Objective To evaluate the clinical value of intraoperative image fusion assisted contrastenhanced ultrasound (CEUS) in real-time assessing the curative effect on radiofrequency ablation of hepatocellular carcinoma(HCC).Methods From November 2010 to August 2011,the patients with HCC which would accept radiofrequency ablation (RFA) in our hospital were divided into image fusion assisted CEUS group and conventional CEUS group.The HCC lesion in each group was named as difficult lesion if it was invisible in B-mode ultrasound,larger than 50 mm in diameter or the puncuture route was affected by lung,ribs or blood vessels.Ten minutes after RFA,two groups of patients were performed intraoperative image fusion assisted CEUS examination and conventional CEUS examination respectively.All the patients received CT/MRI one month after ablation to decide whether the HCC had been completely ablated.Difference of complete ablation rate of HCC was compared between the two groups as well as between the difficult lesions in each group.Results Forty-eight lesions in 39 patients were enrolled in image fusion assisted CEUS group including 19 difficult lesions.Sixty-eight lesions in 53 patients were enrolled in conventional CEUS group including 18 difficult lesions.No statistical difference was found between the two groups in lesion size,proportion of difficult lesions,proportion of lesions received TACE or RFA plus PEIT (P =0.052,P =0.136,P =0.185,P =1.000).Postoperation following-up results demonstrated that complete ablation rate of HCC in navigation assisted CEUS group(100 ％,48/48) was not statistically higher than that in conventional CEUS group(92.6％,63/68) (P =0.145).But the difficult lesions in navigation assisted CEUS group (100％,19/19) had statistically higher complete ablation rate than that in conventional CEUS group(72.2％,13/18) (P =0.020).Conclusions Intraoperative navigation assisted CEUS could real-time assess the curative effect on RFA of HCC,especially in the difficult lesions,and could be used as the beneficial supplement of the conventional CEUS.

Escherichia coli (E. coli) FadR regulator plays dual roles in fatty acid metabolism, which not only represses the fatty acid degradation (fad) system, but also activates the unsaturated fatty acid synthesis pathway. Earlier structural and biochemical studies of FadR protein have provided insights into interplay between FadR protein with its DNA target and/or ligand, while the missing knowledge gap (esp. residues with indirect roles in DNA binding) remains unclear. Here we report this case through deep mapping of old E. coli fadR mutants accumulated. Molecular dissection of E. coli K113 strain, a fadR mutant that can grow on decanoic acid (C10) as sole carbon sources unexpectedly revealed a single point mutation of T178G in fadR locus (W60G in FadRk113). We also observed that a single genetically-recessive mutation of W60G in FadR regulatory protein can lead to loss of its DNA-binding activity, and thereby impair all the regulatory roles in fatty acid metabolisms. Structural analyses of FadR protein indicated that the hydrophobic interaction amongst the three amino acids (W60, F74 and W75) is critical for its DNA-binding ability by maintaining the configuration of its neighboring two β-sheets. Further site-directed mutagenesis analyses demonstrated that the FadR mutants (F74G and/or W75G) do not exhibit the detected DNA-binding activity, validating above structural reasoning.
3-Oxoacyl-(Acyl-Carrier-Protein) Synthase ; genetics ; metabolism ; Amino Acid Sequence ; Bacterial Proteins ; chemistry ; genetics ; metabolism ; DNA, Bacterial ; chemistry ; metabolism ; Escherichia coli ; genetics ; metabolism ; Escherichia coli Proteins ; genetics ; metabolism ; Fatty Acid Synthase, Type II ; genetics ; metabolism ; Fatty Acids ; metabolism ; Gene Expression Regulation, Bacterial ; Hydro-Lyases ; genetics ; metabolism ; Hydrophobic and Hydrophilic Interactions ; Lipid Metabolism ; Models, Molecular ; Molecular Sequence Data ; Mutation ; Protein Binding ; Protein Structure, Secondary ; Repressor Proteins ; chemistry ; genetics ; metabolism ; Sequence Alignment ; Sequence Homology, Amino Acid ; Signal Transduction

Objective:To explore the effect of hand making combined with social skills training on the self-care ability and quality of life of patients with schizophrenia.Methods:According to random number table method, totally 120 patients with schizophrenia admitted to the Second People ′s Hospital of Chuzhou City, Anhui Province from January to December 2019 were divided into observation and control groups, which had 60 patients in each groups, 10 cases and 7 cases fell off respectively. The control group received antipsychotic medication and routine nursing, meanwhile the general recreational activities (circles, radio exercises, etc.) and physical therapy were also carried out in the department and rehabilitation physical therapy center. The observation group was given hand making and social skills training for 12 weeks on the basis of the control group. The self-care ability and quality of life of patients in the two groups were compared before intervention, 6 and 12 weeks after intervention. Results:Before intervention, there was no statistical significance in the scores of World Health Organization Quality of Life Scale (WHOQOL-BREF) and Activities of Daily Living (ADL) in 2 groups ( P>0.05). After 6 and 12 weeks of intervention, ADL scores in the observation group were (96.40±3.79) and (98.50±2.53) points, while those in the control group were (93.96±4.31) and (94.06±4.28) points. And the difference between the two groups was statistically significant ( t values were 3.38, 6.36, P<0.05). However, after 6 weeks of intervention, there was no significant difference in WHOQOL-BREF scores between the two groups ( P>0.05); after 12 weeks of intervention, the scores of WHOQOL-BREF in the domains of G1(patients′ self-rated quality of life), G4(patients′ satisfaction with self-rated health status), physiology, psychology, social relations and environment in the observation group were (3.76±1.14), (3.86±1.03), (14.83±2.56), (15.04±3.07), (14.72±3.67) (14.55±3.22) points. The scores of the control group were (3.00±0.83), (3.34±0.90), (12.79±2.06), (12.70±2.45), (12.70±3.06) and (12.64±2.42) points. And the difference between the two groups was statistically significant ( t values were from 2.73 to 4.47, P<0.01). Conclusions:Hand making combined with social skills training can improve the self-care ability and quality of life of patients with schizophrenia, and it is an effective means of treatment to help the patients with schizophrenia to achieve recovery, out of the hospital, back to society.

