Objective To study the clinical significance of liver failure staging and MELD in predicting the short term prognosis of HBV-acute-on-chronic liver failure (HBV-ACLF).Methods One hundred and ten HBV-ACLF patients admitted to our hospital from July 2013 to July 2015 were included into this study.They were divided into early stage group (n=18),middle stage group (n=48) and end stage group (n=44),the fatality rate in each group was evaluated.According to the MELD score at baseline,they were divided into four groups,MELD＜20 (n =24),20≤ MELD＜30 (n=54),30≤MELD＜40(n =28),40≤MELD (n =4).The fatality rate in each group was evaluated.In the middle stage group,they were be divided into two groups,/△MELD＜0 and △MELD＞0(△MELD=MELD1w-MELDbaseline).The fatality rate in each group was evaluated.Results The fatality rate of the 3 groups(Early,Middle and End stage group) at 3th month was 0,50％,95 ％ respectively(P＜ 0.05).The fatality rate of the 4 groups (MELD＜20,20≤MELD＜30,30≤MELD＜40,40≤MELD)was 31.58％,66.67％,85.71％ and 100％ respectively (P＜ 0.05).In the middle stage group,the fatality rate of the two groups was (△MELD＜0 and △MELD＞ 0)41.18％ and 85.71％ (P=0.001).Conclusion It can be shown that the survival probability of early stage group was high,the probability of death in end stage group and middle stage group with△MELD＞0 was high.

OBJECTIVE: To study the role of nuclear factor-kappa B (NF-kappaB) and cycloxygenase-2 (COX-2) in the onset of phlegm obstruction due to lung-deficiency in rats and the therapeutic mechanism of Huatan Recipe. METHODS: Twenty-four SD rats were randomly divided into normal group, model group and treatment group, with 8 rats in each group. The rats in the model group and treatment group were exposed to sulfur dioxide and cold wind to establish the rat model of phlegm obstruction due to lung-deficiency, and the rats in the treatment group were also treated with Huatan Recipe, a compound traditional Chinese medicine. The expression of NF-kappaB in the bronchial epithelial cells of the rats was tested with the method of immunohistochemistry, and the COX-2 mRNA in the lung tissues of the rats was measured by using reverse transcription-polymerase chain reaction. RESULTS: The expressions of NF-kappaB and COX-2 mRNA in rats of the model group were higher than those of the normal group (P<0.01), and the expressions of NF-kappaB and COX-2 mRNA in rats of the treatment group were obviously lower than those of the model group (P<0.01). CONCLUSION: The NF-kappaB and COX-2 play an important role in the onset of phlegm obstruction in rats. Huatan Recipe may prevent the development of phlegm obstruction by down-regulating the expressions of NF-kappaB and COX-2 mRNA.

Objective To explore mechanical property changes of methyl vinyl silicone rubber modified by ferric nanoparticles and its dispersed phase.Methods Mechanical properties such as Shore A hardness,tensile strength,elongation at break,tearing rate of permanent deformation and tearing strength of pre-prepared ironic nanoparticle enhanced silicone rubber and carbon-coated ferric particle reinforced silicone rubber were tested according to national standards.A thermal field emission scanning electron microscope (TFE-SEM) was used to investigate the morphology of both surface and fracture of the composite materials and to observe the dispersion of ferric nanoparticles in them.Results Mean values of Shore A hardness,tensile strength,elongation at break,tearing permanent deformation rate and tear strength of modified composites increased with the increasing amounts of ferric nanoparticles,however,when the quota of ironic nanoparticles in the composite formula were greater than 17 phr,carbon-coated ferric nanoparticles more than 19 phr,the mean values of tensile strength of two composites stopped increasing and presented the declining trend.When the quota of ferric nanoparticles in the formula exceeding 15 phr,the mean values of elongation at break and tear strength began to decrease in the formula ratio of silicone rubber/ferric nanoparticles up to 85:15,while the Shore A hardness of samples increased all the way.Ferric nanoparticles dispersed evenly on the surface of composites.Nanopowder aggregation in the fracture surface of both composites could be observed at the formula ratio of 85:15 of silicone rubber/iron nanoparticle and 87:13 of silicone rubber/carbon-coated iron specimen.Conclusion Effect of iron nanapareticles and carbon-coated ferric nanoparticles on the mechanical properties of the reinforced methyl vinyl silicone rubber depends on the nanoparticle size,additive amount and agglomeration.

OBJECTIVE: To observe the effects of Guben Huatan Tongmai Recipe (GBHTTMR), a compound Chinese herbal recipe, on expressions of macrophages and cell adhesion molecules (CAMs) of aortic endothelia in rats with syndrome of phlegm blocking blood vessel, and to explore the pathogenesis of the phlegm-pathogen. METHODS: Fifty normal male Wistar rats, 7-week in age, were randomly divided into five groups: normal control group, untreated group, high-dose GBHTTMR-treated group, low-dose GBHTTMR-treated group and simvastatin-treated group, with 10 rats in each group. Syndrome of phlegm blocking blood vessel was induced in rats of the latter 4 groups by feeding the rats with high lipid diet. Levels of blood lipid were compared among the 5 groups. The expressions of macrophages and CAMs in aortic endothelia were tested by immunohistochemical staining method. RESULTS: The level of blood lipid, and the expressions of macrophages and CAMs showed statistical differences between the normal control group and the untreated group (P<0.01), and between the untreated group and the low-, high-dose GBHTTMR-treated and simvastatin-treated groups as well (P<0.05). CONCLUSIONS: GBHTTMR can decrease the level of serum cholesterol and triglycerides, and increase the level of high density lipoprotein. It also can inhibit the expressions of macrophages, intercellular adhesion molecule-1, vascular cell adhesion molecule-1, P-selectin, and E-selectin.

