Objective:Primary gastric choriocarcinoma (PGC) is a rare tumor. This study aimed to analyze cases reported in Chi-nese and two cases in our hospital. This study was also conducted to investigate the clinical characteristics and treatment of PGC. Meth-ods:The Chinese Medical Current Contents and China Biology Medicine database was retrieved with the following terms:primary gas-tric choriocarcinoma, stomach choriocarcinoma, and ectopic choriocarcinoma. The clinical data in published literature were retrospec-tively analyzed. Two cases from our hospital were also retrospectively analyzed. Results:A total of 16 patients with PGC (14 case stud-ies and 2 cases from our hospital) were included in this study. The average age of the patients was 57.69 years (ranging from 42 years to 79 years). Among the 16 patients, 4 were females and 12 were males. The main clinical manifestation was abdominal discomfort (12/16). Laboratory and imaging tests were non-specific, but HCG-βin all of the patients increased (11/11). Organ or lymph node metasta-sis was found in 13 patients, including 6 cases in which two or more organs showed metastasis. These organs were primarily the liver, the stomach lymph nodes, the lungs, the brain, and the abdominal cavity. Pathological examination results showed that 12 of the 16 cas-es displayed ulcers with necrosis and hemorrhage. The four remaining cases manifested lesions. Lesions may occur in the stomach less-er curvature (5 cases), stomach sinus (6 cases), cardiac (2 cases), and gastric body (3 cases). The histological components of PGC co-ex-isted with other factors, such as adenocarcinoma (7 cases), adenocarcinoma and squamous (2 cases), adenocarcinoma and a signet ring cell (1 case), or pure choriocarcinoma (6 cases). Surgery combined with chemotherapy was the main treatment. A total of 14 patients un-derwent surgical operations. Among these patients seven underwent chemotherapy after surgery and one underwent chemotherapy. Among the 10 patients who were followed up, 8 died within six months after diagnosis. Conclusion:PGC is a rare stomach cancer with poor prognosis and primarily affects older men. No characteristic clinical manifestations were observed, but HCG-βas a specific serum tumor biomarker increased in all of the affected patients. Histological components co-existed with other stomach cancers. Surgical exci-sion combined with chemotherapy was the preferred treatment in early stages, and systemic chemotherapy was the recommended treat-ment in advanced stages.

Objective To probe into the social support, coping styles, and mental health status of medical staff in a tertiary hospital in Beijing, for identifying potential mental problems. Methods Such means as the Social Support Rating Sheet (SSRS), Simple Coping Style Questionnaire (SCSQ), Symptom Checklist (SCL-90), and demographic characteristics questionnaire were called into play, to study 2460 medical staff in five tertiary hospitals in Beijing. Results Differences were identified among medical staff of different demographic characteristics, in terms of positive coping style and support dimensions. Analysis of the survey data indicates that the total SCL scores, total symptom problem index, positive symptom pain level, total average score of the factors, are positively related to passive coping style, as P<0. 01; and are negatively related to subjective/objective support, support utilization, and total support scores, as P<0. 01. Conclusions Hospital administration is expected to implement focused intervention to such medical staff as those under 40 years old, women, widows or divorcees, those with education lower than university degree, those with junior academic title or lower, those without titles, those in emergency departments and emergency intensive care units, doctors and nurses, frequent night-shift workers, those of excessively low self evaluation, and medical staff with chronic diseases. The purpose of this practice is to alleviate their mental stress.

