BACKGROUND:Many liver cancer stem cel markers have been found in liver cancer tissues and cel lines such as CD133, acetaldehyde dehydrogenase (ALDH), CD90, CD44, EpcAM, CD13, OV6, K19, c-kit and ABCG2. Of them, CD133, CD90 and CD44 have been shown to be strongly associated with the recurrence and metastasis of liver cancer. OBJECTIVE:To explore the dynamic changes of liver cancer stem cel markers and inflammatory factors during the induction of liver cancer in rats and their correlation. METHODS:Diethyl nitrosamine solution was given to Sprague-Dawley rats for 24 hours to induce rat models of liver cancer. Rats that were given common water were considered as the healthy control group. RESULTS AND CONCLUSION: Immunohistochemical staining revealed that Kupffer cels-related ED2 expression showed a gradual increase in the model group. Compared with the healthy control group, ED2 expression was significantly higher at 12, 16, 20 and 24 weeks after induction in the model group (P < 0.05). Quantitative PCR demonstrated that CD90 showed a gradualy increased trend during induction (P < 0.05). Compared with healthy tissue, CD90 increased significantly in the liver cancer tissue (P < 0.05). CD133 showed an increased trend, but one-way analysis of variance did not show significant differences (P > 0.05). During induction, no significant change was found in other liver cancer stem cel markers (P> 0.05). During the induction, tumor necrosis factor α, transforming growth factor β, MCP-1 and interleukin-6 expression levels were significantly increased (P < 0.05). Compared with healthy tissue, transforming growth factor β, MCP-1 and interleukin-6 expression levels were significantly higher in the liver cancer tissue (P < 0.05). Other inflammatory factors did not exhibit significant alterations during the induction (P > 0.05). Pearson correlation analysis demonstrated that MCP-1, transforming growth factor βand interleukin-6 expression levels were significantly positively correlated with CD90 expression (P < 0.05). These findings suggest that partial inflammatory factors released from Kupffer cels have a certain correlation with liver cancer stem cels. Kupffer cels can promote the occurrence of liver cancer.

Objective To explore the value of multislice CT (MSCT)in the diagnosis of complex congenital heart disease (FCHD)in children.Methods 41 children cases with clinical diagnosis of congenital heart disease were collected randomly.All the children were examined with MSCT and ultrasonic cardiogram(UCG)examination,and 20 cases were examined with cadioangiography(CAG) check.All the cases were confirmed by surgery.The results of Preoperative MSCT,UCG and the CAG heart examination diagnosis were compared with surgical diagnosis results.Results Surgery confirmed 225 deformities and 1 1 5 intracardiac malformations.In the intracardiacmal malformations,the accurate diagnostic rates of MSCT,UCG,the CAG were 92.2%,99.1% and 74.4%,respectively;With surgery confirmed 110 heart malformations,the accurate diagnostic rates of MSCT,UCG,the CAG were 98.2%,84.5%,96.2%,respec-tively.The combined use of MSCT and UCG confirmed 224 correct diagnoses,the diagnosis coincidence rate reached 99.6%;The check accuracy of MSCT was highter than UCG in congenital heart disease with heart malformations(χ2 =12.962,P <0.05),The differences has statistical significance.Conclusion The check accuracy of MSCT is better in the diagnosis of congenital heart disease.The joint application of MSCT and UCG can obviously improve the accuracy of the diagnosis of congenital heart disease and congenital anoma-lies.

Objective To investigate the effect of Shugan-Yishen formula on Tamoxifen-resistant MCF-7 cell line(LCC9) through HER2-ERK/MAPK-ERα pathway. Methods Four serums were prepared with the method of serum pharmacology:the serum of Shugan-Yishen formula, Shugan-Yishen formula plus Tamoxifen(TAM), blank and TAM alone. After LCC-9 cells were affected in the above-mentioed serums in vitro, the inhibition rate and the level of mRNA as well as the protein expression of HER2, ERα, ERK/MAPK, p-ERK/MAPK were detected. Results MTT showed that TAM alone group、Shugan-Yishen formula group and the Shugan-Yishen formula plus TAM group had higher inhibition rates at 48th hour, the inhibition rates was(6.61±0.129)%, (47.43±2.24)%, (54.19±3.364)%, compared to the blank group, Shugan-Yishen formula group and the Shugan-Yishen formula plus TAM group had a stronger inhibition on LCC9 at 48th hour (P<0.05), and the combination group was better than Shugan-Yishen formula alone(P<0.05), there was no difference between TAM group compared to the blank group(P>0.05). RT-PCR result showed that compared to the blank group, the expression levels of ESR1 mRNA of group of Shugan Yishen formula plus TAM werehigher by and large at 48th hour (P<0.05), the expression of ESR1 mRNA was(2.282±0.185);and the levels of ERBB2, MAPK3 mRNAwere lower(P<0.05), which levels were(0.71±0.095), (0.336±0.058). Western blotting result showed that Shugan-Yishen Formula plus TAM group could markedly decrease the expression of HER2, p-ERK/MAPK of LCC9 at 48th hour (P<0.05), which the expressions were(0.708± 0.072), (0.228±0.034), and the expression of ER-αelevated(P<0.05). There was no significant difference on ERK/MAPK(P>0.05). Conclusions ①The combination of Shugan-Yishen formula with tamoxifen can inhibit the LCC9 cells. The inhibition effect reaches the peak at 48th hour. ②The mechanism of Shugan-Yishen formula plus TAM combination effects on human breast cancer TAM-resistant cell line LCC9 may improve the sensitivity of ERαby inhibiting the expression of HER2, ERK/MAPK.

