2 cm, 8 were operated and 2 were untreated. All the lesions were located outside the rectum. There were 3 cases of death and 5 cases of distant or lymph node metastasis. Out of the 44 cases, distant or lymph node metastasis occurred in 6 cases, the metastasis rate being 13.6%. Conclusions[WTBZ] Endoscopy is the first choice to diagnose digestive tract carcinoids, which, if ≤ 1 cm in diameter, can be treated with EMR.

OBJECTIVETo explore the clinical significance of high-sensitivity C-reactive protein (hsCRP) in the development of chronic hepatitis B (CHB).

METHODSA total of 182 patients with untreated CHB and 50 healthy individuals (controls) participated in the study. Correlation analysis was performed to determine the association of serum hs-CRP with the age,sex,medical history,serum hepatitis B virus (HBV) DNA, liver function parameters,liver stiffness measure (LSM) and hepatic fibrosis; in addition, correlation analysis was carried out for the associations of degree of liver damage with grade of hepatic fibrosis, LSM and the serum levels of hs-CRP.

RESULTSCHB patients showed significantly higher serum hs-CRP levels than healthy controls (2.38 ± 2.79 vs.0.78 ± 1.07; t =2.495, P < 0.05). Serum hs-CRP levels were significantly correlated with HBV DNA (r = 0.159), liver function parameters (total bilirubin, r = 0.271; alanine aminotransferase, r = 0.298; aspartate aminotransferase, r = 0.389), and LSM, r = 0.562) (all P < 0.05). The correlations with liver function (r = 0.340), LSM (r = 0.292) and hepatic fibrosis grade were positive (r = 0.434) (all P < 0.01).

CONCLUSIONSerum hs-CRP levels in CHB patients can reflect degree of liver damage and of liver fibrosis.

Objective The aim of this study was to explore the diagnostic value of liver stiffness measurement combined with serum high?sensitivity C?reactive protein detection in HBV?related cirrhosis patients complicated with primary liver cancer. Methods A total of 156 previously untreated chronic hepatitis B?related cirrhosis patients and 50 healthy subjects were included in this study. The 156 patients were divided into two groups: those with primary liver cancer ( 67 cases ) and without liver cancer ( 89 cases) . The 50 healthy subjects were considered as normal control group. Liver stiffness measurement ( LSM) was conducted and serum high?sensitivity C?reactive protein ( CRP) level was assayed in all the 156 patients and 50 normal individuals, and their measurement values were statistically compared and analyzed. Results The LSM value was (39. 72 ± 29. 05)kPa in the liver cancer patients, significantly higher than the (27. 81 ± 18. 46 ) kPa in the cirrhosis alone patients and ( 4. 25 ± 0. 74 ) kPa in the healthy controls (P<0. 01 for both). Serum hs?CRP levels in the liver cancer patients was 5. 81mg/L, significantly higher than 1. 78 mg/L in the cirrhosis alone patients and 0. 38mg/L in healthy controls, (P<0. 01 for both). The higher the grade of LSM values was, the positive rate of CRP was higher in the cirrhosis patients complicated with primary liver cancer. In patients with LSM values≥27. 6 kPa, the serum CRP positive rate was 64. 2%in patients with primary liver cancer, significantly higher than the 38. 0% in patients with cirrhosis alone (P<0. 01). In the 67 HBV?related cirrhosis patients complicated primary liver cancer, the LSM value and serum hs?CRP level in AFP?positive patients were ( 48. 95 ± 28. 59 ) kPa and 4. 91 mg/L, respectively, higher than those in the AFP?negative patients (28. 64 ± 26. 83) kPa and 4. 16 mg/L, but with a non?significant difference (P >0. 05). Conclusion Liver stiffness measurement combined with serum high? sensitivity C?reactive protein detection may have potential diagnostic implications as a marker of primary liver cancer occurrence in patients with HBV?related cirrhosis.

