Objective:To explore the value of magnetic resonance imaging (MRI) parameters combined with serum macrophage migration inhibitory factor (MIF) and microRNA-1203 (miR-1203) in the early diagnosis of hepatocellular carcinoma (HCC) and its relationship with efficacy.Methods:From October 2017 to October 2019, 100 patients with HCC in Hunan Provincial Hospital of Traditional Chinese Medicine were selected as the observation group. 92 patients with benign liver tumor and 102 healthy people were randomly selected as the control group and normal control group. The clinicopathological features, MRI parameters [hepatic artery perfusion index (HPI), volume transfer constant (K trans)], serum MIF and miR-1203 levels were compared among the three groups; the value of MRI parameters, serum MIF and miR-1203 in single and combined diagnosis of HCC was explored; the relationship between each index and curative effect of HCC patients was analyzed. Results:The levels of HPI, K trans, serum MIF and miR-1203 in observation group were higher than those in control group and normal control group ( P<0.05); There were significant differences in HPI, K trans, serum MIF and miR-1203 levels among patients with different tumor length, differentiation degree, Child Pugh grade and distant metastasis in the observation group ( P<0.05). Among HPI, K trans and serum MIF, miR-1203, the specificity of HPI and K trans for diagnosis of HCC were the largest (94.57%), and the sensitivity of K trans for diagnosis of HCC was the largest (75.00%); the area under the curve (AUC) of the combined diagnosis of HCC was 0.879, which was greater than the AUC of the single diagnosis of HPI, K trans and serum MIF, miR-1203 (0.753, 0.793, 0.792, 0.809); the optimal sensitivity and specificity of the combined diagnosis were 79.00% and 86.96%, respectively; the levels of HPI, K trans, serum MIF, and miR-1203 in effective patients in the observation group were lower than those in the ineffective patients after treatment ( P<0.05); the clinical efficacy of HCC patients were significantly correlated with the levels of HPI, K trans, serum MIF and miR-1203 ( P<0.05). Conclusions:The MRI parameters HPI, K trans and serum MIF, miR-1203 levels in patients with HCC increased significantly, which has high application value in assisting clinical diagnosis of HCC, and is closely related to the clinical efficacy of patients, and has great development potential in efficacy evaluation.

Objective To investigate the prevalence rate of senile insomnia and revealing the characteristics of its pathogenesis. Methods On the basic study of senile insomnia clinical literature, the questionnaire was made and followed by epidemiological investigation. The database was set up for statistical analysis with SPSS13.0. Results Prevalence rate of senile insomnia in Wuchang District of Wuhan City was 36.47%. There were significant difference in sleep time, the length of sleep at night, sleep continuity especially mental state during the day between insomnia group and the normal group (P

Objective To investigate early and midterm outcomes after minimally invasive1-stop or 2-stage MICSCABG and PCI hybrid surgery.Methods Between June 2011 and February 2015, 28 patients(19 males and 9 females) with multiple coronary artery disease underwent MICS-CABG and PCI hybrid surgery, 4 cases of which were1-stop hybrid surgery and 24 cases were 2-stage.All patients were followed up to major adverse events(recurrent angina, secondary myocardial infarction, congestive heart failure, serious arrhythmias, secondary bypass graft) as the end point event.Results All patients were no perioperative deaths, shock, infection and myocardial infarction.ICU stay time was(22.9 ± 12.5) h, hospital stay time was(6.75 ±2.10) days, intubation time was(21.1 ± 17.7) h.Perioperative1-stop and2-stages hybrid surgery had significant statistical differences in ICU stay time and intubation time[(41.8 ±32.9) h vs.(16.5 ± 8.5) h;(40.0 ± 34.2) h vs.(18.8 ± 8.5) h;P ＜ 0.05].Patients were followed up for 1-44 months, averaged (17.9 ± 12.8) months.The postoperative major adverse event rate was 7.14％, one patient died of cerebral hemorrhage after 6 months, and one patient underwent coronary angiography because angina.Conclusion l-stop or 2-stage MICS-CABG and PCI hybrid surgery provides a safe,effective and cosmetic revascularized method to patients with multiple coronary artery disease.Meanwhile,the procedure does not destroy the way of re-operation.The perioperative and early results of follow-up are satisfactory.

