Objective To investigate the CT features and the diagnostic value in invasive mole. Methods Eleven cases (age, 30 to 53 years, mean 40 years)with invasive mole proved by operation and pathology were studied, including 3 cases during peri menopausal period of eight months, ten months and twelve months respectively. All cases were scanned by CT and enhanced study was done. Results All cases showed enlargement of uterus of varying degrees. On CT, the density of uterine cavity was similar to that of water, intermingled with spotty patchy and hazzy circular isodense shadows. High density stripe like bleeding foci were found in 3 cases.The outline of uterine cavity was locally disrupted in all case and the muscle layer was thickened in 3 cases. On enhanced CT scan, the lesions in the uterine cavity appeared markedly hyperdense, just like “the crater” and the “mole sign” .The muscle layers at the site of disruption showed inhomogeneous enhancement after contrast injection. Conclusion The CT features of invasive mole are characteristic, with important diagnostic value, especially for those during peri menopausal period.

Twenty-six patients with stenosis of the thoracic spinal canal and myelopathy caused by ossification of the ligamentum flavum were treated from 1983 to June 1991. There were 21 patients with spastic paraplegia and 5 with flaccid paraplegia in the series. The findings on radiograms, CT scans, myelograms and MRI were described. Total laminectomy was performed in all of the patients which resulted in an effective rate of 91.6% and exellent and good results in 83.3%. The mechanism of the disease our experience in diagnosis and surgical treatment, causes of misdiagnosis and surgical techniques are discussed.

Objective To evaluate the therapeutic efficacy of a combination of proton pump inhibitor(PPI) and hydrotalcite for endoscopic submucosal dissection (ESD) induced ulcer.Methods Eightyone consecutive patients who underwent ESD were randomly assigned to either the group of PPI and hydrotalcite therapy ( drug combination group,n =41 ) or the PPI group ( n =40).Delayed bleeding rates were monitored and compared.The main upper abdomen symptoms 1-wk later and ulcer healing rates and ulcer diameter 4-wk later were compared between the two groups.Results There was no significant difference in delayed bleeding rate (P ＞ 0.05 ).At the end of first week after ESD,the combination therapy was significantly more effective than the PPI alone in reducing frequencies and severity of upper abdominal pain and upper abdominal distention,while there was no significant difference between the two groups in relieving belch and nausea.A better ulcer healing rates and a smaller ulcer diameter were observed in the combination group at the end of 4 weeks ( P ＜ 0.05 ).Conclusion The combination therapy of hydrotalcite and PPI can relieve upper abdominal symptoms and improve the healing rate of ESD induced ulcer.

BACKGROUND:Previous study has confirmed that seasonal variation and surfactant associated protein A(SP-A)and interleukin-6(IL-6)exhibit a significant role in lung immune and defense function.However,the effect mechanism of them remains unclear.OBJECTIVE:By observing the changes of SP-A and IL-6 of male rats in autumn and winter.to explore the effects of seasonal changes on the nonspecific immunity of lung of normal rats,and to provide new ideas for the experimental basis to the cognition of pathology and physiology mechanism for seasonal attack of respiratory system diseases.METHODS:Male SD rats were purchased from each seasons and divided into groups in chronological order All rats were housed with normal forage and drank freely under room temperature.Then the rats were sacrificed by decapitation before 18 o'clock at corresponding solar term and the lung tissues were analyzed by RT-PCR.RESULTS AND CONCLUSION:Compared to the other groups.the expression of SP-A and IL-6 in the Winter Begins group were smaller.which demonstrated that immune function of lung was existed the seasonaI rhythm of lower in winter and higher in autumn.The SP-A and IL-6 are main material basis of immune function.

It remains a great challenge to achieve sufficient cancer classification accuracy with theentire set of genes, due to the high dimensions, small sample size, and big noise of gene expressiondata. We thus proposed a hybrid gene selection method, Information Gain-Support Vector Machine(IG-SVM) in this study. IG was initially employed to filter irrelevant and redundant genes. Then,further removal of redundant genes was performed using SVM to eliminate the noise in the datasetsmore effectively. Finally, the informative genes selected by IG-SVM served as the input for theLIBSVM classifier. Compared to other related algorithms, IG-SVM showed the highest classificationaccuracy and superior performance as evaluated using five cancer gene expression datasetsbased on a few selected genes. As an example, IG-SVM achieved a classification accuracy of90.32% for colon cancer, which is difficult to be accurately classified, only based on three genesincluding CSRP1, MYL9, and GUCA2B.

