in OSAHS+T2DM group than that in the OSAHS group, T2DM group and the control group (P < 0.05); TNF-α level in OSAHS group and the T2DM group are higher than that in the control group (P < 0.05), but there was no difference in TNF-α level between the OSAHS group and the T2DM group. There was also no difference in ET level of the four groups. There were significant differences of TNF-α before and after treatment of CPAP or surgery in OSAHS group and OSAHS+T2DM group (P < 0.05). But there was no significant differences of ET before and after treatment of CPAP or surgery in the OSAHS+T2DM group (P > 0.05). CONCLUSION TNF-α may be involved in the development of OSAHS and T2DM, while ET may have little effect on the occurrence and development of OSAHS and T2DM.
Antibodies ; Diabetes Mellitus, Type 2 ; blood ; complications ; Endothelins ; blood ; Enzyme-Linked Immunosorbent Assay ; Humans ; Sleep Apnea, Obstructive ; blood ; complications ; Tumor Necrosis Factor-alpha ; blood

Objective To explore the mutual relationship between serum uric acid (SUA) level with metabolic syndrome (MD) and its factors among the physical examination population.Methods A total of 8 285 people undergoing the physical check-up in a hospital in 2013 were selected by sampling and conducted the physical measurement and biochemical detection;the subjects were grouped according to the MS diagnostic standard,gender and SUA.Then the correlation between SUA and MS was analyzed.Results The age,BMI,SBP,DBP,FPG,TG and SUA in the MS patients were significantly higher than those in the patients without MS,while the HDL-C level was significantly lower.The occurrence rate of MS in males was higher than females.With the increase of MS factors,the SUA level showed the overall rising trend;the multiple stepwise regression analysis indicated that BMI,DBP and TG were positively correlated with SUA,and the HDL-C level was negatively correlated with the SUA level.The regression equation was Y =-2.135 + 0.066X1 +0.010X2 +0.155X3-0.379X4;the MS detection rate in the HUA group was higher than that in the non-HUA group;in the single factor Logistic regression analysis,the SUA level was significantly related with the MS occurrence (OR=1.007,95％CI 0.006-1.007,P＜0.05),in the SUA diagnostic value for M,AUC in male and female were 0.608 (95 ％CI 0.582-0.634,P＜0.01) and 0.744 (95 ％CI 0.705-0.783,P＜0.01) respectively,the MS best critical diagnostic points in male and female were 360.5 and 256.5,the corresponding diagnostic sensitivities in male and female were 46.49％ and 71.94％,the specificities in male and female were 69.94％ and 69.94％ respectively.Conclusion The SUA level is closely associated with MS,and SUA level has a good predictive effect for MS.

Objective:To explore the effect of nursing based on Watson humanistic care theory in elderly patients with severe fractures.Methods:From June 2018 to June 2020, convenience sampling was used to select 92 elderly patients with severe fractures in the ICU of Beijing Jishuitan Hospital as the research object. According to the random number table method, the patients were divided into the control group and the observation group, with 46 cases in each group. The control group was given routine nursing intervention, and the observation group was given the nursing based on Watson humanistic care theory. The Visual Analogue Scale (VAS) and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) were used to compared the pain and quality of life of the two groups of patients.Results:Before intervention, there were no significant differences in VAS and WHOQOL-BREF scores between the two groups ( P>0.05) . After the intervention, the VAS scores of the observation group were lower than those of the control group, and the WHOQOL-BREF scores were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Nursing based on Watson humanistic care theory can relieve the pain and improve the quality of life of elderly patients with severe fractures, which is worthy of clinical application.

Objective To explore the diagnostic value of high frequency three-dimensional (3D) ultrasound in breast masses.Methods Seventy-seven cases of breast lesions were selected by 2D ultrasonic scan,and all the cases had been examined by 3D ultrasound and accepted surgical treatment in Shenzhen People's Hospital.With pathological results as the gold standard for diagnosis,the convergence sign in diagnosis of breast masses was used as malignant standard for 3D ultrasound coronal plane.The sensitivity and specificity were analyzed of 3D ultrasound in the diagnosis of benign and malignant breast tumors.Results A total of 77 cases of breast lesions included 46 malignant and 31 benign.3D ultrasound convergence sign was used to judge the benign and malignant breast tumors with statistical significance (x2 =26.790,P ＜ 0.01).The diagnostic sensitivity and specificity were 69.7％,and 90.3％,respectively.Conclusions High frequency 3D ultrasonography has certain value in differential diagnosis of benign and malignant breast tumors,and has important significance for the formulation of treatment plan.

Objective:To investigate the effects of silicon photomutipliers (SiPM) detector and Bayesian penalized likelihood (BPL) reconstruction algorithm on semiquantitative parameters of 18F-FDG PET/CT and diagnostic efficiency for solitary pulmonary nodules/masses compared with traditional photomultiplier tube (PMT) and ordered subsets expectation maximization (OSEM). Methods:From March 2020 to January 2022, 118 patients (76 males, 42 females, age (63.0±10.1) years) newly diagnosed with solitary pulmonary nodules/masses in First Hospital of Shanxi Medical University were prospectively enrolled and underwent 18F-FDG PET/CT imaging with two different PET/CT scanners successively. The images were divided into PMT+ OSEM, SiPM+ OSEM and SiPM+ BPL groups according to PET detector and reconstruction algorithms. The SUV max, SUV mean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of pulmonary nodules/masses were measured, then signal-to-noise ratio (SNR) and signal-to-background ratio (SBR) were calculated. One-way analysis of variance and Kruskal-Wallis rank sum test were performed to compare differences of above parameters among groups. ROC curve analysis was used to analyze the optimal threshold of SUV max for the differential diagnosis of pulmonary nodules/masses and AUCs were obtained. Results:There were 83 malignant nodules and 35 benign nodules. The image quality of SiPM+ BPL group (4.23±0.64) was better than that of SiPM+ OSEM group (3.57±0.50) or PMT+ OSEM group (3.58±0.51; F=54.85, P<0.001). There were significant differences in SUV max (7.57(3.86, 15.61) vs 4.95(2.22, 10.48)), SUV mean (4.43(2.28, 9.12) vs 2.84(1.21, 5.71)), MTV (3.54(1.57, 7.67) vs 5.09(2.83, 11.79)), SNR (28.12(12.55, 54.38) vs 20.16(8.29, 41.45)) and SBR (4.03(1.83, 7.75) vs 2.32(0.96, 5.03)) between SiPM+ BPL and SiPM+ OSEM groups ( H values: 16.63-37.05, all P<0.001). The optimal threshold values of SUV max in SiPM+ BPL, SiPM+ OSEM and PMT+ OSEM were 3.31, 2.21, 2.05 with AUCs of 0.686, 0.689, 0.615 for nodules < 2 cm, and were 10.29, 6.49, 4.33 with AUCs of 0.775, 0.782, 0.774 for nodules/masses ≥2 cm. Conclusions:Image quality and parameters of pulmonary nodules/masses are mainly affected by the reconstruction algorithms. BPL can improve SUV max, SUV mean, SBR and SNR, but reduce MTV without significant effect on liver parameters. SiPM+ BPL has a higher diagnostic threshold of SUV max than SiPM+ OSEM and PMT+ OSEM.