Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.

Objective:To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test.Methods:This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ2 test. A kappa test was used to compare the consistency between groups. Results:After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea ( Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences ( P < 0.001). Conclusion:The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.

PURPOSE: Although the effect of lysosome-associated protein transmembrane 4 beta (LAPTM4B) on the proliferation, migration, and invasion of breast cancer (BC) cells has already been studied, its specific role in BC progression is still elusive. Here, we evaluated the effect of different levels of LAPTM4B expression on the proliferation, invasion, adhesion, and tumor formation abilities of BC cells in vitro, as well as on breast tumor progression in vivo. METHODS: We investigated the influence of LAPTM4B expression on MCF-7 cell proliferation, invasion, adhesion, and tube formation abilities in vitro through its overexpression or knockdown and on breast tumor progression in vivo. RESULTS: Cell growth curves and colony formation assays showed that LAPTM4B promoted the proliferation of breast tumor cells. Cell cycle analysis results revealed that LAPTM4B promoted the entry of cells from the G1 into the S phase. Transwell invasion and cell extracellular matrix adhesion assays showed that LAPTM4B overexpression increased the invasion and adhesion capabilities of MCF-7 cells. More branches were observed in MCF-7 cells overexpressing LAPTM4B under an electron microscope. In comparison with LAPTM4B overexpression, LAPTM4B knockdown decreased the expression of vascular endothelial growth factor-A and significantly inhibited the vasculogenic tube formation ability of tumors. These results were also verified with western blot analysis. CONCLUSION: LAPTM4B promoted the proliferation of MCF-7 cells through the downregulation of p21 (WAF1/CIP1) and caspase-3, and induced cell invasion, adhesion, and angiogenesis through the upregulation of hypoxia-inducible factor 1 alpha, matrix metalloproteinase 2 (MMP2), and MMP9 expression. This specific role deems LAPTM4B as a potential therapeutic target for BC treatment.
Blotting, Western ; Breast Neoplasms ; Breast ; Caspase 3 ; Cell Cycle ; Disease Progression ; Down-Regulation ; Extracellular Matrix ; Hypoxia-Inducible Factor 1 ; In Vitro Techniques ; Matrix Metalloproteinase 2 ; MCF-7 Cells ; S Phase ; Up-Regulation ; Vascular Endothelial Growth Factor A

Objective To investigate the factors associated with the success rate of external cephalic version (ECV) for singleton and non-cephalic presentation pregnancies in the third trimester.Methods A retrospective study of ECV among singleton and non-cephalic presentation pregnant women in 36-40 weeks of gestation at Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from January 2016 to June 2018 was analyzed.Results (1) Totally,251 cases of 358 pregnant women who underwent ECV were successful,with a total success rate of 70.1％ (251/358).The success rate of multipara was 79.1％ (129/163),while 62.6％ (122/195) in primipara (P＜0.01).The total vaginal delivery rate was 52.2％ (187/358),the vaginal delivery rate of multipara was 61.3％ (100/163),while 44.6％ (87/195) in primipara (P＜0.01).(2) Spontaneous reversion occurred in 7.6％(19/251) of ECV successful women,the rate of reversion of multipara was 10.9％ (14/129),higher than that of the primipara [4.1％ (5/122);P＜0.01].(3) Among the 232 pregnant women who did not reverted after successful ECV,187 cases of successful vaginal delivery,the vaginal delivery rate was 80.6％ (187/232);the vaginal delivery rate of the multipara was 87.0％(100/115),which was higher than that of the primipara [74.4％(87/117);P＜0.01].(4) The variables significantly associated with ECV success were parity,type of breech,whether fetal presentation was in pelvic or not (all P＜0.05).The complication rate was 2.2％ (8/358),among which the incidence of fetal distress,placental abruption and transient fetal heart abnormalities were 0.6％ (2/358),0.3％ (1/358) and 1.4％ (5/358) respectively.Conclusion By close monitoring,ECV is a safe and effective procedure in selected appropriate cases,and worthy of clinical application.

