Objective:To analyze the risk factors of hepatocellular carcinoma microvascular invasion (MVI) and to construct a preoperative prediction clinical scoring system.Methods:A retrospective analysis was made on 113 patients with hepatocellular carcinoma undergoing hepatectomy at Zhongshan Hospital from March 2018 to Jun 2019.Postoperative pathology confirmed 35 cases with microvascular invasion.Results:The multivariate logistic regression model showed that the maximum tumor diameter( OR: 1.028, 95% CI: 1.001-1.005), the smoothness of the capsule edge( OR: 0.208, 95% CI: 0.062-0.699), the positive circulating tumor cells (CTC)( OR: 3.728, 95% CI: 1.029-13.501) and abnormal prothrombin(PIVKA-Ⅱ)( OR: 1.001, 95% CI: 1.000-1.002) were risk factors for MVI. The area, sensitivity and specificity of the clinical score constructed by assigning 1 point to each risk factor were 0.906, 74.29% and 92.31%, respectively. Clinical scores of 0, 1, 2, 3, and 4 predict MVI positive rates of 0 (0/26), 9.09% (3/33), 28.57% (6/21), 77.78% (14/ 18), 85.71% (12/14). Conclusions:Tumor maximum diameter>62 mm, PIVKA-Ⅱ>115 mAU/ml, unsmooth tumor capsule and CTC in peripheral blood are independent high risk factors in patients with MVI.

Objective:To investigate the correlation between preoperative circulating tumor cells (CTC) and microvascular invasion (MVI) in patients with hepatocellular carcinoma.Methods:The data of 227 patients who underwent hepatocellular carcinoma resection in Zhongshan Hospital Affiliated to Sun Yat-sen University from January 2018 to March 2020 were retrospectively analyzed. The peripheral blood CTC was detected by Cyttel detection before operation. The relationship between preoperative peripheral blood CTC and clinical characteristics of patients was analyzed; the multivariate logistic regression model was used to analyze the independent risk factors for MVI; the receiver operating characteristic (ROC) curve was used to compare the efficacy of each independent risk factor in predicting the occurrence of MVI, and the relationship between CTC and MVI was clarified.Results:According to the ROC curve, the cut-off values for predicting MVI of CTC, alpha-fetoprotein (AFP), protein induced by vitamin K absence or antagonist Ⅱ (PIVKA-Ⅱ), and tumor long-axis diameter were 3 CTC/3.2 ml, 158 μg/L, 178 AU/L and 59 mm. CTC-positive group had ≥3 CTC/3.2 ml in peripheral blood, and CTC-negative group had <3 CTC/3.2 ml, and there were 117 and 110 cases in the two groups. The median AFP levels of preoperative CTC-positive group and CTC-negative group were 123.0 μg/L (0-20 000.0 μg/L) and 9.6 μg/L (0-18 676.0 μg/L), and the median tumor long-axis diameter was 50.0 mm (5.0-200.0 mm) and 36.0 mm (2.0-150.0 mm), the differences between the two groups were statistically significant (both P < 0.05). Before operation, AFP≥158 μg/L ( OR = 3.551, 95% CI 1.426-8.843, P = 0.006), PIVKA-Ⅱ≥178 AU/L ( OR = 12.250, 95% CI 4.384-34.231, P < 0.01), peripheral blood CTC ≥ 3 CTC/3.2 ml ( OR = 8.913, 95% CI 3.561-22.306, P < 0.01) and tumor long-axis diameter ≥59 mm ( OR = 3.250, 95% CI 1.339-7.885, P = 0.009) were independent risk factors for the occurrence of MVI; the area under the ROC curve (AUC) of these factors for predicting MVI was 0.752, 0.777, 0.857 and 0.743. CTC was more effective in predicting MVI than AFP and tumor long-axis diameter, and the differences were statistically significant (both P < 0.05). The efficacy of CTC in predicting MVI was slightly better than that of PIVKA-Ⅱ, but the difference was not statistically significant ( P > 0.05). Conclusion:CTC may be one of the important indicators of hepatocellular carcinoma MVI in clinical practice.

Objective To assess the risk factors that could influence the severity of esophageal inju- ry in patients with gastroesophageal reflux disease(GERD).Methods GERD patients diagnosed on the ba- sis of endoscopic reflux esophagitis or pathological results of 24 hour esophageal pH monitoring were divided into three groups as non-erosive reflux disease group(NERD)(n=83),mild esophagitis group(n=51) and severe esophagitis group(n=22).The clinic data and esophageal pH parameters were recorded in the three groups.A logistic regression was used to assess the joint influences of clinic characteristics,hiatus her- nia,and esophageal pH parameters on the severity of esophageal injury.Results Patients in severe esoph- agitis group were more likely to have advanced age and hiatus hernia.The number of supine long reflux epi- sodes measured by esophageal pH monitoring significantly increased with increasing grades of mueosal dam- age(P

OBJECTIVETo observe the therapeutic efficacy of dietary boron supplement on retinoic acid-induced osteoporosis in rats, so as to provide experimental evidence for clinical management of osteoporosis with boron.

