Objective To investigate the influence of postoperative cognitive dysfunction (POCD) to clinical outcome in adult patients and the risk factor. Methods 122 patients after operation on chest were surveyed with Wechsler Adult Intelligence Scale-Revised China (WAIS-RC) within 3 d before operation and on the 7th day after operation. Their pulmonary functions were measured before discharged. Their time on bed, total time in hospital, time after operation in hospital, time in intensive care unit and spending for therapy were investigated. Results 45 patients were finally diagnosed as POCD (POCD group) 7 d after operation. Before operation, the age, the body weight index, the smoking index and the number of risk factor of angiosclerosis in the POCD group were all higher than those whose cognitive function were normal (normal group) (P<0.05). The sores of insight, count, digit scope, vocabulary, figure collocation, figure patch of WAIS-RC in POCD group were obviously lower than those in normal group (P<0.05). Every index of pulmonary function in POCD group was lower than those in normal group(P<0.05). The time keeping on bed, total time in hospital, time after operation in hospital, time in intensive care unit and spending for therapy in POCD group all exceeded those in normal group (P<0.05).Conclusion The adult patients with POCD may spend more time and money for therapy in hospital, and their pulmonary functions may be recovered poorly.

OBJECTIVE To explore cell death type of lateral line hair cellsinduced by cisplatin in zebrafish. METHODS Zebrafish larva were incubated in 1mM cisplatin solution for 6 hrs to induce about 90%lateral line hair cells loss. Time lapse imaging was used to detect the morphology of cisplatin-incubated hair cells in wildtypezebrafish pre-labelled by live dyes Bodipy TR C5-ceramide and Sytogreen 24. TUNEL assay and In situ anti-active Caspase-3 antibody staining were performed to detect nuclei fragmentation and Caspase-3 activity respectively. RESULTS Compared to control group, hair cells condensationand nuclei fragmentation (P<0.05) were detected in cisplatin-incubated group, and active Caspase-3 activity was also observed after cisplatin addition. CONCLUSION Cisplatinmay induced zebrafish lateral line hair cells loss by Caspase-3-dependent apoptotic pathway.

Objective To explore ihe physiological changes of the late-onset depressive(LOD) persons during sleep.Methods 15 cases of LOD patients formed a group and 10 healthy aging persons formed a control group.Hamilton Depression Scale (HAMD) was used to score the severity of depression and polysomnographic recorders were used to monitor the whole night long.The subjective feelings of the sleep and the daytime mental status were assessed in the morning.Results Compared with the controlde group, the LOD patients obviously possessed a disordered sleeping process: sleep efficiency was lower( ( 59.20 ± 2.90 ) %, ( 77.09 ± 1.55 ) %, P ＜0.01 ); their sleep latency was longer( (54.00 ± 4.97 ), ( 24.00 ± 2.91 ), P ＜ 0.01 ); the numbers of rapid eye movement(REM) sleep phase and rapid eye movement latency(REML) were strikingly different(P＜0.01 ).Compad with the control group, the LOD patients' awakening time and percent were significantly increased.Not only were the time and percentage of S2 sleep phase much higher, but the time of slow wave sleep was shorter.Besides,REM sleep activity, its density, and its intensity were raised (P ＜ 0.05 ).Conclusion There is a disturbance of the objective physiological indexes happening among the LOD patients.The increase of S2 sleeping time and percentage and the disinhibition of REM sleep can be used as the diagnosis indexes of LOD patients' specificity.

Objective To evaluate the repeatability of the aperture sizes based on the Iris variable aperture collimator (Iris collimator) of CvberKnife VSITM.Methods Radiochromic films were placed at 800 mm of source-to-axis distance (SAD),and Iris quality assurance (QA) software was used to extract the information from the digital images,which were exposured by X-ray beams.Results The average aperture accuracy of Iris collimator was better than 0.11 mm over the beam range 5-40 mm,and the accuracy for 50 mm and 60 mm beams was within 0.19 mm.Conclusions The results suggest a good repeatability of aperture sizes for the CyberKnife VSITM Iris collimator.

OBJECTIVE To explore the role of Wnt/β-catenin signaling in hair cell regeneration using zebrafish lateral line system. METHODS Zebrafish larval were incubated in cisplatin solution to induce lateral line hair cells loss and then regenerated for 48 hrs. Supporting cells were sorted, and QPCR was taken to detect the expression change of Wnt/β-catenin signaling factors. Whole mount in situ hybridization was used to show the expression pattern of dkks. Wnt/β-catenin signalinginhibitors(FH535 and XAV939) and enhancer(BIO) was added to the medium to observe the influences on hair cell regeneration. RESULTS RT-PCR and Q-PCR showed that the expressions of wnt2, wnt3a and ctnnb1 in sorting supporting cells were elevated(P＜0.05). Whole mount in situ hybridization showed that the expression of dkk1a and dkk2 in lateral lines sub-supporting cellsreduced. The addition of Wnt/β-catenin signaling inhibitors reduced the regenerated hair cells to 40％ of normal, and even to 10％ when the concentration of inhibitor was elevated.And the first 12 hrs Wnt/β-catenin signaling inhibition also led to the reduced regenerated hair cells(P＜0.001). However, regeneratedhair cells have no significant change compared between BIO-treated and nontreated group(P＞0.05). CONCLUSION Wnt/β-catenin signaling is necessary whilenot sufficient for zebrafish lateral line hair cell regeneration.

OBJECTIVETo evaluate the controlled attenuation parameter (CAP) assessment of fatty liver and choose a cut-off value of hepatic steatosis more than 5%.

