0.05).However,50.0% of T1 patients with TNBCs had lymph node metastasis,which was much higher than the other 2 groups.The recurrence rate in TNBC,non-TNBC or Her-2 positive patients were 57.1%,40.5% and 44.2%,respectively.The triple negative group had higher tumor recurrence rate than the other two groups(P=0.03).The overall 3 year survival rate of the TNBC group was 58.9%,which was much lower than the other two groups(76.4% for the luminal a and b group and 74.8% for the Her-2 positive group(P=0.04).Conclusion:The TNBCs was higher in premenopausal patients well as a higher lymph nodes metastasis rate with small tumor size.Moreover,three years recurrence and mortality rates in this group is higher than the non-TNBC groups.

Objective Although aspirin resistance has been recognized to occur in patients with diabetes mellitus, the prevalence and related risk factors for aspirin resistance in elderly patients with diabetes mellitus have not been reported yet. The purpose of the present study was to evaluate the prevalence and potential risk factors for aspirin resistance in elderly patients with type 2 diabetes.Methods The 140 elderly patients [aged from 60 to 92 years, mean age (73.8±8. 0) years] with type 2 diabetes receiving daily aspirin therapy (≥ 75 mg) over one month were recruited. Platelet aggregation was measured by light transmittance aggregometry (LTA) and thrombelastograph (TEG)platelet mapping assay. Results By LTA, 6 patients (4.3%) of the diabetic patients were found to be resistant to aspirin therapy, 44 patients (31.4 %) were semi-responders. By TEG, 31 patients (22. 1%) were aspirin resistant. Among the 31 patients who were aspirin resistant by TEG, 3 were aspirin resistant by LTA. In the multivariate logistic regression analysis, female gender (OR= 5. 54,95%CI: 1.17-27.47, P=0.036) and homocysteine level (OR=1.15, 95%CI: 1.00-1.35, P=0. 043) were statistically significant risk factors for aspirin resistance by TEG. Conclusions The prevalence of aspirin resistance in elderly patients with type 2 diabetes is considerably higher in elderly female patients and in elderly patients with higher serum homocysteine level.

OBJECTIVE: To study MSCT perfusion imaging of nasopharyngeal cancer and its differentiated diagnosis. METHOD: Thirty cases with nasopharyngeal cancer performed multi-detector CT perfusion examination. Among them, there were 6 cases of 25 post-radiotherapy patients performed perfusion imaging with CT scan. Nasopharynx perfusion parameters include blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface (PS). RESULT: Compared with normal region of nasopharynx, BF, BV and PS in nasopharyngeal cancer increased significantly, while MTT has not significant difference between these two areas. CONCLUSION Nasopharynx perfusion parameters (BF, BV and PS) measured with CT were significantly altered in nasopharyngeal cancer. There was important appliance value in differentiated diagnosis of nasopharyngeal malignant neoplasms and evaluation of outcome of radiotherapy of nasopharyngeal cancer.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnostic imaging ; Perfusion ; Tomography, Spiral Computed ; methods

Objective To establish a non-venous bypass orthotopic liver transplantation model in Bama miniature pigs with high repeatability and stability. Methods Twelve Bama miniature pigs were randomly divided into the donor group (n=6) and recipient group (n=6). Pigs underwent non-venous bypass orthotopic liver transplantation. The time of anhepatic phase during operation was shortened, blood pressure during anhepatic phase was stably maintained, and management of anesthesia and body fluid during operation were strengthened. The operation time, anhepatic phase and survival status of the recipients were observed and recorded. The intraoperative heart rate, mean arterial pressure (MAP) and changes in arterial blood gas analysis were monitored. The perioperative liver function was evaluated. Results Among 6 Bama miniature pigs, 1 died from transplantation failure intraoperatively. The operation time of the remaining 5 pigs was (247±27) min and the time of anhepatic phase was (46±4) min. Three animals survived for more than 2 weeks. Compared with the preanhepatic phase, the heart rate of the animals was significantly faster, MAP was considerably reduced to (46±6) mmHg, blood pH value, base excess (BE) and HCO₃^- level were all significantly decreased and serum level of K⁺ was significantly elevated during the anhepatic phase (all P < 0.05). In the neohepatic phase, MAP of Bama miniature pigs was significantly increased, heart rate was dramatically slower.Blood pH value, BE, HCO₃^- level were significantly increased and serum level of K⁺ was significantly declined (all P < 0.05). During abdominal closure, MAP, blood gas indexes and serum level of K⁺ were almost recovered to those in the preanhepatic phase. Compared with preoperative levels, the levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), lactate dehydrogenase(LDH)and alkaline phosphatase(ALP)were significantly increased after operation (all P < 0.05), the change in AST was the most obvious, and it gradually decreased at postoperative 2 d. The level of γ-gutamyl transferase(GGT) did not significantly elevated. The level of total bilirubin (TB) was evidently elevated at postoperative 5 d. Compared with the preoperative levels, the levels of total protein (TP) and albumin (ALB) were significantly decreased after operation (both P < 0.05), and began to gradually increase at postoperative 1 d. Conclusions The non-venous bypass orthotopic liver transplantation model of Bama miniature pig is convenient, with highly reproducible and survival rate, which can be utilized as a standardized liver transplantation model.