METHODSThirty-two SD rats were randomized into normal control group (8 rats) and osteoporotic group (24 rats), and osteoporosis was induced in rats of the latter group by intragastric retinoic acid administration at the daily dose of 80 mg/kg for 15 consecutive days. The osteoporotic rats were subdivided into control group (8 rats) without treatment, boron treatment group (8 rats) and estradiol treatment group (8 rats). After 30 days of treatment, the serum contents of Ca, P, boron and the activities of alkaline phosphatase (AKP) and tartrate-resistant acid phosphatase (TRAP) in the rats were assayed, the bone mineral density (BMD) of the whole body, lumbar vertebrae and tibia were determined, and the morphological changes of the femurs were observed.

RESULTSThe serum contents of Ca and P in the rats of the 4 groups differed scarcely, but the content of boron in boron treatment group was markedly higher than that in the other three groups. In the osteoporotic control group, the activities of serum AKP and TRAP, the masses of spongy bone and cortical bone of the femurs, and the quantity of the osteoclasts were increased, with the BMD of the lumbar vertebrae and tibia decreased, suggesting osteoporotic conditions. The mean trabecular plate density and thickness, trabecular bone volume and cortical bone volume of the femurs in the osteoporotic rats treated with boron or estradiol were significantly increased, but the active osteoclast quantity in the spongy bone and serum TRAP activities were obviously decreased, and the bone quality was comparable with that of the normal group. In addition, the serum AKP activity and the active osteoblast quantity in the spongy bone were obviously increased in boron treatment group.

CONCLUSIONThe dietary boron supplement can increase the serum content of boron of osteoporotic rats to stimulate bone formation and inhibit bone resorption, producing therefore obvious therapeutical effect against osteoporosis.

Acid Phosphatase ; blood ; Alkaline Phosphatase ; blood ; Animals ; Bone Density ; drug effects ; Boron ; administration & dosage ; therapeutic use ; Dietary Supplements ; Female ; Femur ; drug effects ; growth & development ; metabolism ; Isoenzymes ; blood ; Osteoporosis ; blood ; chemically induced ; drug therapy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tartrate-Resistant Acid Phosphatase ; Time Factors ; Tretinoin

OBJECTIVETo compare the clinical effects of three internal fixations as follows:dynamic hip screw (DHS), proximal femoral nail-A (PFNA) and InterTAN, for intertrochanteric femoral fractures in elderly patients.

METHODSFrom February 2007 to May 2012,136 elderly patients with intertrochanteric fractures (including 71 males and 65 females, ranging in age from 60 to 88 years old with an average of 69 years old) were treated with DHS (group A, 80 cases), PFNA (group B, 36 cases) and InterTAN (group C, 20 cases). Statistical analysis were applied to compare the 3 groups in operative time, blood loss, fracture healing time, intrraoperative complications and functional outcome (Harris hip score).

RESULTSThe average follow-up was 4.1 months (from 2.5 to 14 months). Compared with group A,groups B and C showed significant advantages in operative time, blood loss, fracture healing time, and intrraoperative complications, functional outcome (Harris scores) (P < 0.05). Compared with group B, group C had significant fewer intrraoperative complications (P < 0.05). There were no significant differences in all the indexes except intrraoperative complications between groups B and C (P > 0.05).

CONCLUSIONThe PFNA and InterTAN appear to be more reliable than DHS for the treatment of intertrochanteric femoral fractures in the elderly, but InterTAN appear to be more reliable in comminuted and complex intertrochanteric femoral fractures in the elderly than PFNA.

Aged ; Aged, 80 and over ; Bone Nails ; Bone Screws ; Female ; Fracture Fixation, Internal ; adverse effects ; methods ; Fracture Healing ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged

OBJECTIVETo observe the efficacy of cardiac resynchronization therapy for patients with refractory congestive heart failure.