Objective The aim of this study was to explore the diagnostic value of liver stiffness measurement combined with serum high?sensitivity C?reactive protein detection in HBV?related cirrhosis patients complicated with primary liver cancer. Methods A total of 156 previously untreated chronic hepatitis B?related cirrhosis patients and 50 healthy subjects were included in this study. The 156 patients were divided into two groups: those with primary liver cancer ( 67 cases ) and without liver cancer ( 89 cases) . The 50 healthy subjects were considered as normal control group. Liver stiffness measurement ( LSM) was conducted and serum high?sensitivity C?reactive protein ( CRP) level was assayed in all the 156 patients and 50 normal individuals, and their measurement values were statistically compared and analyzed. Results The LSM value was (39. 72 ± 29. 05)kPa in the liver cancer patients, significantly higher than the (27. 81 ± 18. 46 ) kPa in the cirrhosis alone patients and ( 4. 25 ± 0. 74 ) kPa in the healthy controls (P<0. 01 for both). Serum hs?CRP levels in the liver cancer patients was 5. 81mg/L, significantly higher than 1. 78 mg/L in the cirrhosis alone patients and 0. 38mg/L in healthy controls, (P<0. 01 for both). The higher the grade of LSM values was, the positive rate of CRP was higher in the cirrhosis patients complicated with primary liver cancer. In patients with LSM values≥27. 6 kPa, the serum CRP positive rate was 64. 2%in patients with primary liver cancer, significantly higher than the 38. 0% in patients with cirrhosis alone (P<0. 01). In the 67 HBV?related cirrhosis patients complicated primary liver cancer, the LSM value and serum hs?CRP level in AFP?positive patients were ( 48. 95 ± 28. 59 ) kPa and 4. 91 mg/L, respectively, higher than those in the AFP?negative patients (28. 64 ± 26. 83) kPa and 4. 16 mg/L, but with a non?significant difference (P >0. 05). Conclusion Liver stiffness measurement combined with serum high? sensitivity C?reactive protein detection may have potential diagnostic implications as a marker of primary liver cancer occurrence in patients with HBV?related cirrhosis.

Objective:To analyze the clinical phenotype of adult patients with epidemic encephalitis B (encephalitis B) in Ningxia Hui Autonomous Region, and to explore the influence of related factors of the development of encephalitis B.Methods:The medical records of confirmed patients with encephalitis B admitted to the General Hospital of Ningxia Medical University from August to November 2018 were collected, and the general data of patients and the results of laboratory indexes such as blood routine examination and cerebrospinal fluid routine examination were analyzed. Logistic regression analysis and survival curve were used to evaluate the risk factors of the development of encephalitis B.Results:Totally 97 patients with encephalitis B were included, 32 of them died, with a case fatality rate of 32.99%. There were 63 males and 34 females, and the age of onset was (59.13 ± 14.70) years old. There were statistically significant differences in case distribution rate between different sexes and ages (χ 2 = 97.00, 291.00, P < 0.001). The most common clinical type was extremely severe (43 cases), followed by mild (27 cases), severe (15 cases) and ordinary (12 cases). The results of laboratory tests showed that the number of neutrophils, lymphocytes and monocytes in the blood of patients increased; and the white blood cells number in cerebrospinal fluid increased significantly, while neutrophils ratio increased slightly. There were significant differences in cerebrospinal fluid glucose level and neutrophil ratio among patients with different clinical types of encephalitis B ( H = 4.21, 2.74, P < 0.05). There were statistically significant differences in death, hypertension, cerebrovascular diseases, and pulmonary infection among patients with different clinical types of encephalitis B (χ 2 = 34.22, 16.97, 9.91, 15.59, P < 0.05). Logistic regression analysis showed that hypertension [ OR (95% CI) = 5.544 (1.450-21.191)] and pulmonary infection [ OR (95% CI) = 6.490 (1.887-22.325)] were risk factors for the development of encephalitis B patients ( P = 0.012, 0.003). Pulmonary infection was the influencing factor for the death of encephalitis B patients (χ 2 = 18.88, P < 0.001). The survival curve showed that the survival status of encephalitis B patients with cerebrovascular disease and pulmonary infection was significantly worse than that of patients without comorbidity or complications (χ 2 = 6.45, 20.33 , P < 0.05). Conclusions:The majority of encephalitis B patients in this outbreak are the elderly people, and the patient's nervous system has inflammatory reaction. Complicated pulmonary infection is an important factor for the aggravation and death of encephalitis B patients.