Objective To evaluate the effect of the different Child-Pugh classification on the recurrence and survival of hepatocellular carcinoma (HCC) recipients after liver transplantation. Methods Clinical data of 125 HCC recipients undergoing liver transplantation were retrospectively analyzed. The 3-year disease-free survival (DFS) and overall survival (OS) rates were calculated by Kaplan-Meier survival curve. The independent risk factors probably affecting the recurrence and survival of HCC recipients after liver transplantation were identified by using Cox's proportional hazards regression model. Results The median follow-up time was 25.6 months. The 3-year DFS and OS rates were 68.4% and 65.7% for all patients. The 3-year DFS and OS rates in 113 patients with Child-Pugh class A/B HCC were 68.6% and 66.2%, whereas 66.7% and 65.6% for 12 patients with Child-Pugh class C HCC with no statistical significance (all P>0.05). Cox's proportional hazards regression model demonstrated that vascular invasion (P=0.001)and the number of tumors>3 (P=0.025) were the independent risk factors for the postoperative recurrence of HCC in recipients undergoing liver transplantation. Alpha fetoprotein (AFP)>400μg/L (P=0.035), vascular invasion (P=0.031) and number of tumors>3 (P=0.008) were the independent risk factors affecting the survival of HCC patients. Conclusions The postoperative prognosis does not significantly differ between Child-Pugh class C and A/B HCC patients after liver transplantation. AFP, vascular invasion and number of tumors are the risk factors affecting the clinical prognosis of HCC patients after liver transplantation. Liver transplantation is an efficacious treatment for HCC patients with Child-Pugh class C.

BACKGROUNDChitosan (CS) scaffolds combined with osteogenically induced bone marrow mesenchymal stem cells (BMSCs) have been proved to be promising substitutes for repairing bone defects. Nevertheless, the bone-forming and scaffold-biodegrading processes are seldom studied. This study aimed to determine the osteogenic ability of CS/osteo-induced BMSC composites by observing the bone-forming process and explore the relationship between bone formation and scaffold biodegradation.

METHODSThe CS/osteo-induced BMSC composites (CS+cells group) and the CS scaffolds (CS group) were, respectively, implanted into SD rat thigh muscles. At 2, 4, 6, 8, and 12 weeks postoperatively, the rat femurs were scanned by CT, and the CT values of the implants were measured and comparatively analyzed. Subsequently, the implants were harvested and stained with hematoxylin and eosin and Masson trichrome, and the percentages of bone area, scaffold area, and collagen area were calculated and compared between the two groups.

RESULTSThe imaging results showed that the densities of implants of the two groups gradually increased along with time, but the CT values of implants in the CS+cells group were much higher than in the CS group at the same time point (P < 0.05). The histological results showed that the de novo bone and collagen formed in the pores of the scaffolds and gradually increased since 2 weeks postoperation in both groups, and the scaffold gradually degraded along with the boneforming process. However, the comparative analysis results showed that the CS+cells group gained more de novo bone and collagen formation and had less scaffold than the CS group at the same time point (P < 0.05).

CONCLUSIONThe CS/osteo-induced BMSC composites are excellent bone tissue engineering substitutes, and the scaffold biodegradation is accordant with the bone formation.

Animals ; Bone and Bones ; cytology ; Chitosan ; chemistry ; Humans ; Male ; Mesenchymal Stromal Cells ; cytology ; Osteogenesis ; physiology ; Rats ; Rats, Sprague-Dawley ; Tissue Engineering ; methods

Objective:To analyze the incidence and epidemiological characteristics of traumatic spinal cord injury in China in 2018.Methods:Multi-stage stratified cluster sampling was used to randomly select hospitals capable of treating patients with spinal cord injury from 3 regions，9 provinces and 27 cities in China to retrospectively investigate eligible patients with traumatic spinal cord injury admitted in 2018. National and regional incidence rates were calculated. The data of cause of injury，injury level，severity of injury，segment and type of fracture，complications，death and other data were collected by medical record questionnaire，and analyzed according to geographical region，age and gender.Results:Medical records of 4，134 patients were included in this study，with a male-to-female ratio of 2.99∶1. The incidence of traumatic spinal cord injury in China in 2018 was 50.484 / 1 million （95% CI 50.122-50.846）. The highest incidence in the Eastern region was 53.791 / 1 million （95% CI 53.217-54.365）. In the whole country，the main causes of injury were high falls （29.58%），as well as in the Western region （40.68%），while the main causes of injury in the Eastern and Central regions were traffic injuries （31.22%，30.10%）. The main injury level was cervical spinal cord in the whole country （64.49%），and the proportion of cervical spinal cord injury in the Central region was the highest （74.68%），and the proportion of lumbosacral spinal cord injury in the Western region was the highest （32.30%）. The highest proportion of degree of injury was incomplete quadriplegia （55.20%），and the distribution pattern was the same in each region. A total of 65.87% of the patients were complicated with fracture or dislocation，77.95% in the Western region and only 54.77% in the Central region. In the whole country，the head was the main combined injury （37.87%），as well as in the Eastern and Central regions，while the proportion of chest combined injury in the Western region was the highest （38.57%）. A total of 32.90% of the patients were complicated with respiratory complications. There were 23 patients （0.56%） died in hospital，of which 17（73.91%） died of respiratory dysfunction. Conclusions:The Eastern region of China has a high incidence of traumatic spinal cord injury. Other epidemiological features include high fall as the main cause of injury cervical spinal cord injury as the main injury level，incomplete quadriplegia as the main degree of injury，head as the main combined injury，and respiratory complications as the main complication.