METHODSThirty-one patients with refractory congestive heart failure received cardiac resynchronization therapy. Before operation, all patients received standard drug therapy (28 cases) or integrated with CRRT (3 cases). Coronary sinus and its branches were shown by direct angiography with hollow angiographic catheter (11 cases) and by balloon angiographic catheter (20 cases). Left ventricle and right ventricle electrodes were implanted to 3 patients with atrial fibrillation, 4 patients with paroxysmal ventricular tachycardia or ventricular fibrillation received CRT-D implantation. electrocardiogram, 24 hours Holter, echocardiography and physical clinical examinations were made at baseline, 6, 12, 18 and 24 months post resynchronization therapy.

RESULTSPacemakers were successfully implanted in all 31 patients. One patient implanted with CRT-D died of multiple organ failure on third day after operation, 1 patient suffered sudden cardiac death 5 months after therapy and 2 patients were lost to fellow up 6 and 12 months after operation, respectively. Results from the remaining 27 patients showed that QRS duration was significantly decreased (153 +/- 8.4 at baseline vs. 132 +/- 9.8 at 24 months follow up) and cardiac function significantly improved (LVEF 0.29 +/- 0.10 at baseline vs. 0.41 +/- 0.11 at 24 months follow up, P < 0.05 vs. baseline) during follow up compared to baseline. Malignant ventricular arrhythmia occurred in 3 patients with CRT-D and successfully terminated and converted to sinus rhythm.

CONCLUSIONSCardiac resynchronization therapy could improve cardiac function for patients with refractory congestive heart failure. CRT-D can effectively terminate the malignant ventricular arrhythmia.

Aged ; Cardiac Pacing, Artificial ; methods ; Defibrillators, Implantable ; Female ; Heart Failure ; therapy ; Humans ; Male ; Middle Aged ; Pacemaker, Artificial ; Treatment Outcome

Objective: To investigate the effect of elective cesarean section (ECS) on infants' developmental behaviors. Methods: A total of 3 474 pregnant women living in Ma'anshan more than 6 months and accepting obstetric examination in Ma'anshan Maternal and Child Care Center were recruited from May 2013 to September 2014. Excluding participants with pregnancy termination (162), twin pregnancy (39), assisted delivery (14), emergency cesarean section (76) and unclear delivery mode (141), 3 042 pair of mother and infant entered the final analysis. Information of maternal basic demographic characteristics, pregnancy histories, pregnancy life style and pregnancy-related diseases were collected by using self-complied Maternal and Child Health Questionnaire. Information of infants' general condition and delivery modes were acquired from obstetric record. The Ages and Stages Questionnaires-third edition was used to assess infants' communication, gross motor, fine motor, problem solving and person-social function, which was completed at age of 6 months old and 18 months old, respectively. And multi-factor non-conditional logistic regression model was used to analyze the association between ECS and infants' developmental behaviors. Results: The prevalence of ECS was 47.5% (1 443/3 042), among which ECS without medical indication and ECS with medical indication were 27.2% (826/3 042) and 20.3% (617/3 042), respectively. After maternal demographic characteristics, pregnant exposure and infants' basic information adjusted, compared to women with vaginal delivery, both ECS with medical indication and without medical indication increased the risk of a delay in gross motor on infants at 6 months old (RR (95%CI: 1.72 (1.08-2.77) and 1.87 (1.11-3.15), respectively.) ECS without indication decreased the risk of a delay in fine motor on infants at 6 months old (RR (95%CI):0.48 (0.28-0.82)), both ECS without medical indication and with medical indication had no statistically significant effect on 18 months infants' communication, gross motor, fine motor, problem solving and person-social function, the RR (95%CI) for ECS without medical indication were 0.86 (0.43-1.74), 1.55 (0.86-2.78), 0.74 (0.49-1.15), 1.10 (0.68-1.78) and 1.17 (0.66-2.08), respectively; and the RR (95%CI) for ECS with medical indication were 0.33 (0.12-1.02), 1.10 (0.55-2.21), 0.79 (0.48-1.29), 0.58 (0.29-1.13) and 1.48 (0.78-2.81), respectively. Conclusion ECS affected motor development in infants at the age of 6 months old, and no influence was found in infants at the age of 18 months old.