The outbreak of novel coronavirus pneumonia(NCP) caused by 2019 novel coronavirus has become a global public health challenge. Some patients accompany with liver function damage in addition to the main typical respiratory symptom. Here we analyzed the clinical features, susceptible population, potential causes and therapeutic strategies of NCP related liver injury.

Objective:To investigate the evaluation efficacy and predictive prognostic value of alpha-fetoprotein (AFP) response in tyrosine kinase inhibitors (TKIs) in combination with PD-1 inhibitors (α-PD-1) for intermediate-to-advanced hepatocellular carcinoma (HCC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 205 patients with intermediate-to-advanced HCC who were admitted to 9 medical centers, including Mengchao Hepatobiliary Hospital of Fujian Medical University et al, from March 2020 to July 2022 were collected. There were 178 males and 27 females, aged (52±12)years. Based on AFP response at 6-8 weeks after treatment, patients were divided into the AFP response group (AFP level decreased by ≥50% compared to baseline) and the AFP no response group (AFP level decreased by <50% compared to baseline). Observation indicators: (1) AFP response evaluation of anti-tumor efficacy; (2) comparison of patient prognosis; (3) analysis of factors affecting patient prognosis. Measurement data with normal distrubution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range) and M( Q1, Q3). Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. The Kaplan-Meier method was used to draw survival curve and calculate survival rate, and the Log-Rank test was used for survival analysis. The COX proportional risk model was used for univariate analysis and the COX stepwise regression model was used for multivariate analysis. Results:(1) AFP response evaluation of anti-tumor efficacy. Before treatment, all 205 patients were positive of AFP, with a baseline AFP level of 1 560(219,3 400)μg/L. All 205 patients were treated with TKIs in combination with α-PD-1, and the AFP level was 776(66,2 000)μg/L after 6 to 8 weeks of treatment. Of the 205 patients, 88 cases were classified as AFP response and 117 cases were classified as AFP no response. According to the response evaluation criteria in solid tumors version 1.1, the objective response rate (ORR) and disease control rate (DCR) were 42.05%(37/88) and 94.32%(83/88) in patients of the AFP response group and 16.24% (19/117) and 64.10% (75/117) in patients of the AFP no response group, showing significant differences between them ( χ2=16.846, 25.950, P<0.05). According to the modified response evaluation criteria in solid tumors, the ORR and DCR were 69.32% (61/88) and 94.32% (83/88) in patients of the AFP response group and 33.33% (39/117) and 64.10% (75/117) in patients of the AFP no response group, showing significant differences between them ( χ2=26.030, 25.950, P<0.05). (2) Comparison of patient prognosis. All 205 patients were followed up for 12.4(range, 2.4-34.0)months after treatment. The median progression free survival time and total survival time were 5.5 months and 17.8 months, respectively. The 1-year, 2-year progression free survival rates were 20.8% and 7.2%, and the 1-year, 2-year overall survival rates were 68.7% and 31.5%, respectively. The median progression free survival time, 1-year and 2-year progression free survival rates were 9.7 months, 39.6% and 14.2% in patients of the AFP response group and 3.7 months, 7.8% and 2.0% in patients of the AFP no response group, showing a significant difference in progression free survival between them ( χ2=43.154, P<0.05). The median overall survival time, 1-year and 2-year overall survival rates were not reached, 85.2% and 56.3% in patients of the AFP response group and 14.6 months, 56.3% and 14.5% in patients of the AFP no response group, showing a significant difference in overall survival between them ( χ2=33.899, P<0.05). (3) Analysis of factors affecting patient prognosis. Results of multivariate analysis showed that invasion of large blood vessels, extrahepatic metastasis, combined hepatic artery intervention therapy, and AFP response were independent factors influencing progression free survival in patients with intermediate-to-advanced HCC who were treated with TKIs in combination with α-PD-1 ( hazard ratio=1.474, 1.584, 0.631, 0.367, 95% confidence interval as 1.069-2.033, 1.159-2.167, 0.446-0.893, 0.261-0.516, P<0.05), and Eastern Cooperative Oncology Group score, invasion of large blood vessels, extrahepatic metastasis, and AFP response were independent factors influencing overall survival in patients with intermediate-to-advanced HCC who were treated with TKIs in combination with α-PD-1 ( hazard ratio= 1.347, 1.914, 1.673, 0.312, 95% confidence interval as 1.041-1.742, 1.293-2.833, 1.141-2.454, 0.197-0.492, P<0.05). Conclusions:AFP response at 6-8 weeks after treatment can effectively evaluate anti-tumor efficacy of TKIs in combination with α-PD-1 for intermediate-to-advanced HCC. AFP response is the independent factor influencing progression free survival and overall survival in patients with intermediate-to-advanced HCC who were treated with TKIs in combination with α-PD-1.