Objective To explore a new method of establishing rat model of acute myocardial infarction by off ventilator support,spurt and repeated cryoinjury.Methods Sixty Wistar rats with male and female in half were randomized into three experimental groups according to cryoinjury time with 20 rats in each group:15-second group(cryoinjury for 5 s each time,three times in total),25-second group(5 s each time,five times in total)and 40-second group(5 s each time,eight times in total).The heart was exposed through a 1.0-to 1.5-cm left lateral thoracotomy.Cryoinjury of the LV free wall(LVFW)was performed by applying for 5 s a round copper probe of 6-mm in diameter immersed in liquid nitrogen for 5 min to reach-190 ℃,then the thoracic cavity was closed immediately.When the rats' breath restored,the cryoinjury of the LVFW in situ was repeatedly to ensure a transmural injury according to the protocol.The survival rate during operation and in 28 days after operation was observed.Also infarct size was observed by heart pathological section stained with Masson's trichrome on day 28 after operation.Results Infarct size in all three groups was larger than 20% signified by transmural injury,and completely myocardiolysis and distinct infarct boundary were observed.The survival rate was 16/20 in 15-second group,5/20 in 40-second group(P0.05 vs 15-second group and 40-second group).The infarct size in 40-second group was larger than the other two groups(standard deviation:10.564 4% vs 5.192 6%,6.496 0% in 15,25-second group,respectively)and its survival rate was lowest.The procedure of 25-second group was more complicated and had a tendency of higher death rate than that in 15-second group.Conclusion Using spurt,repeated ultra low temperature cryoinjury for 15 s may be an ideal method to establish the rat model of acute myocardial infarction.

Objective To explore the most effective formula to predict the catheterization length of the right internal jugular vein by an-terior approach. Methods Sixty-seven cases performed with right internal jugular vein catheterization from January 2013 to June 2013 were enrolled in this study and 4 formulas were selected to predict the catheterization lengths. Comparing their predicted lengths with the actual lengths defined as the lengths of the internal catheters which terminals were inserted to a accurate position,and analyse their predictive validi-ty. Results The predictive error percentages of the 4 formulas were all less than 15%. Comparing the predicted lengths and the actual lengths, there was no difference between the predicted length of the 1st formula and the actual one(P>0. 05),and the predicted lengths of the other three formulas were significantly less than the actual ones(P<0. 05). Comparing the mean absolute predictive errors of the 4 formu-las in the 3 height groups of 150~159 cm,160~169 cm and 170~179 cm,respectively,those of the 4th formula were all significantly higher than those of the 1st formula in all the 3 groups(P<0. 05);and no differences between those of the 2nd or the 3rd formula and those of the 1st formula were observed(P>0. 05). Conclusion The predictive error of all the 4 formulas is less than 15%, and the 1st formula is simple,practical and associated with a much smaller error,more suitable to estimate the length of the right internal jugular vein catheterization by anterior approach.

Objective To analyze and summarize the clinical features of delayed occurrence of senile asthma,to add the knowledge and understanding of the disease. Methods To retrospectively analyze clinical data of the cases of senile asthma treated in our hospital,all the cases were divided into groups of early onset senile asthma and delayed occurrence senile asthma,according to the age of first onset.Then related indexes were analyzed,to summarize the clinical features of group of delayed occurrence of senile asthma. Results There were 28 cases of delayed occurrence of senile asthma,accounting for 34.6% of total cases.Compared to early onset group,there was no significant difference (all P＞0.05) between two groups for the following items such as age,allergic history and positive rate of family's history,disease causes,clinical symptoms,basic diseases and complications,proportion of severe cases,rate of misdiagnosis and mistreatment,proportion of standardized treatment and un-standardized treatment,prognosis of diseases and mortality.Both groups had low rate of knowledge and application on PEF monitoring equipment and ACT score.The period of misdiagnosis and mistreatment for delayed occurrence group was shorter than the early onset group (P＜0.05＝; the seasonal nature and day and night pattern was significant in delayed occurrence group (P＜0.05＝. Conclusion Late onset elderly asthma had the features such as shorter course of the disease,relatively obvious onset rule during day and night,and obvious symptoms during night,which are different from that of early onset group.

