Objective To investigate the application value of clinical typing in the treatment of BuddChiari syndrome (BCS).Methods The retrospective corss-sectional study was adopted.The clinical data of 95 patients with BCS who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2012 to September 2015 were collected.Based on patients' compensation and clinical symptoms,3 clinical typing and 8 subtypes of BCS were proposed,and each subtype was treated with corresponding strategies.Observation indices included (1) the clinical typing of BCS,(2) selection of treatment,(3) treatment effect,(4) follow-up situations.Follow-up using telephone interview and outpatient examination was performed once within 3 months after the first treatment and then once every 6 months up to December 2015 or death,loss to follow-up and experienced decompensation.During follow-up,color Doppler ultrasound and blood bio-chemistry test were performed regularly,and CT angiography was also conducted when necessary.Count data were presented as the case or percentage.The survival rate was calculated using Kaplan-Meier method and the survival curve was drawn.Results (1) BCS clinical typing of 95 patients:4 were detected in type Ⅰ (3 in type Ⅰ a and 1 in type Ⅰ b),7 in typeⅡ (4 in type Ⅱa and 3 in type Ⅱb),and 84 in type Ⅲ(43 in type Ⅲa,4 in type Ⅲb,32 in type Ⅲc,and 5 in type Ⅲd).(2) Selection of treatment in 95 patients:① among the 3 patients with type Ⅰ a,2 of them received inferior vena cava balloon angioplasty while 1 patient had to give up the operation due to failure in opening the occlusion.This patient underwent close observation and follow-up afterwards.② The patient with type Ⅰ b underwent cavity-antrum artificial blood vessel bypass operation due to failure in opening the occlusion.③Among the 4 patients with type Ⅱ a,one of them underwent hepatic vein balloon angioplasty.The other 3 patients underwent close observation and follow-up because of failure in intervention therapy,such as segmental occlusion of hepatic vein or difficulty in finding the hepatic vein.④ Among the 3 patients with type Ⅱ b,due to the history of upper gastrointestinal bleeding,2 patients received modified spleen-lung fixation and intestine-cavity blood vessels bypass,respectively,and 1 patient received intestine-cavity artificial blood vessels bypass due to severe peritoneal effusion.⑤ Among the 43 patients with type Ⅲ a,35 patients underwent inferior vena cava balloon angioplasty due to failure in hepatic vein intervention therapy (6 of them received firstly thrombolysis treatment due to combined thrombosis.Four patients received inferior vena cava and hepatic vein balloon angioplasties.Another 4 patients received close observation and follow-up due to failure in both inferior vena cava and hepatic vein intervention therapy.⑥Among the 4 patients with type Ⅲ b,2 underwent inferior vena cava balloon angioplasty and intestine-cavity artificial blood vessel bypass.The other 2 patients only received modified spleen-lung fixation because of failure in inferior vena cava intervention therapy.⑦ Among the 32 patients with type Ⅲ c,3 underwent inferior vena cava and hepatic vein balloon angioplasties,and 27 patients underwent only inferior vena cava balloon angioplasty due to failure in hepatic vein intervention therapy (7 of them received balloon angioplasty following thrombolysis treatment due to combined thrombosis).On account of failure in both inferior vena cava and hepatic vein intervention therapy,2 patients underwent resection of lesion membranes and cavity-antrum artificial blood vessel bypass,respectively.⑧ Among the 5 patients with type Ⅲ d,1 underwent inferior vena cava balloon angioplasty and intestine-cavity artificial blood vessel bypass,and 4 underwent only modified spleen-lung fixation due to failure ininferior vena cava intervention therapy.(3) Treatment efficacy:of 95 patients,8 received followup observation,and 87 patients recovered to varied extent after interventional therapies and operations,with symptomatic relief of leg edema,ulcer,peritoneal effusion and esophageal varicosity.Eighty-seven patients went through the perioperative period safely,and no death occurred.The incidence of postoperative complications was 10.3％ (9/87).The complications mainly include venous thrombosis in lower limbs during catheter-directed thrombolysis therapy,pleural effusion,pneumatosis,and peritoneal effusion after surgery,all of which were cured after symptomatic treatment.(4) Follow-up results:87 were followed up for 3-42 months with an average time of 19 months.During the follow-up,5 patients (1 in type Ⅰ a and 4 in type Ⅲa) received recanalization surgery because of the reocclusion after the inferior vena cava balloon angioplasty,and no decompensation occurred.However,decompensation was found in 11 patients (disease progression in 4 patients and symptom relapse in 7 patients).The survival rates of patients without decompensation at 0.5,1.0,2.0 and 3.0 years after the first treatment were 96.5％,95.0％,83.4％ and 80.5％,respectively.Conclusion According to patients' compensation and clinical symptoms,clinical typing of BCS and treatment strategiesis are determined,and it will provide a satisfactory clinical efficacy.