Objective To investigate the clinicopathologic features of GIST. Method Fifty-five GIST cases were collected. Immunohistochemical assays of vimentin, CD117, CD34, S-100, SMA, desmin, NF were used to study the specimen. Results 69% (38/55) of the tumors located in the stomach, 18% (10/55) in the small intestine. Tumors varied greatly in size, ranging from 0.4 to 40 cm (average 6.7 cm). Morphologic criteria of malignancy are tumor size≥5 cm, mitotic rates≥5/50 HPF and ulcer formation and there were significant differences between the benign and the malignant. Immunohistochemical staining results: CD117 positive in 39 cases(71%), CD34 in 45 cases (82%), S-100 in 19 cases (35%), SMA in 12 cases (22%), vimentin in 32 cases (58%), desmin in 6 cases(11%),and NF in 2/4 (50%). All 13 benign cases were alive on the latest follow-up. In 42 cases of malignancy and potential malignancy, 4 developed metastasis, 13 died. Conclusion (1) GIST occur predominantly in middle-aged and older persons.(2) The main criteria of malignancy of GIST are tumor size≥5 cm, mitotic rates≥5/50 HPF and ulcer formation. (3)Whereas it is difficult to identify true leiomyomas/leiomyosarcomars and neuogenic tumors from GIST, immunohistochemical staining is capable of doing this.

OBJECTIVETo investigate the differences between clinicopathological features and prognosis of alpha-fetoprotein (AFP) negative (AFP < 20 ng/ml) and positive (AFP ≥ 20 ng/ml) hepatocellular carcinoma (HCC) patients.

METHODSClinicopathological data of 142 AFP-negative and 109 AFP-positive HCC patients who underwent RO radical hepatectomy in the Cancer Hospital of Chinese Academy of Medical Sciences between January 2006 and December 2011 were retrospectively reviewed and analyzed in this study.

RESULTSCompared with the AFP-negative patients, a higher female to male sex ratio, the later Barcelona Clinic Liver Cancer ( BCLC) stage, more liver capsule invasion and poorer Edmondson-Steiner grade were in the AFP-positive cases (P < 0.05 for all). Furthermore, the 1-, 3-, and 5- year overall survival rates were 94.4%, 82.4% and 61.0% in the AFP-negative group and 87.2%, 61.1% and 40.2%, respectively, in the AFP-positive group (P < 0.001). The multivariate analysis with Cox's proportional hazards model showed that AFP status, tumor size and Edmondson-Steiner grade are independent risk factors for survival of all the patients (P < 0.05) , and large tumor and Edmondson-Steiner grades III/IV are independent risk factors for worse survival in AFP-negative patients (P < 0.05). However, large tumor diameter was proved to be an independent risk factor leading to poor prognosis of AFP-positive cases (P < 0.05).

CONCLUSIONHigh levels of AFP indicate that the tumors are more malignant and with unfavorable prognosis.

Asian Continental Ancestry Group ; Carcinoma, Hepatocellular ; chemistry ; mortality ; pathology ; surgery ; Female ; Hepatectomy ; Humans ; Liver Neoplasms ; chemistry ; mortality ; pathology ; surgery ; Male ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Survival Rate ; alpha-Fetoproteins ; analysis

OBJECTIVE: To assess the effects of varying the number of diffusion gradient directions (NDGDs) on diffusion tensor fiber tracking (FT) in human brain white matter using tract characteristics. MATERIALS AND METHODS: Twelve normal volunteers underwent diffusion tensor imaging (DTI) scanning with NDGDs of 6, 11, 15, 21, and 31 orientations. Three fiber tract groups, including the splenium of the corpus callosum (CC), the entire CC, and the full brain tract, were reconstructed by deterministic DTI-FT. Tract architecture was first qualitatively evaluated by visual observation. Six quantitative tract characteristics, including the number of fibers (NF), average length (AL), fractional anisotropy (FA), relative anisotropy (RA), mean diffusivity (MD), and volume ratio (VR) were measured for the splenium of the CC at the tract branch level, for the entire CC at tract level, and for the full brain tract at the whole brain level. Visual results and those of NF, AL, FA, RA, MD, and VR were compared among the five different NDGDs. RESULTS: The DTI-FT with NDGD of 11, 15, 21, and 31 orientations gave better tracking results compared with NDGD of 6 after the visual evaluation. NF, FA, RA, MD, and VR values with NDGD of six were significantly greater (smallest p = 0.001 to largest p = 0.042) than those with four other NDGDs (11, 15, 21, or 31 orientations), whereas AL measured with NDGD of six was significantly smaller (smallest p = 0.001 to largest p = 0.041) than with four other NDGDs (11, 15, 21, or 31 orientations). No significant differences were observed in the results among the four NDGD groups of 11, 15, 21, and 31 directions (smallest p = 0.059 to largest p = 1.000). CONCLUSION: The main fiber tracts were detected with NDGD of six orientations; however, the use of larger NDGD (> or = 11 orientations) could provide improved tract characteristics at the expense of longer scanning time.
Adult ; Anisotropy ; Diffusion Tensor Imaging/*methods ; Female ; Humans ; Male ; White Matter/*radiography ; Young Adult

