0.05). The operation time, blood loss, ambulation time, early complication, medical diseases and restored function after operation, death rate within 1year after operation in prosthetic replacement group were superior over the internal fixation group (P

Objective To identify risk factors associated with the severity of acute kidney injury (AKI) in-duced by crush syndrome and whether the patient required hemodialysis (HD). Method A retrospective study was designed. Within 19 days after the Chinese Wenchuan earthquake (May 12, 2008), 63 victims (33 men, 30women) of 2139 cases were hospitalized at Mianyang Central Hospital (Siehuau, China) because of crush syn-drome caused by crush injuries. The patients with renal dysfimcfion before the earthquake were excluded. Totally 63 patients with AKI associated with crush syndrome were included in this study and were divided into two groups: group 1, 25 patients, requiring HD (when urine volume <250 mL/d;serum potassium> 6 mmol/L) ; and group 2, 38 patients, without HD. The following data were collected retrospectively for all patients: (1) epidemiological parameters: age, gender, race, time under the rubble, liquid treatmem before being rescued; (2) clinical param-eters: blood pressure, body area crushed, amputation, fasciotomy, blood transfusion, quantity of fluid infusion, urine output in the first 24 hours; (3) initial laboratory data: complete blood count, urine analysis, serum chem-istry, arterial blood gas analysis. Comparisons between the two groups were made using SPSS 10.0. The quantita-tive data and categorical data were analyzed using t tests and χ2 tests, respectively. P -values < 0.05 were consid-ered to indicate significant differences. The significant variables were entered into logistic regression models to de-termine the risk factors for the severity of AK1 in patients with crush syndrome and whether the patient required HD. Results Four significant risk factors with P -values < 0.05 were identified: fasciotomy, cystatin C (Cys C)level, myoglobin (MB) level and lactic acidosis. The odds ratios (95% confidence intervals) were 8.641 (3.027～76.479), 6.956 (3.027～76.479), 5.379 (3.027～76.479) and 4.833 (2.569～32.764), respectively. Conclusions In addition to urine output and potassium levels, we found that four risk factors, namely faseiotomy, Cys C and MB levels, and lactic acidosis, were significanfly associated with the severity of AKI and whether the patient required hemodialysis.

Objective To validate the predictive value of hepatitis B virus ( HBV )-related hepatocellular carcinoma ( HCC) risk score model D2AS in chronic HBV infection patients without antiviral therapy.Methods A total of 93 patients with chronic HBV infection were selected between January 2015 and July 2017 in the Third Affiliated Hospital of Hebei Medical University.Clinical data including age , gender, medical history, ultrasonography, hepatitis B surface antigen ( HBsAg), hepatitis B surface antibody ( anti-HBs), hepatitis B e antigen ( HBeAg), hepatitis B e antibody ( anti-HBe), hepatitis B core antibody ( anti-HBc), HBV DNA and alanine aminotransferase levels were collected by information center .REACH-B score and D2AS score were used to predict the risk of HCC.Receiver operating characteristic curve (ROC) was used to evaluate the discrimination , and Hosmer-Lemeshow ( H-L) goodness-of-fit test was used to evaluate the calibration of the model.Results REACH-B score and D2 AS score for the 95 chronic HBV infection patients were 9 (8,12) and 0.95 (0.57,2.08), respectively.The area under the curve ( AUC) for REACH-B score and D2 AS score were 0.916 (95% confidence interval [ CI] 0.834-0.998) and 0.784 (95%CI 0.587-0.981), respectively.The difference was not statistically significant ( P ＝0.195).However, for HBeAg-negative patients with chronic HBV infection , the AUC for D2 AS score and REACH-B score were 0.952 (95%CI 0.876-1.000) and 0.913 (95%CI 0.821-1.000), respectively (P＝0.458).The H-L goodness-of-fit test was P＞0.05.Conclusions The D2 AS score can be used for HCC prediction among patients who do not meet antiviral criteria.The predictive value of the D 2AS score for HCC is comparable to the REACH-B score in HBeAg-negative patients with chronic HBV infection.