In order to improve the poor solubility and low bioavailability of paeonol (Pae), paeonol-nanoemulsion (Pae-NE) was prepared, and its effect on uptake of human umbilical vein endothelial cells (HUVECs) was investigated.Pae-NE was prepared by phase inversion composition (PIC), the formulation of Pae-NE was optimized by single factor method and central composite design-response surface method (CCD), and the pharmaceutical properties were further characterized.Moreover, MTT was applied to evaluate the toxicity of Pae-NE on HUVECs, and the cellular uptake efficiency of Pae-NE was detected by fluorescence microscopy and flow cytometry.The results showed that the optimal formulation of Pae-NE was 20 mg of Pae, 55.1 mg of LCT, 144.9 mg of MCT, 600 mg of HS15, and 200 mg of 1,2 propylene glycol.The Pae-NE appearance was a light blue emulsion, and the average particle size is (25.69 ± 0.03) nm, with PDI of 0.182 ± 0.09, Zeta potential of -(4.01 ± 0.30) mV and good stability.The drug loading of Pae-NE was (1.967 ± 0.28) mg/mL and encapsulation rate of (99.36 ± 0.1)%.Pae-NE performed no significant effect on HUVECs growth in the Pae concentration range of 10-1-10-3 μg/mL.Moreover, NE as a drug delivery carrier significantly enhanced the uptake efficiency of Pae on HUVECs.In conclusion, Pae-NE preparation method was simple and stable, and promotes HUVECs uptake efficiency of Pae, suggesting that NE was a better dosage form reference for the lipid-soluble drug of Pae.

Objective To analyze the magnetic resonance imaging (MRI) images of patients with adult Japanese encephalitis (JE),and to investigate the diagnostic value of MRI for the disease.Methods Thirty-two adult JE patients who underwent cranial MRI at General Hospital of Ningxia Medical University between August 2016 and September 2018 were enrolled.All patients had disease onset between August and September and they aged 17 to 83 years old.The clinical data,laboratory results,MRI signal characteristics of each scanning sequence and the distribution of the brain lesions were retrospectively analyzed.Results Of the 32 adult JE patients,29 (90.6％)cases had acute onset,28 (87.5％) cases had unconsciousness and cognitive impairment,26 (81.2％) cases had intracranial hypertension,3 (9.4％) cases had meningeal irritation,3 (9.4％) cases had Parkinson-like symptoms,10 (31.2％) cases had epilepsy,and 15 (46.9％) cases had decreased muscle strength.Twenty patients were positive for JE virus-specific IgM antibodies.Twenty-eight patients underwent cerebrospinal fluid examination,15 (53.6％) cases showed intracranial pressure ≥180 mmH2O (1 mmH2O =0.009 8 kPa),7 (25％) cases developed lymphocyte reaction,and 16 (57.1％) cases showed mixed cell reaction.Twenty-three cases (71.9％) showed lesions of brain on MRI,including thalamus (17 cases,73.9％),hippocampus (13 cases,56.5％),cerebral peduncle (6 cases,26.1％),cortical and subcortical (4 cases,17.4％),basal ganglia (2 cases,8.7％),brainstem (1 case,4.3％) and splenium of corpus callosum (1 case,4.3％).Positive T1 weight image (T1WI) and T2 weight image (T2WI) results were found in 21 patients,respectively,23 patients had positive T2-fluid attenuated inversion recovery (FLAIR) images,and 20 patients had positive diffusion weighted imaging (DWI) images.Among them,T2-FLAIR and DWI images showed more lesions,wider range of lesions and clearer boundary of cortical involvement range than T1WI and T2WI images.Conclusions Bilateral thalamus and hippocampus are often involved in adult JE.T2-FLAIR and DWI sequences are more sensitive to detect lesions.Combining MRI images with epidemiological characteristics,clinical manifestations,and laboratory tests is of great assistance for early diagnosis of JE.

