Objective: To analyze the basic thyroid hormone level on long term prognosis and peri-operative recovery in patients after heart transplantation (HT) at the terminal stage of heart failure (HF).
Methods: A total of 270 consecutive patients who received HT at the terminal stage of HF in our hospital from 2009-09 to 2014-07 were retrospectively studied. According to serum levels of thyroid stimulating hormone (TSH), the patients were divided into 3 groups: TSH < 0.55 mIU/L group, TSH (0.55-2.5) mIU/L group and TSH > 2.5 mIU/L group. The peri-operative recovery condition and long term prognosis were observed and compared among 3 groups.
Result: The average age of patients was at (44.58 ± 13.30) years including 228 (84.4%) male and 42 (15.6%) female. The average post-operative follow-up period was (31.88 ± 17.48) months with 100% follow-up rate. There were 41.8% of patients with hypothyroidism, and 46 (17.0%) patients with low T3 syndrome, 56 (20.7%) with subclinical hypothyroidism and 11 (4.1%) with clinical hypothyroidism. The ratio of low level thyroid hormone in HT patients was much higher than general population. For peri-operative recovery, the ICU stay time and mechanical ventilation time were similar among 3 groups,P>0.05, while TSH (0.55-2.50) mIU/L group had the shortest times and TSH > 2.50 mIU/L group had longest times. For long term prognosis, no matter uni-/multi- aviate regression analysis or Kaplan-Meier surviving curve all suggested that TSH > 2.50 mIU/L was the independent risk factor inlfuencing the prognosis of HT patients at the terminal stage of HF. Upon TSH increasing, the patients would have worse prognosis accordingly.
Conclusion: Serum level of TSH > 2.50 mIU/L was the independent risk factor in HT patients at the terminal stage of HF.

Objective To investigate the correlation of platelet-to-lymphocyte ratio(PLR)with depression in patients with maintenance hemodialysis(MHD)based on propensity score matching(PSM).Methods General information such as age,gender and underlying diseases,biochemical indicators,and Beck Depression Inventory(BDI)scores of patients in hemodialysis centers of 20 Grade Ⅲ and Level A hospitals in Guizhou Province from June to August 2023 were collected.Pa-tients were divided into depression group and non-depression group based on the occurrence of depres-sion,and differences in clinical characteristics were compared between the groups.A 1 to 1 propensi-ty score matching was used to obtain patients with similar baseline data(gender,age,education lev-el)in the depression and non-depression groups,and differences in clinical characteristics between the two groups were compared.Participants were divided into Q1,Q2,Q3 and Q4 groups according to the quartiles of PLR,and differences in clinical characteristics among the groups were compared.Lo-gistic regression analysis was used to evaluate the relationship between PLR and depression in MHD pa-tients.Receiver operating characteristic(ROC)curve was used to assess the value of PLR in predicting depression in MHD patients.Results A total of 2,081 MHD patients were included in this study,including 1,286 males(61.8％),with a mean age of(54.3±14.7)years.A total of 368 pa-tients(17.7％)had depression,and 359 pairs were successfully matched after propensity score matching.The depression group had higher rates of diabetes and PLR,but lower serum creatinine and hemoglobin levels(P＜0.05).The risk of depression in the PLR Q4 group was 22.654 times than that of the Q1 group(95％CI,12.713 to 40.369,P＜0.001).After initially adjusting for age,diabetes,and hypertension,the risk of depression in the PLR Q4 group was 28.272 times than that of the Q1 group(95％CI,15.390 to 51.937,P＜0.001).After further adjusting for serum creatinine,hemoglobin,albumin,white blood cell count,total cholesterol,monocyte-to-lymphocyte ratio,systemic immune-inflammation index,and neutrophil-to-lymphocyte ratio,the risk of depres-sion in the PLR Q4 group was 10.557 times than that of the Q1 group(95％CI,3.461 to 32.201,P＜0.001).The ROC curve analysis results indicated that the sensitivity of PLR in predicting de-pression in MHD patients was 78.0％,the specificity was 73.5％,the optimal threshold was 114.14,and the area under the curve was 0.798(95％CI,0.765 to 0.832,P＜0.001).Conclu-sion PLR is an independent risk factor for depression and has a high predictive value for depres-sion in MHD patients.