Background Our previous studies found that mesenchymal stem cells (MSCs) can ameliorate experimental autoimmune uveitis (EAU) and reduce tissue impairment.Its mechanism is still pending.Objective This study was performed to investigate the effects of MSCs on T cell subsets and antigen presenting cells (APCs) in EAU rats.Methods MSCs were isolated from bone marrow of six male Wistar rats and cultured by plastic adherence method.Twelve female Lewis rats were assigned randomly into MSCs group and PBS group.EAU rat model was induced by immunization with 200 μl emulsion containing 30 μg interphotoreceptor retinoid-binding protein (IRBP) 1177-1191 polypeptide fragment R16 and complete Freund adjuvant (CFA).The eye manifestations of the rats were observed and scored under the slit lamp microscope after modeling.The R16-immunized rats were treated intravenously with 5×106/ml MSCs for 3 consecutive days from day 9 to 11 after modeling in the MSCs group,and the equivalent volume of PBS was used with the same way in the PBS group.Fifteen days after modeling,the spleens and draining lymph nodes were collected to evaluate the proportion of interferon-γ (IFN-γ) positive CD4+ T cells,interleukin-17 (IL-17)positive CD4+ T cells and forkhead helix transcription factor p3 (Foxp3) positive CD4+ T cells by flow cytometry.The T cells and APCs from the different groups were cocultured and divided into PBS cocultured group,MSCs cocultured group, PBS-MSCs cross-cultured group and MSCs-PBS cross-cultured group under the stimulation of R16 at the concentration of 0.3,1.0 or 10.0 μg/ml, and the proliferation indexes of the T cells in different groups were assayed by 5-bromodeoxyuridine (BrdU) Elisa kit.The use of experimental animals complied with the regulations on the management of experimental animals promulgated by the national science and technology commission.Results The ocular surface inflammatory scores of 11,12,13 and 14 days after modeling in the MSCs group were significantly lower than that in the PBS group (t=3.825,5.100,4.250,3.400, all at P＜0.05).Compared with the PBS group, the proportions of IFN-γ positive CD4+ T cells in spleen and draining lymph notes were considerably decreased in the MSCs group (t =5.651,4.376, both at P＜0.05) , so were the IL-17+ CD4+ T cells (t =3.300,4.925, both at P＜0.05).However,the proportions of Foxp3 + CD4+ T cells in spleen and draining lymph notes were statistically raised in the MSCs group compared with the PBS group (t =-5.172,-2.825,both at P＜0.05).The proliferation index of T cells increased with the rise of R16 dose in the PBS cocultured group, and the proliferation indexes were all declined in the MSCs cocultured group compared with the PBS cocultured group under the stimulation of 0.3,1.0 and 10.0 μg/ml of R16 (P =0.027,0.000,0.000).In addition, significant reduces of proliferation indexes of T cells were seen in the PBS-MSCs cross-cultured group and MSCs-PBS cross-cultured group in comparison with the PBS cocultured group when stimulated by 1.0 μg/ml and 10.0 μg/ml R16 (1.0 μg/ml R16 : P =0.001,0.000;10.0 μg/ml R16:P=0.000,0.000).Conclusions MSCs can ameliorate EAU by inhibiting the functions of antigen-specific T cells and APCs and up-regulating T regulatory cells in EAU rats.

Objective To analyze the diagnosis and prognosis value of abdominal CT scans in patients with acute pancreatitis complications.Methods 151 cases with acute pancreatitis were selected.The relationship between abdominal CT performances and the common complications and death in patients was analyzed.The prognosis of patients with different Balthazar CT severity index (CTSI) grade was compared.Results The complication rate of patients with CT signs of fatty liver, pleural effusion, liver gap effusion, adrenal gland involvement (AGI), penirenal space involvement (PSI) and gastric bare area involvement (GBAI) was significantly higher than that of patients with negative CT findings above (P<0.05).With CTSI grading increasing, the patient''s fasting time, heating time, hospital stay, recovery time of blood amylase were extended, and the incidence of pseudo cyst, transit surgery, organ failure and death was gradually increasing (P<0.05).Conclusion Severe fatty liver, AGI, GBAI, PSI and liver gap effusion are risk factors for acute complications and death in patients with pancreatitis.

Objective To investigate the influence of diversification continuing care on quality of life and activities of daily living of epilepsy patients secondary to cerebral hemispheric atrophy.Methods Twenty epilepsy patients with cerebral hemispheric atrophy,admitted to Second Department of Neurosurgery of Hebei Provincial People's Hospital from March 2012 to December 2014 were selected by convenience sampling method,and divided into the intervention group (12 cases) and control group (8 cases),Patients in the control group were given routine guidance discharge,and intervention group were given continuing nursing intervention.The influence of diversification continuing care on quality of life and activities of daily living of epilepsy patients were compared between two groups.Results Twelve months after discharge,QOL in the control group and the intervention group scored 58.8±20.9 and 77.2±14.3,t=2.37,P ＜ 0.05.The ADL scored 49.42±8.14 and 62.72±7.06,t=2.39,P ＜0.05.Conclusions Diversification continuing nursing intervention is helpful to improve quality of life and activities of daily living of epilepsy patients secondary to cerebral hemispheric atrophy.