Objective To quantitatively study the pressure of residual lateral displacement in distal radius AO C3.1 fracture after manual reduction corrected by dynamic airbag pad using finite element analysis and to verify its effectiveness for correcting the residual displacement of fractures. Methods Imageware 13.0, Mimics 15.0 and ANSYS Workbench were used to simulate 1 cm residual lateral displacement after manual reduction of distal radius fracture corrected by dynamic airbag pad. Then the correlation between the distance of residual lateral displacement and the adjustment of dynamic airbag pad pressure were quantitatively analyzed. Results In the case of constant load restrained by airbag ribbon, during the process of pressure adjustment by splint pad, the stress was mainly distributed in the fracture end where the airbag pad was located. About 2.4 kPa pressure was needed to correct 1 mm displacement on radial side, while about 1.3 kPa pressure was needed to correct 1 mm displacement on dorsal side. The dynamic airbag pad was depressurized after the restoration of residual shift. At this time, displacement could be effectively prevented due to the constant load of airbag ribbon and the frictional load at the fracture end. Conclusions In the case of constant load constrained by airbag ribbon, intelligent airbag splint can effectively correct the residual lateral displacement after the manual reduction of the distal radius AO C3.1 fracture and prevent it from being displaced by adjusting pressure of the dynamic airbag pad.

OBJECTIVE:To systematically review the efficacy and safety of Magnesium isoglycyrrhizinate injection versus 4 comnon medicines in the treatment of drug-induced liver damage,and to provide evidence-based reference for clinic treatment. METHODS:Retrieved from PubMed,EMBase,Cochrane Library,CBM,CJFD,Wanfang Database and VIP Database,random-ized controlled trials (RCT) about Magnesium isoglycyrrhizinate injection versus other medicines in the treatment of drug-induced liver damage were enrolled. Meta-analysis was performed by using Rev Man 5.3 software after literature selection,data extract and quality assessment. RESULTS:A total of 13 RCTs were included,involving 1 093 patients. Results of Meta-analysis showed clini-cal effective in magnesium isoglycyrrhizinate group was significantly higher than tiopronin group[RD=0.29,95%CI(0.17,0.42), P<0.001] and diammonium glycyrrhizinate group [RD=0.07,95%CI(0.01,0.12),P=0.02],compared with glutathione group and compound ammonium glycyrrhetate group,there were no significant differences ;incidence of adverse reactions in magnesium iso-glycyrrhizinate group was significantly lower than diammonium glycyrrhizinate group [RD=-0.07,95%CI(-0.11,-0.03),P<0.001] and compound ammonium glycyrrhetate group[RD=-0.21,95%CI(-0.38,-0.04),P=0.02],compared with triopro-nin group and glutathione group,there were no significant differences among 3 groups. CONCLUSIONS:Magnesium isoglycyrrhiz-inate injection has better efficacy and safety than other 4 commons hepatoprotective medicines in the treatment of drug-induced liver damage. Due to the limit of methodological quality,more large-scale and long-term follow-up studies with strict designed are need-ed for the further verification of the conclusion.

Objective To explore the double blood vessels bridge application and efficacy in multiple localized narrow of the anterior descending coronary artery.Methods The clinical data of 106 patients with multiple localized narrow of the anterior descending coronary artery were retrospectively analyzed.The patients were divided into two groups according to the operation methods.Fifty-six patients (improvement group) were conducted double blood vessels bridge on the anterior descending coronary artery,50 patients (control group) were conducted a single blood vessel bridge on the anterior descending coronary artery.Results The age,sex,body mass index,left ventricular ejection fraction,extracorporeal circulation time,endotracheal intubation time,length of hospital stay between two groups had no significant difference (P ＞ 0.05).One case in improvement group occurred angina pectoris,left ventricular size was (51 ± 6) mm,left ventricular ejection fraction was (60.8 ± 8.0)％.Nine cases in control group occurred angina pectoris,left ventricular size was(43 ± 6) mm,left ventricular ejection fraction was(55.1 ± 10.0)％.There was significant difference between two groups(P ＜ 0.05).Conclusion Double blood vessels bridge is safe and effective in multiple localized narrow of the anterior descending coronary artery.