Objective The aim of this study is to summarize primarily the application range and the clinical effect of the minimally invasive direct cardiac surgery (MIDCS).Methods From April 2010 to August 2011,108 operations had been performed in our centre using MIDCS,among of which 44 males and 64 females,mean age (44.3 ± 16.4 ) years old,mean weight (60.0 ± 12.0 ) kg.These operations included 29 MVR operations (replacement with mechanical valve 19,with tissue valve 10),17 AVR operations( replacement with mechanical valve 11,with tissue valve 6 ),5 MVP operations,6 MVR + AVR operations (replacement with mechanical valve 5,with tissue valve 1 ),12 VSD repair operations and 23 ASD repair operations,9 MIDCAB operations,1 MVR + CABG oparation,2 PECD correction,1 repair of ruptruec chordae tendineae of tricuspid septum and 1 Ebstein deformity correction operation.Concomitant procedures included 19 TVP operations and 11 radiofrequency ablation operations.Except MIDCAB operations,other operations are performed with closed type extracorporeal circulation.Conversion to median sternotomy was necessary in only two patients ( 1.9％ ).Results Mean cardiopulnonary bypass time and aortic eross-clamp time were ( 104.4 ± 59.3 ) minutes and ( 66.7 ± 52.8 ) minutes respectively,74 patients ( 92.5 ％ ) recover to beat automatically after heart ceased operation.Median mechanical ventilation time was ( 14.5 ± 11.9 ) hours,Median intensive care unit stay was ( 18.8 ± 15.3 ) hours,median hospital stay post operative was (6.9 ± 2.9) days.Median incision length was (5.3 ± 1.2 )cm.Median draining volume was( 337.6 ± 240.9 )ml in the first day after operation,No transfusion occurred in 72 patients(66.7％ ).Hospital mortality was 0.No re-exploration for bleeding and sternal wound infection.When leaving hospital,94 being of heart functional class Ⅰ,8 of class Ⅱ,6 of class Ⅲ.Conclusion MIDCS was associated with good operative effect in the near future,superior safety and broad application range.Furthermore MIDCS has minimally invasive,less postoperative bleeding,fewer blood transfusions,good cosmesis,as well as the absence of sternal wound infection.It may be safely performed on selected patients with low postoperative mortality and morbidity.

Cell therapy has a very promising potential for end-stage liver diseases (ESLD).Fetal liver stem/progenitor cells (FLSPCs) have advantages of safety,high survival and proliferation rates,and a small volume,all which make them ideal for liver disease stem cell therapy.During the early phase of our study,we applied a three-step separation method to enrich FLSPCs and obtained a separation efficiency similar to that of the flow-cell sorting method.Additionally,using a fulminant hepatic failure model in rats,we have demonstrated that FLSPCs can contribute to morphological and functional recovery of the liver.This manuscript will discuss how FLSPCs can be induced to accurately differentiate into hepatocytes and cholangiocytes and how FLSPCs maintain self-renewal.The Notch signaling plays a critical role in regulating the differentiation and self-renewal of many types of stem cells.Our previous findings have shown that the Notch signaling plays an important role in FLSPCs differentiation into hepatocytes.Therefore,the Notch signaling might be involved in the differentiation and self-renewal of FLSPCs.We conducted a study on the regulatory effects and relative molecular mechanisms of the Notch signaling on FLSPCs and found the corresponding interfering target,which might become an index for the clinical application of FLSPCs.