Objective:To investigate the difference of metabolomics between acute heart failure (AHF) patients and control. To find and validate new metabolic biomarkers.Methods:This was a single-center case-control study which included 89 acute heart failure patients admitted to the emergency department of Henan Provincial People's Hospital from January 2018 to June 2019. Eighty people without heart failure and diastolic dysfunction were enrolled as control group whose age and sex were matched to the study group. The fasting blood samples were collected from femoral arterial. Qualitative and quantitative analyses of plasma metabolites were performed in 2 groups by high performance liquid chromatography tandem mass spectrometry (UHPLC-MS), Orthogonal partial least squares-discriminant analysis (OPLS-DA) model and ROC curve method were applied.Results:Compared with the control group, we found that AHF group had higher likelihood to groups with coronary heart disease (37% vs. 7%, P<0.001), hypertension (58% vs. 28%, P<0.001), diabetes (33% vs. 18%, P=0.033), atrial fibrillation (24% vs. 4%, P<0.001), smoking history (42% vs. 18%, P=0.001), and that AHF group had higher creatinine level [(121.6 ± 78.4) vs. (69.0 ± 21.0), P<0.001], higher urea level [(11.5 ± 7.6) vs. (6.2 ± 2.0), P<0.001], higher heart rate [(92 ± 23) vs. (78 ± 14), P<0.001], hypoproteinemia [(32.4 ± 5 .2) vs. (40.4 ± 2.2), P<0.001], and significantly increased BNP level [(4 200 ± 5 229) vs. (100 ± 68), P<0.001], lower left ventricular ejection fraction[(45 ± 8) vs. (57 ± 6), P<0.001], low serum sodium level ( P<0.001). The metabolites of AHF group were significantly different from those of the control group. The metabolites involved amino acids, fatty acids, lipids, nucleosides and their derivatives. Adenine, N-acetyl-L-glutamic, pseudouridine and Gamma-Glutamylcysteine had certain diagnostic value for AHF comparing to control. The AUC were 0.995, 0.932, 0.920 and 0.900. And the AUC value for BNP diagnosis of AHF is 0.978. Conclusions:There were significant differences in metabolism between AHF group and control group including multiple substances. Adenine, N-acetyl-L-glutamic, pseudouridine and Gamma-Glutamylcysteine has similar diagnostic value compared with BNP for diagnosing AHF.

The flocculating yeast strain SPSC01 is a fusant strain of Saccharomyces cerevisiae and Schizosaccharomyces pombe. The use of SPSC01 to absorb Cr(VI) from Cr(VI) containing aqueous solution would greatly reduce the cost of post-adsorption separation, since the superior flocculating property of SPSC01 would allow easy separation of the Cr(VI)-biomass from the solution. In order to investigate the effects of flocculating proteins on Cr(VI) reduction and absorption by SPSC01, the absorption behaviors of SPSC01 and its parental strains were compared. The results showed that Cr(VI) removal rate of SPSC01 was almost the same as that of S. pombe, which also has flocculating ability, but was faster than that of S. cerevisiae, which has no flocculating ability. When the system reached equilibrium, the amount of total Cr adsorbed by S. pombe, SPSC01 and S. cerevisiae were 68.8%, 48.6% and 37.5%, respectively. This showed that flocculation was beneficial to Cr(VI) reduction and adsorption, and suggested that focculating proteins may play a role in enhancing the Cr(VI) adsorption capacity of SPSC01 and S. pombe. We investigated the mechanism of Cr(VI) adsorption by SPSC01 using chemical modification and FTIR. The results indicated that the major functional groups (amino, carboxyl and amide) of surface proteins may contribute to the absorption of Cr(VI).
Adsorption ; Biodegradation, Environmental ; Chromium ; isolation & purification ; Flocculation ; Saccharomyces cerevisiae ; metabolism ; Schizosaccharomyces ; metabolism ; Surface Properties ; Water Pollutants, Chemical ; isolation & purification