Objective To investigate the correlation between admission hyperglycemia and clinical prognosis in elderly patients with community-acquired pneumonia.Methods Based on the electrical medical record (EMR),information of the patients with pneumonia was retrospectively collected and the necessary data were prepared and arranged.Based on clinical outcomes,demographic characteristics and clinical indicators were compared between groups in order to screen potential variables affecting clinical outcomes.Then,the random blood glucose level 8.6 mmol/L was considered to be the cutoff point for grouping patients,with clinical outcomes as outcome variables,random blood glucose levels as grouping variables,propensity score value analysis method was applied along with the ratio of 1:1 nearest neighbor matching method to generate paired samples in order to assess the impact of blood glucose level on mortality rate;With hospitalization time serving as time variable,survive analysis method was used to analyze COX proportional model.Results Five hundred and fifty-eight patients were enrolled in the analysis,197 patients of which were recorded dead during hospitalization (the dead group).After the correction of demographic characteristics,past medical history and blood test indexes,white blood cells,C reactive protein,random blood glucose at admission and triglyceride levels were regarded as potential factors for the deaths of patients (P<0.05).However,the propensity score analysis method suggested that there was no significant difference between the blood glucose levels and mortality.The survival analysis showed that the mortality in the high blood glucose group was higher than that in the normal blood glucose group (HR=1.68,95%CI(1.22,2.31)).Conclusion Admission hyperglycemia is an important indicator of adverse prognosis in elderly patients with pneumonia.It may be of significance for screening and identifying high-risk patients.

Objective To explore the predictive value of serum uric acid levels for the occurrence of sarcopenia after hepatectomy in patients with primary liver cancer(PLC).Method A convenience sampling method was used to prospectively include 161 PLC patients who underwent liver resection surgery at Baoding NO.2 Central Hospital of Hebei Province from January 2019 to December 2021.They were divided into occurrence group and non occurrence group based on whether they had muscle deficiency.The clinical data,serum uric acid and other blood biochemical examination results were compared between the two groups,and the predictive value and influence of serum uric acid level on sarcopenia after hepatectomy in PLC patients were analyzed.Results Among the 158 PLC patients who underwent hepatectomy in the final inclusion of this study,34 patients developed postoperative sarcopenia,with an incidence rate of approximately 21.52％.The serum uric acid level(311.79±35.32)μmol/L in the occurrence group was higher than that in the non-occurrence group(280.52±31.15)μmol/L,the ALB level(31.59±5.73)g/L was lower than that in the non-occurrence group(35.63±5.13)g/L,and the proportion of postoperative adjuvant hepatic arterial infusion chemotherapy(HAIC)(38.24％)was higher than that in the non-occurrence group(20.16％),with statistical significant differences(P＜0.05).Multiple Logistic regression analysis showed that serum uric acid、ALB、postoperative adjuvant HAIC were associated with sarcopenia after hepatectomy in PLC patients(OR=0.853,1.035,11.189,95％CI:0.770-0.945,1.018-1.052,3.533-35.433,P＜0.05).The receiver operating characteristic curve(ROC)showed that the area under the curve(AUC)of serum uric acid in predicting sarcopenia after hepatectomy in PLC patients was 0.754(95％CI:0.657-0.850),which had certain predictive value.The nomogram showed that the C-index of the prediction model constructed by serum uric acid assisted other major clinical indicators to predict the occurrence of sarcopenia after hepatectomy in PLC patients was 0.847(95％CI:0.782-0.913),suggesting that the model had certain predictive value.The results of the decision curve showed that when the threshold was in the range of 0.00-1.00,the actual clinical net benefit rate of the model was always greater than 0,and the maximum net benefit rate was 0.215,suggesting that the model had good clinical application value.Conclusion The increase of serum uric acid level in PLC patients is a risk factor for postoperative sarcopenia.The detection of serum uric acid level is helpful to assist in the early prediction of the risk of sarcopenia.

Hepatocellular carcinoma is a common malignant disease in clinical practice, and portal vein tumor thrombosis (PVTT) is one of the important factors affecting the prognosis of hepatocellular carcinoma. PVTT has strong oncologic characteristics and is highly susceptible to extrahepatic metastasis, complicating portal hypertension, leading to gastrointestinal bleeding or liver failure and causing death. In this paper, we review the formation mechanism of hepatocellular carcinoma combined with PVTT in terms of local anatomy, hemodynamics, molecular biology and tumor microenvironment to provide effective reference for clinical treatment.