Objective:To describe the cancer incidences and mortalities in Henan cancer registries in 2013.Methods:Registration data were evaluated according to the criteria of quality control of cancer registry,and the qualified data were analyzed based on areas(urban/rural), gender,age and cancer sites.The age-standardized rates were applied according to Segi's population and the fifth Chinese population census in 2000.Results:The total coverage of population from 19 qualified cancer registries data was 16,225,815(15.13%),Among which,8,370, 772(51.59%)were males and 7,855,043(48.41%)were females;and 2,819,817(17.38%)live in urban areas and 13,405,998(82.62%) live in rural areas.The crude incidence rate in Henan was 250.34/105(males:264.35/105,females:235.42/105),whereas the age-standardized incidence rates by Chinese standard population and by world standard population were 208.66/105and 207.25/105,respectively.The cumulative incidence rate(0-74 years old)was 24.31%.The cancer mortality in Henan was 161.05/105(males:185.50/105,females:134.98/105),whereas the age-standardized mortality by Chinese standard population and by world standard population were 131.18/105and 131.52/105,respectively.The cumulative mortality rate(0-74 years old)was 15.05%.Cancer incidence and mortality rates were increasing by age, reaching the peak values at 80 age group and 85 plus age group,respectively.Lung cancer,gastric cancer,esophageal cancer,liver cancer and colorectal cancer were the most common cancers ranked by the incidence rate,and the most common cause of cancer death was lung cancer,followed by gastric cancer,esophageal cancer,liver cancer and colorectal cancer.Incidence rate and mortality rate of breast cancer ranked the first and the fifth among the females,respectively.Conclusion:Cancer incidence and mortality rates were higher in the rural areas and in males than in the urban areas and in females.Lung cancer,digestive system cancers,and female breast cancer are the major cancer types that require attention for the prevention and control in Henan.

Objective: To investigate the effect of fried food intake on the pathogenesis of gastric cancer and precancerous lesions. Methods: From 2005 to 2013, the residents aged 40-69 years from 11 counties/cities where cancer screening of upper gastrointestinal cancer were conducted in rural areas of Henan province as the subjects (82 367 cases). The information such as demography and lifestyle was collected. The residents were screened with endoscopic examination. The biopsy sampleswere diagnosed pathologically, according to pathological diagnosis criteria, the subjects with high risk were divided into the groups with different pathological degrees. The multivariate ordinal logistic regression analysis was used to analyze the relationship between the frequency of fried food intake and gastric cancer and precancerous lesions. Results: The study coverd 46 425 males and 35 942 females, with a age of (53.46±8.07)years. The study collected 6 707 cases of normal stomach, 2 325 cases of low grade intraepithelial neoplasia, 226 cases of high grade intraepithelial neoplasia and 331 cases of gastric cancer. Multivariate logistic regression analysis showed that, compared with those whoeat fried food less than one time per week, fried foods intake (<2 times/week: OR=1.89, 95%CI: 1.57-2.28; ≥ 2 times/week: OR=1.91, 95%CI: 1.66-2.20) were a risk factor for gastric cancer and precancerous lesions after adjustment for age, sex, marital status, educational level, body mass index (BMI), smoking and drinking status. Conclusion The intake of fried food is a risk factor for gastric cancer and precancerous lesions. Therefore, reducing the intake of fried food can prevent the occurrence of gastric carcinoma and precancerous lesions.

