Objective To investigate the relationship between chromosome 6p copy number alterations (CNAs) and postoperative intrahepatic recurrence of hepatocellular carcinoma (HCC);and to screen for the target genes in CNA(s).Methods Array comparative genomic hybridization (CGH) and expression arrays were used to detect CNAs and differences in gene expression, respectively.The associations between CNAs in 6p and HCC recurrence were analyzed using the log-rank test, the Kaplan-Meier curves and the Cox proportional hazards models on 66 patients who had been follow-up for 2.6 ～ 73.3 months.The differentially expression of genes in the potentially recurrence-related CNAs were further evaluated by the MannWhitney U test on 117 HCCs, which included 109 cases with paired array CGH and expression data.Results 6p CNAs were detected in 46 (69.7％) of the 66 HCCs.Of the 8 CNAs with the most frequent recurrence of over 20％ , a gain at 6p21.1 was independently associated with a 2.3-fold (95％ CI =1.1 ～ 5.1, P ＜ 0.05) increased risk for intrahepatic recurrence and with a more pronounced 3.3-fold (95％ CI =1.4 ～ 8.2, P ＜0.05) risk for early recurrence (≤ 1 year).A panel of 9 genes, including BYSL and RPL7L1 within the documented 6p21.1, were observed to be upregulated in HCCs with 6p21.1 gain when compared with HCCs without (all P ＜ 0.05).A high BYSL expression significantly correlated with a larger tumor size (＞ 6 cm), vascular invasion and advanced tumor stage (all P ＜ 0.05), and high RPL7L1 expression significantly correlated with vascular invasion and advanced tumor stage (all P ＜ 0.05).Conclusion A gain at 6p21.1 was an independently prognostic marker for intrahepatic recurrence of postoperative HCC, particular for early recurrence, and BYSL and RPL7L1 might be the target genes in the recurrence-related 6p21.1 gain.

Objective To investigate the clinical effect of minimally invasive percutaneous repair of acute closed Achilles tendon ruptures with intraoperative ultrasound assistance.Methods A retrospective case series study was made on 24 patients with acute closed Achilles tendon ruptures hospitalized between January 2013 and June 2015.There were 19 males and five females,aged 18-50 years (mean,30.5 years).MRI showed total Achilles tendon ruptures,and time from injury to operation was 1-3 days.All patients underwent minimally invasive percutaneous repair with high-frequency ultrasound assistance.Operation time and either intraoperative or postoperative complications were documented.At last follow-up,American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Arner Lindholm system were used to evaluate ankle functional recovery.Results Operation time was 35-60 minutes (mean,42 minutes).No intraoperative injury to the major vessel and nerve occurred.Follow-up was conducted for 10-18 months (mean,14.5 months).No surgery-related complications were detected,including wound infection,skin necrosis and tendon reruptures.Ankle function was recovered to normal.AOFAS score were improved from preoperative 53-74 points [(61.5-± 6.7)points] to 91-100 points [(97.1 ± 3.2) points] at last follow-up (P ＜ 0.05).According to the Amer Lindholm system,the treatment outcome was excellent in 21 patients and good in three,with the excellence rate of 100％.Conclusion Ultrasound-assisted minimally invasive percutaneous technique improves the quality of tendon anastomosis,avoids injury to the sural nerve,minimizes the incidence rate of complications such as re-rupture,wounds infections or skin necrosis and hence is an ideal method for repair of acute closed Achilles tendon ruptures.

Objective To compare the therapeutic effect between three cannulated screws and proximal femoral locking plate in treatment of femoral neck fracture.Methods A total of 75 patients were included,the three cannulated screws group contained 31 patients,and the proximal femoral locking plate group contained 44 patients.The clinical healing time,hip function score at last follow-up and postoperative complication were compared.Results All patients were followed up for 13-18 (15.3 ± 3.2) months.The excellent and good rate of proximal femoral locking plate group was 95.5％ (42/44),and three cannulated screws group was 83.9％(26/31),there was no statistical difference between the two groups (P ＞ 0.05).The clinical healing time of fracture and hip function score at last follow-up in proximal femoral locking plate group were significantly better than those in three cannulated screws group [(14.6 ± 1.7) weeks vs.(18.1 ± 4.9) weeks,(90.9 ± 3.5) scores vs.(82.3 ± 8.3) scores],there were statistical differences between the two groups (P ＜ 0.05).Conclusions Proximal femoral locking plate provides short clinical healing time of fracture,stable fixation,good biomechanical properties and a low rate of postoperative complication in treatment of femoral neck fracture.It is one of the ideal methods in treatment of femoral neck fracture.