Objective To investigate the effect of FoxM1 inhibitor thiostrepton on proliferation and apoptosis of Daoy cell line in medulloblastoma.Methods Daoy cells from medulloblastoma were routinely cultured in vitro,and they were treated with thiostrepton at various concentrations (0,1,1.5,2,3 and 5 μmol/L); the mRNA and protein levels of FoxM1 were detected by real-time PCR and Western blotting 48 h after treatment; the proliferation of Daoy cells was investigated using CCK-8 assay 24,48 and 72 h after treatment; flow cytometry was used to observe the changes of cycle and apoptosis of Daoy cells after thiostrepton treatment; the effects of thiostrepton on apoptosis-relating proteins of Bcl-2 and Bax were studied using Western blotting.Results Thiostrepton could obviously inhibit Daoy cell proliferation in time-and dose-dependent manners,with significant difference between each two concentrations (P＜0.05),and IC50 at 24,48 and 72 h after treatment was (2.1±0.15),(1.69±0.11) and (1.39±0.1) μmol/L.As thiostrepton concentration increased,FoxM1 mRNA and protein expressions gradually decreased in Daoy cells; increasing thiostrepton concentration induced Daoy cell cycle being gradually blocked at G2/M phase,decreased Bcl-2 expression,up-regulated Bax expression and significantly increased apoptosis rate,with significant differences between each two concentrations (P＜0.05).Conclusion FoxM1 inhibitor Thiostrepton can obviously inhibit Daoy cell proliferation,which might be related to cells being arrested at G2/M stage and apoptosis being induced by Bcl-2/Bax expression proportion changes.

Objective To investigate the effects of FoxM 1 inhibition by thiostrepton on CDDP chemosensitivity in medulloblastoma Daoy cells.Methods Medulloblastoma Daoy cells were cultured in vitro; the inhibitory rates of Daoy cells after the treatments of 1,1.25,1.5,1.75,2,3,5 μmol/L thiostrepton (thiostrepton treatment groups),or 1,2,3,4,5,10,20 and 40 μmol/L CDDP (CDDP treatment groups) or 1 μmol/L thiostrepton combined with 1,2,3,4,5,10,20 and 40 μmol/L cDDP (combination treatment groups) were evaluated by CCK8 assay,and the interaction between thiostrepton and cDDP was analyzed by means of Jin's formulatin.According to the analysis results,Daoy cells were treated with thiostrepton (1 μmol/L) and CDDP (3 μmol/L) combination or either drug alone for 24 h,and then,flow cytometry was used to observe the changes of apoptosis; Western blotting was employed to detect the expressions of FoxM1 and apoptosis-relating proteins of bcl-2,bax,caspase 3 and poly-ADP-ribose polymerase (PARP).Results Thiostrepton and cDDP used alone could inhibit the proliferation of Daoy cells,and there was simple addition or synergistic effect after combined treatment (1,2,3,4 and 5 μmol/L cDDP and thiostrepton).Flow cytometric analysis showed that the apoptosis rate of thiostrepton treatment groups and CDDP treatment groups was significantly higher than that of control groups,while that of combination treatment groups was significantly higher than that of thiostrepton treatment groups and CDDP treatment groups (P＜0.05).Western blotting indicated that the FoxMl expression level in the combination treatment groups and thiostrepton treatment groups was significantly lower than that in the control group (P＜0.05); as compared with that in the thiostrepton treatment groups and CDDP treatment groups,the bcl-2 protein level was significantly lower in the combination treatment groups,while Bax,caspase 3 and PARP protein expressions were significantly increased (P＜0.05).Conclusion Thiostrepton acts synergistically with cDDP in low concentration,and its mechanism may involve in inhibiting FoxM 1 expression,and then,enhancing cDDP-induced apoptosis.

OBJECTIVESTo investigate the effects of antisense oligodeoxynucleotide(ASON) on the cyclic nucleotide monophosphates (cNMP) in smooth muscle cells of human corpus cavernosum, and provide experimental groundwork for the gene therapy of erectile dysfunction.

METHODSPDE5 gene ASON(containing exon 1) was transfected into the corpus cavernosum smooth muscle cells with the presence of liposome DOTAP. Another sense oligodeoxynucleotide(SON) and 1% of bovine serum were also transducted into the cells as controls. Two of cNMP, cAMP and cGMP, were probed and measured by ELISA at 1, 2, 4, 6, 10, 24 and 48 h after transfection.

RESULTSAfter transfection, the level of cGMP(1-6 h) in human corpus cavernosum smooth muscle cells was significantly higher than that in controls(P < 0.01).

CONCLUSIONSThe PDE5 gene ASON had been showed to manifest stimulative effect on the cGMP in smooth muscle cells of human corpus cavernosum in vitro, and it provides experimental groundwork for the gene therapy of erectile dysfunction.

3',5'-Cyclic-GMP Phosphodiesterases ; antagonists & inhibitors ; genetics ; Cyclic AMP ; metabolism ; Cyclic GMP ; metabolism ; Cyclic Nucleotide Phosphodiesterases, Type 5 ; Humans ; Male ; Muscle, Smooth ; drug effects ; metabolism ; Oligodeoxyribonucleotides, Antisense ; pharmacology ; Penis ; cytology