The purpose was to optimize the vitrification for porcine embryos cryopreservation. Blastocyst/Morula (5-6th day-embryos) were collected from superovulated Bama mini-pigs (sows/gilts). We compared different cryopreservation methods, cryopreservation tools, thining of zona pellucida (ZP) and recipient breeds on the efficiency of porcine embryo cryopreservation. The results showed that: in embryo survival rate and blastocyst cell number, there were no significant differences between cryopreservation method I [embryos were vitrified by two step method with open pulled straw (OPS) and glass micropipette (GMP) in solution 1 (TCM199 + 20% FBS + 10% EG + 10% DMSO) for 3 min, and solution 2 (TCM199 + 20% FBS + 20% EG + 20% DMSO + 0.4 mol/L SUC) for 1 min, stored in liquid nitrogen] and method II[Blastocysts were cultured for 25 min in NCSU23 + 7.5 microg/mL cytochalasin B, centrifuged at approximately 13 000 xg for 12-13 min, and recovered back into pNCSU23. They were then equilibrated for 5 min in 2 mol/L ethylene glycol in pNCSU23, washed quickly in the vitrification medium, 8 mol/L ethylene glycol, 7% polyvinylpyrrolidone (PVP) in pNCSU23, loaded into OPS/GMP, and plunged into liquid nitrogen]. GMP vitrification method was more suitable and efficient than OPS method (P < 0.05) in embryo survival rate (83.8% vs 77.6%) and blastocyst cell number (53.1 vs 47.5) after thawing. Thining of ZP did not increase the survival rate, but significantly improved blastocyst cell number in the survival blastcysts (60.1 and 46, P < 0.01). Local pig breeds (Fengjing sows) were more suitable as recipients for embryo transfer of vitrified/warmed blastcysts, which can improve pregnant rate and embryo efficiency.
Animals ; Blastomeres ; cytology ; Cryopreservation ; methods ; veterinary ; Embryo Transfer ; veterinary ; Embryo, Mammalian ; Swine ; Swine, Miniature ; Vitrification ; Zona Pellucida ; physiology

Objective:To evaluate the role of adiponectin in sevoflurane pretreatment-induced improvement in cognitive function in mice with myocardial ischemia/reperfusion (I/R).Methods:Thirty SPF healthy adult male wild-type C57 mice, aged 8-10 weeks, weighing 20-25 g, were divided into 3 groups ( n=10 each) using a random number table method: sham operation group (group Sham), myocardial I/R group (group MI/R) and sevoflurane pretreatment group (group SP). Another 10 SPF healthy male adiponectin knockout SPF mice, aged 8-10 weeks, weighing 20-25 g, were selected and served as APNKO group.Myocardial I/R was induced by 30 min occlusion of anterior descending branch of left coronary artery followed by reperfusion.In SP and APNKO groups, sevoflurane pretreatment included 3 cycles of 10-minute inhalation of 2% sevoflurane-93% O 2-5% CO 2 interspersed with 15-minute inhalation of 95% O 2-5% CO 2, and then the model was established.At 1, 2 and 4 days of reperfusion, cognitive function was assessed by Morris water maze test. Results:There was no significant difference in swimming velocity at each time point between the 4 groups ( P>0.05). Compared with group Sham, the escape latency was significantly prolonged, and the frequency of crossing the original platform was decreased at each time point in group MI/R ( P<0.05). Compared with group MI/R, the escape latency was significantly shortened, and the frequency of crossing the original platform was increased at each time point in group SP ( P<0.05). Compared with group SP, the escape latency was significantly prolonged, and the frequency of crossing the original platform was decreased at each time point in group APNKO ( P<0.05). Conclusion:Adiponectin is involved in the process of sevoflurane pretreatment-induced improvement in cognitive function in mice with myocardial I/R.

OBJECTIVETo evaluate effect of screening of esophageal cancer at rural areas in Henan province.

METHODSAt rural areas with high incidence of upper gastrointestinal carcinoma in Henan province total of 88,263 persons with 40 to 69 years old were set to the target population of the screening by the 12 cities and countries and endoscope and pathology diagnosis were performed during 2009-2013. For patients with precancerous lesions, follow-up visits were conducted and defined as follows: once in three years for patients with mild dysplasia, once per year for moderate hyperplasia patients, the patients with severe intraepithelial neoplasia/carcinoma in situ should be treat, at least once per year for those one who didn't under treatment. The result data of screening were summarized and detection rates of esophagus hyperplasia, carcinoma in situ, early and middle-late cancer were calculated, as well as the early diagnosis rate. The result between first round and follow-up screening was compared.