METHODSConsecutive patients, 18 years or older, who had undergone percutaneous liver biopsy and CAP measurement were recruited from five liver healthcare centers in China. All enrollees were categorized as hepatic steatosis grade S0 (<5%) or S1 (5%). An M-probe equipped FibroScan 502 was used to capture CAP values. Receiver operating characteristic (ROC) curves were plotted, and the areas under (AU) the curves were calculated to determine the diagnostic efficacy. The CAP cut-off values at the optimal thresholds were defined by maximum Youden indices; sensitivity and specificity were also calculated.

RESULTSA total of 332 patients were enrolled in the study, including 67 patients with non-alcoholic fatty liver disease (NAFLD) and 265 with chronic hepatitis B (CHB) viru: infection. The median age (inter quartile range, IQR) of the study cohort was 39.0 (32.0-50.5) years-old. There were 46 males (68.7%) in the NAFLD group, with a median age of 37.0 (28.0-45.0) years-old, and 182 males (68.7%) in the CHB group; the differences between the two groups in median age and male: female ratio did not reach statistical significance. Multivariate linear regression analysis identified steatosis grade and body mass index (BMI) as independently associated with CAP. The median (IQR) CAP values among patients with S0 and S1 grade steatosis were 215.0 (190.0-241.0) dB/m and 294.0 (255.0-325.5) dB/m (P<0.001), respectively. For all patients, when BMI was <25 kg/m2, the ability of the AUROC of the CAP to discriminate hepatic steatosis more than or equal to 5% was 0.853, and the optimal cut-off value was 244.5 dB/m; however, when BMI≥25 kg/m2, the AUROC was 0.835 and the optimal cut-off value 269.5 dB/m.

CONCLUSIONCAP can identify hepatic steatosis more than or equal to 5% and is applicable for the diagnosis of fatty liver if it is adjusted for BMI.

Adult ; Area Under Curve ; Bile ; Biopsy ; Body Mass Index ; China ; Fatty Liver ; Female ; Hepatitis B, Chronic ; Humans ; Linear Models ; Male ; Middle Aged ; Multivariate Analysis ; ROC Curve ; Tissue Extracts

Objective: To establish overfed zebrafish model for non-alcoholic steatohepatitis. Methods: The wild-type zebrafish was fed 3 times a day with normal diet. Body length, weight, and triglyceride levels were measured after 20 days of feeding. The changes in expression of genes associated with cholesterol metabolism, lipid metabolism, endoplasmic reticulum stress, and inflammation were detected by quantitative PCR. Liver tissue sections were stained with H&E. Statistical analyses between groups were compared using t-test. Results: The body length (0.71±0.014) cm and body weight (44.83±1.833) mg of model group were higher than that of control group (0.50±0.009) cm and body weight (19.33±2.753) mg (total _{body length} = 12.36, total _{body weight} = 7.71, P < 0.01). Triglyceride content in the model group was (59.15 ± 0.5612) μmol / L, higher than the control group (16.71 ± 0.3562) μmol / L (t = 63.84, P < 0.001). Quantitative PCR results showed that the expression of genes related to cholesterol synthesis in the model group was higher than that in the control group (P < 0.01). The expression levels of lipid production and lipid oxidation related factors in the model group were higher than the control group. The difference between the two groups was statistically significant (P < 0.05). The expression of inflammation-related factors in the model group was higher than that in the control group (P < 0.001), and the expression of genes related to endoplasmic reticulum stress in the model group was higher than that to control group (P<0.001). Liver H&E staining showed that the model group had pathological changes such as large bulla and vesicles compared to the control group. Conclusion A continuous 3 times 20 days of normal diet can simulate the disease characteristics of human non-alcoholic steatohepatitis in a zebrafish.

Antibodies, Antiphospholipid ; Antiphospholipid Syndrome ; Female ; Humans ; Killer Cells, Natural ; Pregnancy ; Pregnancy Complications

BACKGROUND: Liver biopsy for the diagnosis of non-alcoholic steatohepatitis (NASH) is limited by its inherent invasiveness and possible sampling errors. Some studies have shown that cytokeratin-18 (CK-18) concentrations may be useful in diagnosing NASH, but results across studies have been inconsistent. We aimed to identify the utility of CK-18 M30 concentrations as an alternative to liver biopsy for non-invasive identification of NASH. METHODS: Individual data were collected from 14 registry centers on patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD), and in all patients, circulating CK-18 M30 levels were measured. Individuals with a NAFLD activity score (NAS) ≥5 with a score of ≥1 for each of steatosis, ballooning, and lobular inflammation were diagnosed as having definite NASH; individuals with a NAS ≤2 and no fibrosis were diagnosed as having non-alcoholic fatty liver (NAFL). RESULTS: A total of 2571 participants were screened, and 1008 (153 with NAFL and 855 with NASH) were finally enrolled. Median CK-18 M30 levels were higher in patients with NASH than in those with NAFL (mean difference 177 U/L; standardized mean difference [SMD]: 0.87 [0.69-1.04]). There was an interaction between CK-18 M30 levels and serum alanine aminotransferase, body mass index (BMI), and hypertension ( P  < 0.001, P  = 0.026 and P  = 0.049, respectively). CK-18 M30 levels were positively associated with histological NAS in most centers. The area under the receiver operating characteristics (AUROC) for NASH was 0.750 (95% confidence intervals: 0.714-0.787), and CK-18 M30 at Youden's index maximum was 275.7 U/L. Both sensitivity (55% [52%-59%]) and positive predictive value (59%) were not ideal. CONCLUSION This large multicenter registry study shows that CK-18 M30 measurement in isolation is of limited value for non-invasively diagnosing NASH.
Humans ; Non-alcoholic Fatty Liver Disease/diagnosis* ; Keratin-18 ; Biomarkers ; Biopsy ; Hepatocytes/pathology* ; Apoptosis ; Liver/pathology*