Objective To compare the application value of three different planes obtained by automated breast volume scanner for the observation of margin characteristics of breast masses.Methods Two hundred and eight women patients with 237 masses (120 benign and 1 1 7 malignant,confirmed by pathology)were included in this study.The detection rates of mass margin characteristics in three different planes were compared.The diagnostic performance of mass margin characteristics in differentiating benign and malignant breast masses in three different planes was compared by area under the ROC curve (AUC). Results The detection rate of angular margins for malignant masses in sagittal planes(41 .9%)was higher than that in coronal planes(22.2%)and axial planes(26.5%)with statistical difference (P =0.001 ,0.013);the detection rate of spiculated margins for malignant masses in coronal planes(42.7%)was higher than that in sagittal planes (1 1 .1 %)and axial planes (1 7.1 %)with statistical difference (both P < 0.001 ).No significant difference was found between any two of the three planes in the detection rates of margin characteristics for benign masses.The AUC of angular margins in sagittal planes (0.693)was higher than that in coronal planes (0.607)and axial planes (0.624);the AUC of spiculated margins in coronal planes (0.697)was higher than that in sagittal planes (0.55 1 )and axial planes (0.573 );the AUC of indistinct margins in axial planes(0.606)was higher than that in coronal planes (0.552)and sagittal planes (0.552);the AUC of microlobulated margins in axial planes (0.825)was higher than that in coronal planes (0.778) and sagittal planes (0.81 7).Conclusions Three different planes of ABVS have their own advantages for the observation of margin characteristics of breast masses.

Objective To explore the effect of comorbidities on the surgical outcomes of elderly patients with hip fracture. Methods The Age,gender,weight,type of fracture,preoperative comorbidities and surgical outcomes of 117 patients aged 80 yr or over who undergoing hip fracture surgery in our hospital were recorded. Patients were divided into rehabilitation group and postoperative in-hospital death group ac-cording to surgical outcomes. The potential predictors of postoperative in-hospital death were identified by univariate model and were then entered into multiple Logistic regression analysis. Results Twenty three patients(19. 7%)had no comorbidity,94 patients(80. 3%)had one or more comorbidities. Ten patients(8. 5%)died in hospital after the operation. Predictors of postoperative in-hospital death were preoperative respiratory diseases and three or more comorbidities. Conclusion Surgical outcomes of elderly patients with hip fracture may be predicted by analysing preoperative comorbidities. Preoperative preparations must be sufficient in order to ensure successful operation.

Objective:To investigate the difference of radiofrequency ablation combined with ethanol ablation and radiofrequency ablation in the treatment of benign cystic solid thyroid nodule.Methods:A total of 80 patients who visited the Thyroid Surgery Department of the First Affiliated Hospital of Zhengzhou University from January 2015 to July 2018 were selected. All selected patients are required to meet the following criteria: (1)Color doppler ultrasonography of the neck revealed a cystic solid thyroid nodule greater than 20 mm in diameter. (2) The results of fine needle aspiration cytology of thyroid nodules were benign. (3)The patients is to undergo radiofrequency ablation of thyroid nodule. According to the condition and patients′ wishes, radiofrequency ablation (Group A, n=40) and combined ethanol and radiofrequency ablation(Group B, n=40) were performed respectively to observe the changes of nodule volume and maximum diameter at 3, 6 and 12 months after surgery.The difference of intraoperative radiofrequency ablation energy, postoperative complications and patient satisfaction at 12 months after operation were also observed. The respective clinical effects of the two groups and the difference of curative effects between the two groups were analyzed. Two-factor repeated measurement analysis of variance or independent sample t test was used to compare the measurement data in line with normal distribution between groups. Friedman′s rank sum test was used for comparison of measurement data groups that did not conform to normal distribution, and Bonferroni correction was used for pairwise comparison. Chi-square test was used to compare the counting data between groups. Results:On the 12th months after operation, the volume reduction of of nodules in group B was greater than that of group A, and the difference was statistically significant[(7.0±5.1) mL vs (5.5±4.9) mL, P<0.05]. The maximum diameter reduction of nodules in group B was greater than that of group A and the difference was statistically significant [(1.5±0.6) cm vs (1.4±0.8) cm, P<0.05]. During the period of 6 to 12 months after operation, the trend of nodular shrinkage in group B was more obvious than that in group A ( P<0.05). The radiofrequency ablation energy of group was lower than that of group A, and the difference was statistically significant [(2.37±1.18) kJ vs (3.89±1.17) kJ, P<0.05]. Voice reduction occurred in 2 cases and recovered within 2 weeks.Local bleeding occurred in 1 case during the operation, which was stopped after ablation. There was no statistical significance in the satisfaction of patients in group A and group B (87.5% vs 90%, P>0.05). Conclusion:Compared with radiofrequency ablation, radiofrequency ablation combined with ethanol ablation for benign cystic solid thyroid nodules can achieve better nodule reduction effect and reduce the ablation energy.

Consensus ; Hirschsprung Disease ; diagnosis ; Humans