Objective To investigate the differences in gene expression profiles of peripheral blood from patients with Keshan disease (KD) and the apoptosis mechanism in KD,to obtain diagnostic markers and establish diagnostic centroids plot for KD.Methods RNA was isolated from ten patients with KD diagnosed according to the clinical criteria for KD in China and ten health controls.The expression profiles were evaluated by Agilent 4 ×44K Whole Human Genome density oligonucleotide microarray analysis.The data were extracted by Agilent Feature Extraction Software t test,Pathway studio analysis and prediction analysis for microarray (PAM) were used to identify differently expressed genes,gene pathways,diagnostic markers and establish diagnostic centroids plot.Results Totally 1 570 up-regulated genes and 1 498 down-regulated genes were identified.Thirty-eight enrichment pathways were also identified,and the highest ranked by Pathway studio analysis was related to apoptosis.Six genes involved in apoptosis pathway were up-regulated in KD included ataxia telangiectasia mutated (ATM),cAMP-dependent protein kinase,protein kinase A (PKA),baculoviral IAP repeat-containing 2 (BIRC2),NLR family,apoptosis inhibitory protein (NAIP),BCL2-1ike 11 (Bim),BCL2-related protein A1 (BCL2A1) and down-regulated were 7 which included caspase 8 (CASP8),BCL2 binding component 3 (BBC3),BCL2--associated athanogene (BAG1),BCL2-associated X protein (BAX),BCL2-1ike 1 (BCL2L1),BCL2-related ovarian killer (BOK),and caspase 6 (CASP6).Forty-two diagnostic markers were obtained through PAM analysis.Conclusions Apoptosis related to genes and pathways might play an important role in the pathogenesis of KD.Forty-two markers could be used as molecular markers for the diagnosis of KD,which is important to the diagnosis of KD.

Multiple myeloma (MM) is characterized by genetic heterogeneity and is a common secondary hematological malignancy. Many studies have revealed that variation in the number of long non-coding RNAs (lncRNAs) is related to the degree of MM malignancy. Advances in molecular biology technologies, such as fluorescence in situ hybridization, high-throughput sequencing, gene microarrays, and qRT-PCR, have furthered research into cytogenetic malfunction in MM. Eleven newly discovered lncRNAs in MM have been fully interpreted according to the different mechanisms of MM and have the potential to be promising biomarkers for MM diagnosis and therapy.

Multiple myeloma (MM) is a kind of refractory diseases, characterized by clonal proliferation of malignant plasma cells. Thanks to the wide application of new drugs such as proteasome inhibitors and immunomodulators, the survival time of MM patients has been prolonged obviously. Cellular immunotherapies like genetically modified T cell, activated marrow-infiltrating lymphocytes, dendritic cell vaccines, natural killer cells and donor lymphocyte infusion have made great progresses in the field of MM management recently, following the stable advance in clinical trials. This review discusses the recent progress of cellular immunotherapy for MM.

OBJECTIVE To assess the association of copy number variations (CNVs) in chromosome 17q with the overall survival(OS) of patients with hepatocellular carcinoma(HCC), and to screen for target genes contained in the OS-related CNVs. METHODS A total of 174 HCC cases were enrolled. For 66 patients, the follow-up data was available. High-resolution Agilent Hu-244A array comparative genomic hybridization (aCGH) and Affymetrix U133 Plus 2.0 expression arrays were used to detect CNVs and gene expression of genes from the 17q region, respectively. The association of CNVs and OS was assessed with Log-rank test, Kaplan-Meier survival analysis, and Cox proportional hazards models. The gene expression in HCCs with 17q gain, HCCs without, and non-tumor liver tissues were compared with a Mann-Whitney U test. RESULTS Univariate association analysis showed that copy number gain in 17q25.1-25.3 was significantly associated with reduced OS (Log-rank test, P = 0.00002), and HCC cases with 17q25.1-25.3 gain had a 4.76-fold (95%CI: 2.31-9.81) increased hazard ratio (HR) for death from HCC, as compared to those without the gain. Multivariate Cox proportional hazards regression model revealed 17q25.1-25.3 gain to be an independent prognostic marker for poor OS (HR = 3.17, 95%CI: 1.39-7.26, P = 0.006). The expression levels of 18 genes in 17q25.1-25.3 including SLC9A3R1, GRB2, and TK1 were significantly increased in HCCs with gain than in those without (all P < 0.01) and non-tumor liver tissues (all P < 0.01). CONCLUSION The association of 17q25.1-25.3 gain with reduced OS has indicated that it is a prognostic marker for poor patient survival in HCC, for which SLC9A3R1, GRB2, and TK1 are candidate genes.
Adult ; Aged ; Carcinoma, Hepatocellular ; genetics ; mortality ; Chromosomes, Human, Pair 17 ; DNA Copy Number Variations ; Female ; Humans ; Liver Neoplasms ; genetics ; mortality ; Male ; Middle Aged