Objective To evaluate the left ventricular and right ventricular systolic function by two‐dimensional speckle tracking echocardiography ( 2D‐STE) in patients with rheumatoid arthritis ( RA ) . Methods Fifty five patients with RA and 50 healthy subjects were received echocardiography . 2D‐STE were applied for all the subjects to obtain left ventricular global longitudinal strain ( LVGLS) and right ventricular global longitudinal strain ( RVGLS) .Tricuspid annular plane systolic excursion ( TAPSE) and the change ratio of right ventricular area ( RVACR) were measured by echocardiography . The anti‐cyclic citrullinated peptide antibodies ( anti‐CCP‐II) ,rheumatoid factor ( RF) ,C‐reactive protein ( CRP) and erythrocyte sedimentation rate ( ESR) were detected in both group . The LVGLS and RVGLS in RA group were used to conduce correlation analysis with the level of anti‐CCP‐II ,RF ,CRP , ESR and the duration of disease . Results There was a significant decrease in RVGLS and LVGLS in RA group compared with control group( P <0 .05) . However there was no statistical differenc in TAPSE and RVACR between RA and control group( P > 0 .05) . The anti‐CCP‐II ,RF ,CRP and ESR in RA group increased significantly compared with control group ( P < 0 .001 ) . The result of correlation analysis showed there was no correlation between RVGLS ,LVGLS and anti‐CCP‐II ,RF ,CRP ,ESR in RA group . However ,RVGLS and LVGLS were negatively correlated with the duration of disease . Conclusions LVGLS and RVGLS in RA patients were lower than those in healthy people ,strain decreases with the extension of disease duration ,2D‐STE may be an efficacious assessment to assess left ventricular and right ventricular systolic function in patients w ith RA .

Objective To explore the role of clinical application of enteral nutrition sequential therapy in early enteral nutrition support by comparison with enteral nutrition non-sequential therapy in critically ill patients with cerebrovascular diseases.Methods A total of 62 patients were randomly (random number) divided into sequential group and conventional (non-sequential) grouThe comparisons of tolerance for enteral nutrition support,levels of prealbumin,the mechanically ventilated time and mortality rate in 28-day between two groups were carried out.Results The tolerance of sequential group was superior to that of conventional group (P＜0.05).The higher level of prealbumin and the shorter mechanical ventilation time were observed in sequential group compared with conventional group (P＜0.01).Compared with conventional group,the patients in sequential group had lower mortality rate in 28 days (P＜0.05).Conclusions Sequential therapy is beneficial to the implementation of early enteral nutrition support in patients with severe cerebrovascular disease,reducing the nutritional adverse events,and improves the prognosis.

Objective To evaluate the association between the decrease of the perioperative serum carcinoembryonic antigen (CEA) level during perioperative period and the prognosis in patients with colon cancer after a curative resection.Methods Retrospective analysis was conducted to evaluate the relationship between preoperative serum CEA level and different clinicopathologic features in 605 cases who underwent a curative resection for colon cancer from January 2006 to April 2011.According to the preoperative serum CEA level,the patients were divided into two groups:≤5 ng/ml and ＞5 ng/ml group.The critical value of the CEA decreasing rate in preoperative serum CEA ＞ 5 ng/ml group was calculated,and the relationship between this critical value and survival rate was then analyzed.Univariate and multivariate models were used to detect the risk factors of overall survival rate (OS) and disease free survival (DFS) in preoperative serum CEA ＞ 5 ng/ml patients.Results The preoperative serum CEA levels were significantly associated with lymphatic invasion (x2 =14.122,P＜0.001),T stages (x2 =40.153,P ＜0.001),N stages (x2 =22.721,P ＜0.001) and pathological stages (x2 =38.576,P ＜ 0.001),except for sex (x2 =0.453,P =0.501),age (x2 =0.195,P =0.659) and histological stages (x2 =6.135,P =0.112).The critical values of CEA decreasing rate for OS and DFS were 48.95％ and 50.81％ in preoperative serum CEA ＞5 ng/ml group respectively.There were significant differences of 5-year OS (31.37％ vs.76.63％,x2 =43.235,P ＜ 0.001) and 5-year DFS (27.69％ vs.72.10％,x2 =55.561,P ＜0.001) between patients after operation whose CEA decreasing rate were lower than critical value and those whose were higher.Univariate analysis showed that the decreasing rate of CEA was an influence factor for OS (x2 =43.235,P ＜ 0.001) and DFS (x2 =55.561,P ＜ 0.001) of preoperative serum CEA ＞ 5 ng/ml patients.The N stages and pathological stages were both related to OS (x2 =14.683,P＜0.001;x2 =12.295,P＜0.001) and DFS (x2 =16.212,P＜0.001;x2 =13.704,P＜0.001)respectively.Multivariate model showed that the decreasing rate of CEA level and N stages were both associated withOS (x2=18.885,P＜0.001;x2 =7.523,P＜0.001) and DFS (x2 =19.275,P＜0.001;x2 =6.997,P ＜ 0.001) of preoperative serum CEA ＞ 5 ng/ml patients.Conclusion A high decreasing rate of serum CEA level after operation in colon cancer patients who have high CEA levels before the curative resection can be a protective factor for prognosis,especially when the decreasing rate is higher than the critical value.