OBJECTIVETo explore the clinical and pathological factors influencing the prognosis of patients with hepatocellular carcinoma (HCC)(≤5 cm) after hepatectomy.

METHODSTwo hundreds and nineteen cases with HCC(≤5 cm) undergoing hepatectomy in Cancer Hospital, Chinese Academy of Medical Sciences between December 2003 and July 2013 were collected. The alpha fetoprotein (AFP) level, tumor number, tumor size (diameter), liver cirrhosis, vascular invasion, capsular invasion, differentiation, surgical methods, resection margin, the way of treatments, the situation of recurrence and time to recurrence were analyzed. Log-rank test and the stepwise Cox proportional-hazards models were used to compare the prognosis, respectively.

RESULTSThe 1-, 3-, 5- and 10- year overall survival rates were 95.9%, 85.3%, 67.8% and 53.3% respectively in all patients.Single factor analysis indicated that vascular invasion, capsular invasion, tumor size, hepatic vascular occult, liver cirrhosis, tumor differentiation, AFP, the way of treatments, the situation of recurrence and time to recurrence can affect the prognosis significantly (all P<0.05). The multifactor analysis showed that AFP, tumor differentiation, liver cirrhosis, capsular invasion, tumor size and the situation of recurrence and time to recurrence were independent prognostic factors (all P<0.05).

CONCLUSIONThe prognosis of patients with HCC(≤5 cm) underwent hepatectomy are affected by multi-factors, such as AFP, tumor differentiation, liver cirrhosis, capsular invasion, tumor size and the situation of recurrence and time to recurrence.

Carcinoma, Hepatocellular ; diagnosis ; surgery ; Hepatectomy ; Humans ; Liver Cirrhosis ; diagnosis ; pathology ; Liver Neoplasms ; diagnosis ; surgery ; Neoplasm Recurrence, Local ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; alpha-Fetoproteins ; analysis

OBJECTIVE: To determine the prevalence and incidence of illness of two-week duration, and the factors influencing these, among residents 15 years and older in four counties of Hunan Province. METHODS: Data were sampled from four counties of Hunan Province for the Fourth National Health Service Survey. Incidence and two-week prevalence of disease were used to assess the health service needs of residents. A non-conditional, stepwise logistic regression was employed to explore the influencing factors. RESULTS: The two-week prevalence and incidence were 11.5% and 3.9%, respectively, in four counties of Hunan. The three leading diseases of two-week prevalence were: respiratory diseases, digestive diseases, and musculoskeletal diseases. Non-conditional stepwise logistic regression showed that urban residents had 0.64 times the risk of two-week illness compared with the rural residents (P< 0.05); residents in the 45-59 year age group and the 60+ year age group had 1.69 and 2.62 times the risk of two-week illness compared with residents in the 15-44 year age group, respectively (P<0.05). The widowed had 1.91 times the risk of prevalence of two-week illness contrasted to singles (P<0.05); the students had 0.29 times the risk of two-week illness contrasted to the workers (P<0.05); urban residents had 0.63 times the risk of two-week illness compared with the rural (P<0.05); the widowed had 2.37 times the risk of incidence of two-week illness compared with singles (P<0.05). CONCLUSION The majority of health service needs of residents of four counties is generated by three diseases: respiratory diseases, digestive diseases, and musculoskeletal diseases. Relatively, rural residents, the elderly, employed persons and the widowed have higher health service needs than others and deserve specific attention.
Adolescent ; Adult ; Aged ; China ; epidemiology ; Community Health Services ; statistics & numerical data ; Digestive System Diseases ; epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Musculoskeletal Diseases ; epidemiology ; Respiratory Tract Diseases ; epidemiology ; Sampling Studies ; Surveys and Questionnaires ; Young Adult

The American College of Rheumatology (ACR) and the American Association of Hip and Knee Surgeons (AAHKS) convened a writing group to develop a consensus report on the management of anti-rheumatic medication in patients with rheumatic diseases undergoing elective total hip or total knee arthroplasty in June 2022. In particular, the consensus provides significant updates on target synthetic disease modifying anti-rheumatic drugs and perioperative medication management in patients with systemic lupus erythematosus, as well as the addition of newly approved antirheumatic medications for administration. This article will interpret the consensus and provide a reference for the perioperative management of antirheumatic medications for hip and knee arthroplasty in patients with rheumatic diseases in China.