Objective:To investigate the application value of machine learning algorithms for gauze detection in laparoscopic pancreatic surgery.Methods:The retrospective and descriptive study was conducted. The 80 intact laparoscopic pancreatic surgery videos from Peking Union Medical College Hospital of Chinese Academy of Medical Sciences with timing of July 2017 to July 2020 were collected. The training set was used to train the neural network, and the test set was used to test the ability of neural network for gauze detection under different difficulties. Under the supervision of two superior doctors, videos that containing gauze were selected and classified according to recognition difficulty into three difficulty level including easy, normal and hard difficulty, and further divided based on random number method into training set with 61 videos and test set with 19 videos in a ratio of 3:1 roughly. The minimum enclosing rectangle of the gauze were marked frame by frame. All images were input to the neural network model for training after normalization and preprocessing. For every image, the output of neural network is the predicted minimum enclosing rectangle of gauze. The intersection over union >0.5 was identified as positive result. Observation indicators: (1) video annotation and classification; (2) test outcomes of neural network for test set.Count data were represented as absolute numbers or percentages.Results:(1) Video annotation and classification: a total of 26 893 frames of images form 80 videos were annotated, with 61 videos including 22 564 frames of images as the training set and 19 videos including 4 329 frames of images as the test set. Of the training set, 19 videos including 5 791 frames of images were classifed as easy difficulty, 38 videos including 15 771 frames of images were classifed as normal difficulty, 4 videos including 1 002 frames of images were classifed as hard difficulty, respectively. Of the test set, 4 videos including 1 684 frames of images were classifed as easy difficulty, 6 videos including 1 016 frames of images were classifed as normal difficulty, 9 videos including 1 629 frames of images were classifed as hard difficulty, respectively. (2) Test outcomes of neural network for test set: the overall sensitivity and accuracy of gauze detection by neural network in the test set were 78.471%(3 397/4 329) and 69.811%(3 397/4 866), respectively. The sensitivity and accuracy of gauze detection by neural network were 94.478%(1 591/1 684) and 83.168%(1 591/1 913) in easy difficulty test set. The sensitivity and accuracy of gauze detection by neural network were 80.413%(817/1 016) and 70.859%(817/1 153) in normal difficulty test set, 60.712%(989/1 629) and 54.944%(989/1 800)in hard difficulty test set. The frame rate reached more than or equally to 15 fps. The overall false negative rate and false positive rate of gauze detection by neural network in the test set were 21.529%(932/4 329) and 30.189%(1 469/4 866), respectively. The false negative was mainly due to the existence of blurred images, too small gauze exposure or blood immersion of gauze. The false positive was caused by the reflection of connective tissue or body fluids.Conclusion:The machine learning algorithms for gauze detection in laparoscopic pancreatic surgery is feasible, which could help medical staff identify gauze.

Objective:To analyze the safety and effectiveness of application of modified double-lumen microcatheter in the measurement of fractional flow reserve(FFR) in coronary bifurcation lesions.Methods:Total of 28 patients with coronary bifurcation lesions in two centers were divided into two groups:conventional technique group(CON) and novel technique group(NOV). The fluoroscopy time, contrast dye usage and FFR-related complications of the two groups were analyzed retrospectively.Results:There were 16 cases in CON group and 12 cases in NOV group. The median time required fluoroscopy in NOV group was significantly less than that in CON group; additionally, lesser amounts of contrast dye were used in NOV group (both P<0.05). The NOV group procedures were successfully accomplished in all cases without complications, such as damage of the pressure sensor, SB spasm or dissection. However, The CON group failed in three patients, including two who experienced coronary artery spasms( P>0.05). Conclusions:Limited experience suggests that the application of modified double-lumen microcatheter in the jailed SB FFR measurement after MV stenting is a safe and technically feasible approach.

Objective:To compare clinical characteristics,treatment patterns and physiological indicators in bipolar disorder(BD)patients with different age of onset.Methods:Totally 380 patients with DSM-5 BD were se-lected in this study.Psychiatrists diagnosed the patients using the Mini International Neuropsychiatric Interview.The clinical information questionnaire and the Global Assessment of Functioning scale were utilized to collected clinical characteristics,treatment status,and physiological indicators.The onset age of BD was divided into 21 and 35 years as cut-off points.Multivariate logistic regression and linear regression were used to analyze related factors.Results:Among the 380 patients with BD,199 cases were early-onset group(52.4％),121 cases were middle-onset group(31.8％),and 60 cases were late-onset group(15.8％).There were 26.6％of patients in the early-onset group in-itially diagnosed as depression,23.1％in the middle-onset group,and 11.7％in the late-onset group.Multivariate analysis revealed that compared to the early-onset group of BD,the middle-onset(OR=2.22)and late-onset(OR=4.99)groups had more risk to experience depressive episodes,and the late-onset group(OR=6.74)had 6.74 times of risk to suffer from bipolar Ⅱ disorder.Additionally,patients in the middle-onset(β=-1.52)and late-on-set(β=-4.29)groups had shorter durations of delayed treatment,and those in the middle-onset(β=-1.62)and late-onset(β=-3.14)groups had fewer hospitalizations.Uric acid levels were lower in both the middle-onset(β=-28.39)and late-onset(β=-31.47)groups,and total cholesterol level was lower in the middle-onset group(β=-0.23).Conclusion:Patients with BD in different age of onset show significant differences in clinical charac-teristics,treatment conditions and physiological indicators.