RESULTSTarget population were examined in first round screening. There were 8,434 persons with above mild dysplasia and the detection rate was 9.56%, among them there were 7,224 (8.18%) cases with light-middle hyperplasia, 789 (0.89%) cases with serious dysplasia or cancer in situ, 239 (0.27%) cases with early cancer and 182 (0.21%) cases with middle-late cancer. The sum of serious dysplasia or cancer in situ and early cancer was 1 028 and the early detection rate was 84.96% (1,028/1,210). From 2012 to 2013, the follow-up screening for persons with light-middle hyperplasia which should be followed 4,230 cases, there were 2 853 people to take in screening and compliance was 67.45%. Total of 94 cases were diagnosed with cancer in situ or early cancer. The detection rate and the early detection rate were 3.29% and 100%, respectively. The rates of detection and early detection in phase of follow-up screening were statistically significantly higher than that in first round screening respectively (P<0.001).

CONCLUSIONAt rural areas of high incidence upper gastrointestinal carcinoma in Henan province, the screening with endoscope had good effect and strengthening the follow-up screening could increase the effect.

Early Detection of Cancer ; Esophageal Neoplasms ; Humans ; Incidence ; Rural Population ; Time-to-Treatment

Objective: To evaluate the performance of high risk human papillomavirus (HR-HPV) DNA test for triage ASC-US in Chinese population. Methods: The study population was from Jiyuan city in Henan Province where a cervical cancer screening cohort (4 026 women) was set up from April to July in 2017. Women with ASC-US and complete recall information of colposcope were selected as the study objects. Self-designed questionnaire was used to survey the general information and medical history of cervical cancer, thencervical cytological speciments were collected for cytodiagnosis and HPV DNA test, followed by colposcopy, lesion biopsy and histology diagnose. The diagnosis of histology was used as the gold standard. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) as well as corresponding 95% confidential interval (CI) were calculated. Results: The average age of the included 393 women with ASC-US were (50.81±9.22) years old. The positivity of high risk human papillomavirus (HR-HPV), HPV16 and HPV18 were 35.6%, 10.69% and 2.80%, respectively. The sensitivity, specificity, PPV and NPV for HR-HPV to detect CIN2+ were 84.38% (68.25%-93.14%), 68.70% (63.74%-73.26%), 19.29% (13.61%-26.61%) and 98.02% (95.46%-99.15%). When compared with HR-HPV, HPV16/18 had a lower sensitivity (59.38% (42.26%-74.48%)) and a higher specificity(91.14% (87.75%-93.65%)), the PPV and NPV were 59.38% (25.32%-50.98%) and 91.14% (93.61%-97.77%). Conclusion It was more effective for HR-HPV to triage ASC-US than HPV16/18. In order to improve the effect of HPV16/18, it should include more HR-HPV types which were more prevalent in Chinese population.

Objective To investigate the effect of fried food intake on the pathogenesis of esophageal cancer and precancerous lesions.Methods From 2005 to 2013,all the residents aged 40-69 years from 11 counties (cities) where cancer screening of upper gastrointestinal cancer had been conducted in rural areas of Henan province,were recruited as the subjects of study.Information on demography and lifestyle was collected.The residents under study were screened with iodine staining endoscopic examination and biopsy samples were diagnosed pathologically,under standardized criteria.Subjects with high risk were divided into the groups based on their different pathological degrees.Multivariate ordinal logistic regression analysis was used to analyze the relationship between the frequency of fried food intake and esophageal cancer and precancerous lesions.Results A total number of 8 792 cases with normal esophagus,3 680 with mild hyperplasia,972 with moderate hyperplasia,413 with severe hyperplasia carcinoma in situ,and 336 cases of esophageal cancer were recruited.Results from multivariate logistic regression analysis showed that,when compared with those who did not eat fried food,the intake of fried food (＜2 times/week:OR=1.60,95％C1:1.40-1.83;≥2 times/week:OR=2.58,95％ CI:1.98-3.37) appeared a risk factor for both esophageal cancer or precancerous lesions after adjustment for age,sex,marital status,educational level,body mass index,smoking and alcohol intake.Conclusion The intake of fried food appeared a risk factor for both esophageal cancer and precancerous lesions.