Objective To investigate the correlation of platelet-to-lymphocyte ratio(PLR)with depression in patients with maintenance hemodialysis(MHD)based on propensity score matching(PSM).Methods General information such as age,gender and underlying diseases,biochemical indicators,and Beck Depression Inventory(BDI)scores of patients in hemodialysis centers of 20 Grade Ⅲ and Level A hospitals in Guizhou Province from June to August 2023 were collected.Pa-tients were divided into depression group and non-depression group based on the occurrence of depres-sion,and differences in clinical characteristics were compared between the groups.A 1 to 1 propensi-ty score matching was used to obtain patients with similar baseline data(gender,age,education lev-el)in the depression and non-depression groups,and differences in clinical characteristics between the two groups were compared.Participants were divided into Q1,Q2,Q3 and Q4 groups according to the quartiles of PLR,and differences in clinical characteristics among the groups were compared.Lo-gistic regression analysis was used to evaluate the relationship between PLR and depression in MHD pa-tients.Receiver operating characteristic(ROC)curve was used to assess the value of PLR in predicting depression in MHD patients.Results A total of 2,081 MHD patients were included in this study,including 1,286 males(61.8％),with a mean age of(54.3±14.7)years.A total of 368 pa-tients(17.7％)had depression,and 359 pairs were successfully matched after propensity score matching.The depression group had higher rates of diabetes and PLR,but lower serum creatinine and hemoglobin levels(P＜0.05).The risk of depression in the PLR Q4 group was 22.654 times than that of the Q1 group(95％CI,12.713 to 40.369,P＜0.001).After initially adjusting for age,diabetes,and hypertension,the risk of depression in the PLR Q4 group was 28.272 times than that of the Q1 group(95％CI,15.390 to 51.937,P＜0.001).After further adjusting for serum creatinine,hemoglobin,albumin,white blood cell count,total cholesterol,monocyte-to-lymphocyte ratio,systemic immune-inflammation index,and neutrophil-to-lymphocyte ratio,the risk of depres-sion in the PLR Q4 group was 10.557 times than that of the Q1 group(95％CI,3.461 to 32.201,P＜0.001).The ROC curve analysis results indicated that the sensitivity of PLR in predicting de-pression in MHD patients was 78.0％,the specificity was 73.5％,the optimal threshold was 114.14,and the area under the curve was 0.798(95％CI,0.765 to 0.832,P＜0.001).Conclu-sion PLR is an independent risk factor for depression and has a high predictive value for depres-sion in MHD patients.

PURPOSE: We report the clinical efficacy of amniotic membrane transplantation which dyed by Chinese-ink and Davidson marking dye in patients of bullous keratopathy. METHODS: We performed permanent amniotic membrane transplantation in 23 eyes with bullous keratopathy during the period of October 1998 to May 2002. Simple amniotic membranes were transplanted in 9 eyes, Chinese-ink dyed amniotic membranes in 10 eyes, and Davidson marking dyed amniotic membranes in 4 eyes. RESULTS: 23 eyes were successfully transplanted by amniotic membrane. Most of patients with photophobia, pain, cosmetic problem had been satisfactory effects in Chinese-ink and Davidson marking dye groups and Davidson marking dye groups noted longer staining than Chinese-ink group. CONCLUSIONS: We suggest that dyed amniotic membrane transplantation may be effective method to release pain, photophobia, and cosmetic problem by stabilization of corneal surface than previous simple amniotic membrane transplantation in bullous keratopathy.
Amnion ; Humans ; Membranes* ; Photophobia