Objective To observe the effects of wild jujube seed decoction (WJSD) on learning memory and the levels of malondialdehyde (MDA) and the activities of supemxide dismutase (SOD) and nitric oxide synthase (NOS) in the brain of the pathogeny model rats with sleep deprivation (SD). Methods Levels of learning memory and MDA, and activities of SOD and NOS in rats' brain were assayed after SD induced by made-self multiple platform method ( MMPM), senescence induced by D-galactose, and Yin and blood-deficiency induced by eyclophosphamide and hydrocortisonum. Results After 48 h SD, the levels of learning memory was lower in the model group( ( 108.9 ± 12.5 ) s, ( 89 ± 11.5 ) s, ( 0 ) ) than those in the environmental control group ( ( 47.3 ±4.6)s,(9±1.4)s,(6.5 ±1.2))(( t=4.36,3.18,2.07, P＜0.01＝＝. While MDA, and activities of SOD and NO in rats'brain higher in the model group( (3.8 ±0.6) ,(3.0 ±0.5)nmol · mgprot-1 ,(229.7 ±25.8) ,(236.3± 25.2 ) U · mgprot - 1, ( 5.7 ± 0. 8 ), ( 5.4 ± 0.9 ) U · mgprot - 1 ) than those in the environmental control group ( (2. 1 ±0.4) ,(1.6 ±0.4)nmol · mgprot-1 ,(155.5 ±10.6) ,( 147.2 ±26.1 )U · mgprot-1 ,(2.8 ±0.7),(2.9 ± 0.5 ) U · mgprot -1 ) ( t = 2.89,3.01,6.78,5.94,3.10,3.46, P ＜ 0.05 ＝. However, the observation of the groups treated with WJSD, the levels of learning memory showed a tendency in returning to normal level (P ＜ 0.05 ＝ ,and MDA, and activities of SOD and NO of the high dose of WJSD showed a tendency in returning to normal leve1 (P ＜ 0.05 ＝ ,and the low dose of WJSD showed a tendency in returning to normal level too(P ＜ 0.05 ＝. Conclusion WJSD can improve the disability of learning and memory of the pathogeny rats model, and its one of mechanism maybe involve the reduction of neural cell damage with free radical and NO.

Objective To explore the expressions and significances of p 53、bcl-2、Ki-67 and apopto-sis in keratoacanthoma(KA)and well differentiated squamous cell carcinoma (WDSCC).Methods The expres-sions of p53、bcl-2、Ki-67 were detected by immunohistochemical technique in 44 cases of KA and 20 cases of WDSCC.Apoptosis was identified by using terminal deoxynucleotidyl transfers ( TdT) -mediated dUTP -biotin nick and labelling(TUNEL)method.Results The positive expressive rates of p53 in proliferative、mature and re-gressive of KA were 22.23%、26.18% and 6.52%, which was lower than the positive rate of WDSCC (41.82%).Significant differences were found between every period of KA with WDSCC in p 53 expression;The intensity of expression and pattern were similar in KA of Ki -67 and p53.There were a positive correlation be-tween p53 and Ki-67 expression rate(r=0.986,P<0.001).The bcl-2 staining showed weak expression in 1 case in WDSCC and 2 cases in KA ,but only a few positive tumor cells was limited to basal cell layer in KA .The average apoptosis rate in KA was 21.72%,which was apparently higher than in WDSCC (9.925%).There were a negative correlation between the apoptosis rate and proliferation rate of Ki -67(r=-0.824,P<0.001).Con-clusion The proliferation and apoptosis in KA can coexist .However ,the apoptosis will occupy a dominance posi-tion in regressive phase ,which results in the regression of tumor .The expressions of p53、Ki-67 and apoptosis would be a certain significance in differentiated KA and WDSCC .

Objective The aim of this study is to evaluate the early and midterm results of reconstructive new tricuspid valvar annulus technique and prosthetic ring in the anatomic correction of Ebstein's anomaly.Methods 60 operations for Ebstein's anomaly were performed by the reconstructive new tricuspid valvar annulus technique,prosthetic ring was used to reinforce the new tricuspid valvar annulus,the plastic effect of tricuspid valve was observed real-time by trans-esophagus echocardiography during operation.The follow-up results of the plastic effect of tricuspid valve were studied after operation.Results Mean operation time was (3.1 ± 2.3) h,mean cardiopulmonary bypass time was (148.8 ± 44.6) min,mean aortic cross-clamp time was(112.6 ± 34.1) min.3 patients had tricuspid valve replacement because of bad plastic effect;1 patient had bidirectional shunt Glenn procedure because of right sided heart failure.Hospital mortality was 1.When the patients were discharged,tricuspid regurgitation severe 1,medium 5,mild or no 50;53 being of heart functional class Ⅰ and class Ⅱ,3 of classⅢ.45 patients (80.3 ％) were followed-up out-hospital from 6 months to 7 years,mean (24.4 ± 21.4) months.Tricuspid regurgitation severe 1,medium 6,mild or no 38.And the nice stability of tricuspid valve was found during the follow-up period,41 patients being of heart functional class Ⅰ or Ⅱ (NYHA),4 of class Ⅲ.1 need reoperation.Conclusion The reconstructive new tricuspid valvar annulus technique can maintain farthest the dimension and geometric configuration of functional right ventricle,longitudinal plication of the atrialized right ventricle can restore a large ventricular cavity,improve it's pump function,and make valvuloplasty perfect,which widen obviously the indication of tricuspid valvuloplasty for Ebstein's anomaly.The research concluded that this technique can correct anatomically Ebstein's anomaly effectively,and it can get the stable effect of tricuspid valvuloplasty obviously if use prosthetic ring to reinforce the new tricuspid valvar annulus.