Objective:To evaluate the performance of rural practitioners of endoscopic cleaning and disinfection participating in the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers and to analyze the influencing factors.Methods:The questionnaires for skill assessment were designed based on the skill scheme and clinical practice of the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers in rural China, and the App Early diagnosis, Early treatment was used as the examination platform. The practitioners in 539 county hospitals from 25 provinces participating in the program in 2019 were assessed for techniques and skills for endoscopic cleaning and disinfection and the excellence rate was calculated. Multivariate logistic regression model was used to analyze the influencing factors for the examination. Results:A total of 1 671 endoscopic cleaning and disinfection practitioners participated in the assessment with the score of 73.41±16.60. The passing rate was 85.82%, and the excellence rate was 44.94%. Among all questions, the correct rate of "opportunistic screening flow chart" was the highest (98.21%), and that of "the evaluation index for mass screening" was the lowest (57.89%). The multivariate logistic regression analysis showed that the excellence rate was high in practitioners who had a bachelor degree or above ( OR=1.627,95% CI:1.319-2.007, P<0.001), the career for 5 to <15 years (5 to <10 years: OR=1.329,95% CI:1.045-1.689, P=0.020; 10 to <15 years: OR=1.384,95% CI:1.026-1.867, P=0.033), working in eastern and central regions (eastern regions: OR=3.476,95% CI:2.368-5.103, P<0.001;central regions: OR=4.028,95% CI:2.679-6.057, P<0.001) and with full understanding of the screening scheme ( OR=1.547,95% CI:1.246-1.921, P<0.001) . Conclusion:Practitioners on the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers in rural China have mastered the basic screening scheme and skills for endoscopic cleaning and disinfection. The education background, duration of the career, area and understanding of screening scheme are influencing factors for the excellence rate of endoscopic cleaning and disinfection.

OBJECTIVETo analyze the efficacy of endoscopic screening for gastric cancer in rural population in high risk areas of upper gastrointestinal cancer in Henan province.

METHODSSubjects aged 40-69 years in the high risk areas were selected to participate in the endoscopic screening based on the cluster sampling, and screening-positive subjects were sampled for pathological examination. The data of screening were summarized and the detection rates of severe chronic atrophic gastritis, severe intestinal metaplasia, low grade intraepithelial neoplasia, high grade intraepithelial neoplasia, early and middle-late cancer were calculated, and the constituent ratio of early cancer cases was calculated. The detection rates and early diagnosis rates for the first round screening and follow-up screening were compared.

RESULTSIn the 5 years, a total of 88 263 subjects were endoscopically examined in the first round screening and 4 004 subjects were diagnosed with low grade intraepithelial neoplasia or above (the detection rate was 4.54%), in which 3 256 cases were with low grade intraepithelial neoplasia (the detection rate of 3.69%), 366 cases with high grade intraepithelial neoplasia (the rate of 0.41%), 199 cases with early cancer (the rate of 0.22%) and 183 cases with middle-late cancer (the rate of 0.21%). The number of cases of high grade intraepithelial neoplasia and early cancer was 565 and the early diagnosis rate was 75.53%. 1 894 subjects with severe chronic atrophic gastritis, severe intestinal metaplasia and low grade intraepithelial were followed up with a compliance of 66.32%. A total of 45 cases of early cancer were diagnosed, with a detection rate of 2.38% and early diagnosis rate of 100%. The detection rate and early diagnosis rate in the follow-up screening were both statistically significantly higher than that in the first round screening (P<0.01 for both).

CONCLUSIONThe efficacy of endoscopic screening for gastric cancer is significant in high risk areas of upper gastrointestinal cancer, and improving the quality of follow-up screening will achieve a better performance of the screening.

Adult ; Aged ; Carcinoma in Situ ; diagnosis ; pathology ; China ; Chronic Disease ; Early Detection of Cancer ; statistics & numerical data ; Gastritis, Atrophic ; diagnosis ; Gastroscopy ; Humans ; Mass Screening ; Middle Aged ; Rural Population ; Stomach Neoplasms ; diagnosis ; pathology