Nonalcoholic fatty liver disease (NAFLD) is a clinicopathological syndrome with similar hepatic histological changes to alcoholic liver disease, but without a history of excessive alcohol intake. Obesity, hyperlipidemia, diabetes, hypertension and other metabolic disorders are closely related to its occurrence and development, and its core mechanism is insulin resistance. In addition, there are also non-metabolic-related factors for the occurrence of non-alcoholic fatty liver disease, such as pancreatoduodenectomy. Pancreatoduodenectomy is the standard procedure for the treatment of tumor around the head of pancreas and ampulla. Postoperative pancreatic malfunction induced by pancreatic exocrine function after pancreatoduodenectomy is associated with the occurrence and development of secondary non-alcoholic fatty liver disease.

Most hepatocellular carcinoma are diagnosed at an advanced stage and thereby have a high mortality rate. Thus, the key to improving patient prognosis is early diagnosis of hepatocellular carcinoma. In recent years, Asian scholars have summarized a series of hepatocellular carcinoma risk score model for population with chronic hepatitis B, which can help to identify high-risk groups early and improve the early diagnosis rate. This paper briefly analyzes the risk factors and validated risk model for early prediction of hepatitis B virus-related hepatocellular carcinoma, and further reviews the effect of antiviral therapy on the risk of hepatocellular carcinoma.

Hepatitis B virus (-HBV) infection is the most common cause ofhepatocellular carcinoma in China.Epidemiological surveys show that male have a much higher incidence of hepatocellular carcinoma than female.Studies have shown that estrogen and its receptors are associated to gender disparity in hepatocellular carcinoma,but the underlying molecular mechanisms has not yet been fully elucidated.This article reviews the possible mechanisms of estrogen and its receptors in the occurrence and progression of hepatitis B virus-related hepatocellular carcinoma.

Objective To investigate the evaluating the value of CT quantitative analysis and visual scores on pulmonary alveolar proteinosis (PAP). Methods Thirty one patients with PAP who underwent chest HRCT scans and pulmonary function tests(PFTs)between July 2014 and April 2016 in our hospital were collected and analyzed.HRCT mean lung density(MLD)was measured by syngo InSpace Lung Parenchyma Analysis.Using CT visual scores(HRCT score and RE score),two radiologists with three-years experience at least evaluated pulmonary lesions retrospectively. SPSS 21.0 statistical software was used to analyze the data. Spearman correlation analysis was used to evaluate the correlation between MLD, HRCT score and RE score.The correlation between MLD, HRCT score, RE score, the parameters of PFTs, and blood gas parameters were also analyzed by Spearman correlation analysis. Results There were correlations between MLD,HRCT score and RE score.The correlation coefficient among MLD,HRCT score and RE score were r=0.835 vs r=0.768 vs r=0.838 in baseline. The correlation coefficient among MLD, HRCT score and RE score were r=0.827 vs r=0.780 vs r=0.896 in follow-up. And there were also strong correlation between ΔMLD, ΔHRCTscore and ΔREscore. The correlation coefficient among ΔMLD, ΔHRCTscore and ΔREscore were r=0.599 vs r=0.651 vs r=0.867. There were significantly (P＜0.05) negative correlations among MLD, HRCT score, RE score and VA, DLCO in baseline and follow-up retrospectively. There were significantly (P≤0.001) negative correlations among the ΔMLD, ΔHRCTscore, ΔREscore and ΔVA, ΔDLCO.The correlation among MLD, HRCT score, RE score and DLCO was more significant than that of VA. The correlation among ΔMLD, ΔHRCTscore,ΔREscore and ΔDLCO was more significant than that of ΔVA.There were markedly(P＜0.05) negative correlations between MLD and PO2,and the correlation coefficient were r=-0.738 in baseline vs r=- 0.810 in follow-up. Conclusion The HRCT quantitative analysis and HRCT visual scores are feasible to evaluate PAP.