Objective To optimize the concentration of polyethylene glycol (PEG) for the growth of Chlamydia trachomatis (Ct) reference strains D-UW-5/Cx and E-UW-5/Cx,and to evaluate the effects of PEG on the sensitivity of Ct to 4 common antibiotics.Methods After the inoculation of Ct standard strains (D-UW-5/Cx and E-UW-5/Cx) into McCoy cell monolayer,different concentrations of PEG were added into the culture medium followed by centrifugation.After 2 hours of incubation at 37 ℃,the inoculum was removed and a complete culture medium containing 1 μg/mL cycloheximide was added followed by another 48-hour culture.Subsequently,the culture was fixed and subjected to iodine staining for the calculation of Ct inclusions and optimization of PEG for the growth of Ct.Some Ct standard strains were used to infect McCoy cells,with PEG (0.7％,wt/vol) added to the culture medium after inoculation and before centrifugation process,and when the infection rate reached higher than 90％,a microdilution method was utilized to evaluate the minimal inhibitory concentration (MIC) of 4 antibiotics,including azithromycin,minocyline,moxifloxacin and doxycycline.Thirty-one clinical specimens,which had been confirmed to be positive for Ct serovar D or E strain,were inoculated into McCoy cell monolayer for the passage of Ct with or without the presence of 0.7％ PEG.Results The optimal concentration of PEG was 0.7％ for the growth of Ct,and this concentration of PEG could increase the number of inclusion bodies of Ct serovar E by 3.44 folds,and that of Ct serovar D by 3.56 folds.In vitro,the MICs of the 4 antibiotics were consistent between PEG-treated and untreated Ct reference strains.Moreover,PEG notably increased the quantity of inclusion bodies of Ct serovar E or D from clinical specimens after passages.Conclusions PEG (0.7％) can enhance the growth of Ct serovar D and E,but has no obvious influence on antimicrobial susceptibility of Ct.

ObjectiveTo detect the changes of heat shock protein 60 (HSP60) during the subcultures of standard and clinical strains of Chlamydia trachomatis(Ct),and to determine if the absence of chlamydial inclusions is associated with the persistent infection of Ct.MethodsA total of 40 Ct strains isolated by cell culture from patients were included in this study and classified into 2 groups according to whether inclusions appeared after initial culture.Reverse transcription PCR was conducted to quantify the levels of HSP60 in specimens containing Ct after 1-4 subcuhures.Chi-squared test was performed to analyze the relationship between the levels of HSP60 and treatment outcomes of patients.ResultsThe levels of HSP60 in clinical specimens containing Ct serovar E were significantly higher in subcultures prior to the appearance of inclusions than in subcultures with the appearance of inclusions(P ＜ 0.05).The ratio of HSP60:16S rRNA mRNA expression after the first,second,third,fourth passage was 0.38 ± 0.06,0.39 ± 0.03,0.38 ± 0.04 and 0.39 ±0.03 respectively in 18 specimens with inclusions appearing after the initial culture,1.18 ± 0.10,0.28 ± 0.06,0.30 ± 0.03 and 0.29 ± 0.05 respectively in 12 specimens with inclusions appearing after the second culture,1.20 ± 0.04,1.20 ± 0.04,0.28 ± 0.04 and 0.28 ± 0.05 in 10 specimens with inclusions appearing after the third culture.Whether inclusions appeared after the initial culture was associated with the treatment outcome of patients.Inclusions were undetected after the initial culture in 16 of 20 specimens from patients with poor response to treatment,but observed in 14 of 20 specimens from patients who tested negative for Ct after one course of treatment.Conclusions It is implicated that no inclusions form after the initial culture in 80％ of specimens from patients experiencing treatment failure.The Ct strains whose inclusions do not form after passages may be in a persistent state,and the expression of HSP60 is high in these strains.Specimens should be subjected to at least 3 blind passages to avoid missed diagnosis of Ct infection.