This study examined the correlation between osteoporosis and the degeneration of intervertebral discs. Sprague-Dawley rats were maintained up to 22 or 28 months. The femoral bone, tibial bone and lumbar vertebra were histologically studied and the expression of collagen type II and X in intervertebral discs was immunohistochemiscally determined. Several indices for the degeneration of intervertebral discs and osteoporosis and the correlation among them were then analyzed. Close correlations were found among the indices for the degeneration of intervertebral discs, including the relative area of the vascular bud, the ratio of the uncalcified and the calcified layers, the expression of collagen type II and X. The correlation with collagen type X was negative. There existed positive correlations among the indices for osteoporosis, including the thickness ratio of cortical bone, the relative area of bone trabecula, the density of femoral and vertebral body bones, and the maximum stress and strain on bone. Analysis on the relationship of osteoporosis and the disease on disc showed that the indices of osteoporosis were negatively correlated with the indices of the degeneration of intervertebral discs but the expression of collagen type X was positively correlated, with the density of vertebral body bones having the strongest dependence on collagen type X. The maximum stress and strain bore no correlation with the degeneration of intervertebral discs. These results suggest that osteoporosis was negatively correlated with the degeneration of intervertebral discs.

This study examined the correlation between osteoporosis and the degeneration of intervertebral discs.Sprague-Dawley rats were maintained up to 22 or 28 months.The femoral bone,tibial bone and lumbar vertebra were histologically studied and the expression of collagen type Ⅱ and X in intervertebral discs was immunohistochemiscally determined.Several indices for the degeneration of intervertebral discs and osteoporosis and the correlation among them were then analyzed.Close correlations were found among the indices for the degeneration of intervertebral discs,including the relative area of the vascular bud,the ratio of the uncalcified and the calcified layers,the expression of collagen type Ⅱ and X.The correlation with collagen type X was negative.There existed positive correlations among the indices for osteoporosis,including the thickness ratio of cortical bone,the relative area of bone trabecula,the density of femoral and vertebral body bones,and the maximum stress and strain on bone.Analysis on the relationship of osteoporosis and the disease on disc showed that the indices of osteoporosis were negatively correlated with the indices of the degeneration of intervertebral discs but the expression of collagen type X was positively correlated,with the density of vertebral body bones having the strongest dependence on collagen type X.The maximum stress and strain bore no correlation with the degeneration of intervertebral discs.These results suggest that osteoporosis was negatively correlated with the degeneration of intervertebral discs.

ObjectiveTo investigate the effects of short-term enriched environment on the hippocampal formation and the myelinated fibers in the hippocampal formation of mid-aged female rats. Methods Twenty 14-month female SD rats were randomly divided into 10 enriched environment (EE) rats and 10 standard environment (SE) rats. EE rats were reared in enriched environment and SE rats were reared in standard environment for 4 months. Then, five rats were randomly selected from each group. The spatial learning capacity was assessed with Morris water maze. The hippocampal formation and the myelinated fibers in the rat hippocampal formation were quantitatively investigated with transmission electronic microscopy technique and stereological methods. Results Short-term enriched environment enhanced the spatial learning capacity of the mid-aged female rats. The total length and total volume of the myelinated fibers in the hippocampal formation of the EE rats was significantly increased by 43.3% and 47.4%, respectively, when compared to the SE rats. There was no significant difference in the hippocampal volume and the mean diameter of the myelinated fibers in the hippocampal formation between two groups. The increase of the total length of the myelinated nerve fibers in the hippocampal formation was mainly due to the increase of the myelinated fibers with small diameter. Conclusion Short-term enriched environment had significant effects on the spatial learning capacity and the myelinated fibers in the hippocampal formation of middle-aged female rats.