Monitoring blood glucose level timely and accurately and management of glucose level is crucial for the treatment of diabetes and the prevention of diabetic complications. Glycated albumin is one of the important biomarker to evaluate the fluctuation of blood glucose level, which has been widely used in clinic. To understand the advantages and limitations of the glycated albumin in monitoring glucose level will contribute to its better application in clinic.

Objective:To examine the correlation between DEPDC5 rs5998152 variants and the risk of hepatitis C virus (HCV) related liver diseases onset. Methods:Patients with chronic hepatic diseases diagnosed as HCV infection in Tianjin Second People′s Hospital from September 2016 to July 2017 were enrolled in the study and were divided into chronic hepatitis C (CHC) group, CHC related liver cirrhosis (LC) group and hepatocellular carcinoma (HCC) group. DEPDC5 rs5998152 was genotyped using the matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) assay and the case data were reviewed. T test, analysis of variance (ANOVA), and non-parametric test were used to perform the comparison of the quantitative data between groups according to normally distributed or not. Chi-square test was used to examine the different distribution of enumeration data between groups. Logistic regression analysis was employed to analyze the correlation between the genetic polymorphism and risk of LC and HCC. Results:A total of 147 patients were included in this study, with 55 in CHC group, 54 in LC group and 48 in HCC group. The levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), α-fetoprotein (AFP), total bilirubin and rate of hepatic encephalopathy were significantly higher in LC and HCC groups compared to CHC group( P<0.05). And the levels of AFP and total bilirubin were significantly higher in HCC group than LC group ( P<0.05). There was no significant difference among the three groups in terms of DEPDC5 rs5998152 genotype distribution ( P > 0.05). The frequency of the C allele at DEPDC5 rs5998152 was higher in LC and HCC subjects than in CHC patients ( P<0.05) and the Logistic analysis indicated that CHC individuals with C allele and TC+ CC genotypes showed higher risk of LC and HCC compared with those with T allele and TT genotype ( P<0.05). In addition, the difference of DEPDC5 rs5998152 allele frequency was not significant between LC and HCC groups and it was not correlated with risk of HCC for LC patients. Conclusions:DEPDC5 rs5998152 may be a risk factor of progression to LC and HCC in the Chinese Han patients with CHC.

Objective To compare measurements of dual-energy CT iodine map parameters and liver perfusion CT parameters in patients with focal liver lesions using a third-generation dual-source CT scanner. Methods Between November 2015 and August 2016,33 patients with non-cystic focal lesions of liver were enrolled in this study. CT examinations were performed with a third-generation dual-source CT. The study CT protocol included a perfusion CT and dual-energy arterial and portal venous scans,with a time interval of 15 minutes. Iodine attenuation was measured at five region of interests including areas of high,medium,and low density within the lesion,as well as right and left liver parenchyma from the iodine map,while arterial liver perfusion (ALP),portal venous liver perfusion (PVP),and hepatic perfusion index (HPI) at the same location were measured from perfusion CT. The Pearson product-moment correlation coefficient was used to evaluate the relationship between iodine attenuation and perfusion parameters. Results The iodine attenuation at arterial phase showed significant intra-individual correlation with ALP (r=0.812,95% CI=0.728-0.885,P<0.001)and PVP (r=-0.209,95% CI=-0.323--0.073,P=0.007),but not significantly correlated with HPI (r=0.058,95% CI=0.046-0.498,P=0.461). The iodine attenuation at portal venous phase showed significant correlation with PVP (r=0.214,95% CI=0.072-0.361,P=0.005) but not with HPI(r=0.036,95% CI=-0.002-0.242,P=0.649). The mean effective dose of arterial phase and portal venous phase of dual-energy CT together [(3.53±1.17)mSv] was significantly lower than that of the perfusion CT [(14.53±0.45)mSv](t=25.212,P<0.001). Conclusion Iodine attenuation from arterial phase of dual energy CT demonstrates significant correlation with ALP and PVP,and iodine attenuation from portal venous phase demonstrates significant correlation with PVP.
Contrast Media ; Humans ; Iodine ; Liver ; diagnostic imaging ; pathology ; Perfusion ; Portal Vein ; Tomography, X-Ray Computed ; methods