Objective To evaluate the feasibility and effectiveness of four closure techniques ,large incision with plastic distal at‐tachment and clip with suction ,1 .1 cm small incision with plastic distal attachment and clip with suction in natural orifice translu‐minal endoscopic surgery(NOTES) .Methods Forty‐one ex vivo porcine stomachs were involved in this research .According to the size of incision and different methods of incision closure ,all ex vivo porcine stomachs were divided into four groups .Group A in‐volved 8 ex vivo porcine stomachs ,their size of incision were 1 .2-2 .0 cm ,and their incisions were closured by a clip closure direct‐ly ;group B involved 10 ex vivo porcine stomachs ,their size of incision were 1 .2-2 .0 cm ,and their incisions were closed by plastic end attachment with suction and clip enclosure technique;group C involved 10 ex vivo porcine stomachs ,their size of incision were smaller than 1 .1 cm ,and their incisions were by a clip closure directly ;group D involved 13 ex vivo porcine stomachs ,their size of incision were smaller than 1 .1 cm ,and closured by plastic end attachment with suction and clip enclosure technique .Stomach leaks were evaluated by leaking studies after the procedure .Results In group A ,1 incision was closed successfully ,7 incisions were clo‐sured unsuccessfully ;in group B ,2 incisions were closed successfully ,8 incisions were closed unsuccessfully ;in group C ,2 incisions were closed successfully ,8 incisions were closured unsuccessfully ;in group D ,11 incisions were closed successfully ,2 incisions were Closured unsuccessfully .Fisher′s exact test showed that group D was significantly related to the success of incision closure .The were significant differences between group A and D ,group B and group D(P<0 .05) .Conclusion Small incision(smaller than 1 cm) and plastic end attachment with suction and clip enclosure technique are optimal in NOTES procedure in this ex vivo porcine stomachs study .

PURPOSE: This study was conducted to determine long-term results of Hydroxyapatite and Medpor(R) ocular implants. METHODS: This study was done on 108 eyes inserted with hydroxyapatite ocular implant and 82 eyes inserted with Medpor(R) ocular implant that were treated at the present hospital from January 1992 to December 2002. We compared the types, frequencies, and onset and treatment of complications according to the types of surgery. RESULTS: The clinical outcome for 14 months to 10 years (average: 57.6 months) was examined in the hydroxyapatite implantation group. The complications were implant exposure in 14 eyes (13%), soft tissue complication in 27 (25%), eyelid complication in 30 (27.8%), and complication due to Peg insertion in 21 (27.3%). The clinical outcome for 5 months to 4 years (average: 18.6 months) was examined in the Medpor(R) implant group. The complications involved were implant exposure in 5 eyes (6.1%), soft tissue complication in 14 (17.1%), eyelid complication in 25 (30.5%), and complication due to MCP insertion in 3 (16.7%). CONCLUSIONS: Active treatment for early complications and long-term follow-up for late complications are needed with hydroxyapatite and Medpor(R) implantations.
Durapatite* ; Eyelids ; Follow-Up Studies ; Orbit* ; Orbital Implants*

OBJECTIVETo investigate the relationship between heparanase 1 (Hpa1) expression and the development of human pancreatic cancer.

METHODSReal-time PCR and Western blot methods were used the expression of Hpa1 in 37 cases of pancreatic cancer were analyzed quantitatively. The relationship between the expression of Hpa1 and the clinicopathological features of pancreatic cancer was analyzed.

RESULTSThe expression of Hpa1 mRNA in pancreatic cancer was 23.53 +/- 4.13, in pancreatic tissues was 4.08 +/- 2.14 and in pancreatic cancer adjacent tissue was 16.93 +/- 3.06 by real-time PCR detected (P < 0.01). The expression of Hpa1 protein in normal tissue was 0.36 +/- 0.14, in pancreatic cancer adjacent tissue was 1.21 +/- 0.37 and in pancreatic cancer tissue was 1.76 +/- 0.28 by Western blot detected (P < 0.05). The expression of Hpa1 mRNA and Hpa1 protein in pancreatic cancer tissue were both higher than pancreatic cancer adjacent tissue and normal tissue. The expression of Hpa1 was significant associated with TNM grade and Invasion to nerves or vascellum lymph node metastasis separately (P < 0.05). But no relationship between histological differentiation and the tumor size (P > 0.05).

CONCLUSIONSThe Hpa1 overexpressed in pancreatic cancer tissues and its abnormal expression may be involved in the oncogenesis and development of pancreatic cancer.

Adult ; Aged ; Female ; Glucuronidase ; biosynthesis ; genetics ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms ; enzymology ; pathology ; RNA, Messenger ; genetics