Objective To investigate the association between serum macrophage polarization-related factors and liver fibrosis in patients with alveolar echinococcosis (AE). Methods A total of 120 patients with AE who attended Department of Hepatobiliary and Pancreatic Surgery in The Affiliated Hospital of Qinghai University from September 2018 to October 2020 were enrolled as AE group, and 33 healthy controls were enrolled as normal control group. The two groups and the patients with varying degrees of liver fibrosis were compared in terms of the levels of interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), and transforming growth factor-β1 (TGF-β1). Comparison of normally distributed continuous data between two groups was made by the independent samples t -test, while comparison of non-normally distributed continuous data was made by the Mann-Whitney U test or Kruskal-Wallis H test. Comparison of categorical data between groups was made by the chi-square test. Univariate and multivariate logistic regression analyses were used to investigate the association between serum macrophage polarization-related factors and liver fibrosis in patients with AE, and the receiver operating characteristic (ROC) curve was used to analyze the value of serological examination in the diagnosis of liver fibrosis in patients with AE. A Spearman correlation analysis was used to analyze the correlation of each index with HAI score and Metavir score. Results Compared with the normal control group, the AE group had significant increases in the serum levels of IL-6 [13.97 (9.64-23.62) pg/mL vs 1.30 (0.35-2.71) pg/mL, Z =-5.980, P < 0.001], TNF-α [2.26 (1.65-4.13) pg/mL vs 1.40 (1.04-2.10) pg/mL, Z =-3.114, P < 0.01], and TGF-β1 [3.64(2.71-5.72) pg/mL vs 2.91(2.20-3.35) pg/mL, Z =-2.594, P < 0.05], and increases in the serum levels of IL-6 (hazard ratio [ HR ]=2.721, 95% confidence interval [ CI ]: 1.730-4.280, P < 0.05) and TNF-α( HR =3.527, 95% CI : 1.158-10.747, P < 0.05) were independent risk factors for the onset of liver fibrosis in AE patients. The ROC curve analysis showed that hydatid IgG combined with the serum levels of IL-6 and TNF-α had a sensitivity of 88.4%, a specificity of 95.8%, and an area under the ROC curve of 0.951(95% CI : 0.937-0.964) in the diagnosis of liver fibrosis, which were significantly higher than those of IL-6, TNF-α, or hydatid IgG alone ( Z =-3.458, -4.011, and 2.379, all P < 0.05). The Spearman analysis showed that the serum levels of IL-6, TNF-α, and TGF-β1 were positively correlated with HAI score ( r =0.560, 0.644, and 0.465, all P < 0.001) and Metavir fibrosis score ( r =0.530, 0.758, and 0.567, all P < 0.001), and the serum level of IL-10 was negatively correlated with HAI score ( r =-0.232, P =0.011) and Metavir fibrosis score ( r =-0.288, P =0.001). Conclusion Macrophage polarization is often observed in patients with hepatic AE, and the levels of the macrophage polarization-related factors IL-6, TNF-α, and TGF-β1 are associated with the development and progression of liver fibrosis, which can provide certain reference information for predicting the onset of liver fibrosis.

Emerging evidence indicates that the gut microbiome contributes to the host immune response to infectious diseases. Here, to explore the role of the gut microbiome in the host immune responses in COVID-19, we conducted shotgun metagenomic sequencing and immune profiling of 14 severe/critical and 24 mild/moderate COVID-19 cases as well as 31 healthy control samples. We found that the diversity of the gut microbiome was reduced in severe/critical COVID-19 cases compared to mild/moderate ones. We identified the abundance of some gut microbes altered post-SARS-CoV-2 infection and related to disease severity, such as Enterococcus faecium, Coprococcus comes, Roseburia intestinalis, Akkermansia muciniphila, Bacteroides cellulosilyticus and Blautia obeum. We further analyzed the correlation between the abundance of gut microbes and host responses, and obtained a correlation map between clinical features of COVID-19 and 16 severity-related gut microbe, including Coprococcus comes that was positively correlated with CD3⁺/CD4⁺/CD8⁺ lymphocyte counts. In addition, an integrative analysis of gut microbiome and the transcriptome of peripheral blood mononuclear cells (PBMCs) showed that genes related to viral transcription and apoptosis were up-regulated in Coprococcus comes low samples. Moreover, a number of metabolic pathways in gut microbes were also found to be differentially enriched in severe/critical or mild/moderate COVID-19 cases, including the superpathways of polyamine biosynthesis II and sulfur oxidation that were suppressed in severe/critical COVID-19. Together, our study highlighted a potential regulatory role of severity related gut microbes in the immune response of host.
COVID-19 ; Clostridiales ; Gastrointestinal Microbiome ; Humans ; Immunity ; Leukocytes, Mononuclear ; SARS-CoV-2