Objective: To explore the correlation between antithrombotic strategy and its prognostic value in coronary artery disease (CAD) patients combining with atrial ifbrillation (AF) after percutaneous coronary intervention (PCI).
Methods: A total of 570 CAD patients with AF received PCI in our hospital from 2012-01 to 2013-12 were retrospectively analyzed by CHADS2 and HAS-BLED Score system. According to CHADS2 < 2 and CHADS2 ≥ 2 or with/without warfarin medication, the patients were divided into 2 groups:①CHADS2 < 2 (Low risk of stroke) group,n=339 including 309 patients without warfarin and 30 with warfarin medication;②CHADS2 ≥ 2 (High risk of stroke) group,n=231 including 200 patients without warfarin and 31 with warfarin medication. All patients were followed-up for 15 months to compare the different anti-platelet/ anti-coagulation strategies for the occurrence rate of MACCE, ischemic and bleeding events.
Results: Compared with Low risk of stroke group, the patients in High risk of stroke group had the worse prognosis and higher rate of MACCE occurrence,P<0.001, HR=2.677, 95% CI (1.535-4.635), more ischemic events,P=0.013, HR=2.080, 95% CI (1.167-3.709). Multi-factor Cox surving analysis indicated that compared with low risk patients without warfarin medication, the high risk patients without warfarin had the higher rate of MACCE occurrence,P=0.001, HR=2.985, 95% CI (1.532-5.816), more ischemic events,P=0.026, HR=2.068, 95% CI (1.090-3.925). Whereas, the occurrence rates of MACCE and ischemic events in high risk, low risk patients with warfarin and low risk patients without warfarin were similar, all P>0.05. The major bleeding events in patients with warfarin were a little higher than those without warfarin,P>0.05. The minor bleeding events were increased in both Low risk stroke group asP<0.001, OR=4.458, 95% CI (1.934-10.277) and High risk stroke group asP=0.002, OR=4.155, 95% CI (1.717-10.055).
Conclusion: Warfarin medication may obviously decrease the occurrence rates of MACCE and ischemic events in high risk of stroke patients, while in low risk patients, warfarin could not further decrease the occurrence of MACCE and ischemic events. Warfarin could increase the risk for minor bleeding in both low risk and high risk of stroke in CAD patients combining with AF after PCI.

Objective The optimal access for natural orifice transluminal endoscopic surgery is still uncertain .This study was designed to compare the practicability and maneuverability of transgastric ,transunmbilical ,and transrectal approach in abdominal surgery in a canine model .Methods Three dogs were used in this research .Three approach :trangastric ,transunmbilical and tran-srectal approach were carried out for abdominal exploration ,liver biopsy ,bladder biopsy and an attempted cholecystectomy .The ma-neuverability ,endoscopic image ,performer′s perception ,and spatial orientation were evaluated .Results The maneuverability of trangastric ,and transrectal approach NOTES were better than transunmbilical NOTES .Abdominal exploration ,live biopsy ,and bladder biopsy were completed successfully .The cholecystectomy was failed because of poor exposure and difficulty of separating the around tissure .Conclusion The optimal approach for upper abdomen NOTES is transrectal route .For lower abdomen NOTES , the trangastric approach is superior to other accesses .Further study is needed to develop more flexible and precise equipment for NOTES and to evaluate more feasible access approach .

OBJECTIVETo detect the role of Vascular endothelial growth factor C (VEGF-C) in the interaction of tongue squamous cell carcinoma (TSCC) with the peri-carcinoma lymphatics.

METHODSTSCC cells were implanted on the chorioallantoic membrane (CAM), in which, group A was transfected by plasmid pREP7 including VEGF-C, group B was transfected by plasmid pREP7, and group C was Tca8113. Lymphatic vessels were stained by 5'-Nase. Morphologic analysis was used to evaluate the alteration of lymphatic vessels density (LVD), area and perimeter.

RESULTSThe transplanted tumor well on CAM. The expression of VEGF-C in group A was higher than that in control group B and C. The LVD, perimeter and area in group A were (5.3 +/- 0.41)/high-power field, (148 +/- 21) microm and (76.8 +/- 13.5) microm(2) respectively in group A, which were significantly higher than that of group B and C (P < 0.01), while there were no significant difference between group B and C.

CONCLUSIONSCAM is ideal model for the research of lymphatic vessels; Over-expression of VEGF-C could induce the dilatation and LVD increase of peri-tumor lymphatic vessels, which maybe one of the mechanisms that VEGF-C metastasis of TSCC through lymphatic vessels.

Animals ; Carcinoma, Squamous Cell ; pathology ; Cell Line, Tumor ; Chick Embryo ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Lymphatic Vessels ; drug effects ; pathology ; Neck ; Neoplasm Transplantation ; Tongue Neoplasms ; pathology ; Transfection ; Vascular Endothelial Growth Factor C ; genetics