Objective:To analyze the clinical phenotypic characteristics and therapeutic effect of cutaneous anthrax patients in Ningxia Hui Autonomous Region (referred to as Ningxia).Methods:A retrospective analysis was conducted on the medical records of 76 confirmed patients with cutaneous anthrax in three prefecture level hospitals in Ningxia from 2017 to 2022. According to the length of hospital treatment, the patients were divided into a disease course ≥7 d group ( n = 54) and a disease course < 7 d group ( n = 22), and the clinical phenotypic characteristics (including patients' general condition, clinical symptoms, and laboratory tests) and therapeutic effects (the effect of hormone use and the choice of antibiotics) of the two groups were analyzed by methods such as χ 2 test. Results:Among 76 patients with cutaneous anthrax, males accounted for 81.6% (62/76) and females accounted for 18.4% (14/76), with a statistically significant difference in gender composition ratio (χ 2 = 5.71, P = 0.017). Among the 76 patients, 73 caces (96.1%) achieved clinical cure. There was no statistically significant differences between the groups in clinical characteristics such as temperature, pain, pruritus, edema, and site of onset ( P > 0.05). There were no statistically significant differences between groups in laboratory tests such as blood routine, liver function, hypersensitive C-reactive protein, secretion culture, PCR, etc. ( P > 0.05). There was a statistically significant difference in the distribution of edema resolution time between patients using hormone or not (χ 2 = 17.01, P = 0.002). There was no statistically significant difference in the distribution of disease course between different antibiotic treatment regimens when using hormone (χ 2 = 5.43, P = 0.143). There was a statistically significant difference in the distribution of disease course between different antibiotic treatment regimens when no using hormone (χ 2 = 108.46, P < 0.001). Conclusions:The majority of cutaneous anthrax patients in Ningxia from 2017 to 2022 are males. Early use of hormones can affect the duration of edema in patients. For patients who have not received hormone therapy, different treatment plans can affect the patient's course of disease.

Objective To investigate the regulatory effect of miRNA-933 on the apoptosis and proliferation of human hepatic stellate cell line LX-2 and its mechanism.Methods Firstly,with human liver tissue for research,gene microarray technology was used to detect the differentially expressed genes in liver tissue between liver cirrhosis/chronic hepatitis B tissue and normal liver tissue,among which the significantly differentially expressed miRNAs were identified,and thus miRNA-933 was determined as the research object.Then,with the human hepatic stellate cell line LX-2 for research,miRNA-933 mimic and inhibitor(miRNA-933 siRNA)were used to construct the LX-2 models of overexpression and knockdown,and the cells transfected with mimic-NC(overexpression)or siRNA-NC(knockdown)were established as the negative control group.Quantitative real-time PCR and Western blot were used to measure the expression levels of miRNA-933 and activation biomarkers;techniques such as cell proliferation assay and flow cytometry were used to investigate the effect and mechanism of miRNA-933 on cell apoptosis,proliferation,and activation.The independent-samples t test was used for comparison of continuous data between two groups;a one-way analysis of variance was used for comparison between multiple groups,and Bonferroni correction was also performed.Results A total of 18 significantly differentially expressed miRNAs were obtained based on the results of gene microarray,among which miRNA-933 was significantly downregulated(P<0.05).After LX-2 cells were transfected with miRNA-933 mimic or siRNA,compared with the negative control group,miRNA-933 siRNA significantly downregulated the expression of miRNA-933(P=0.000 7),while miRNA-933 mimic significantly upregulated the expression of miRNA-933(P=0.000 3).Western blot and quantitative real-time PCR showed that miRNA-933 siRNA significantly upregulated the expression of collagen Ⅰ and α-SMA(P<0.001),while miRNA-933 mimic significantly inhibited the expression of collagen Ⅰ and α-SMA(P<0.05).Flow cytometry showed that compared with the negative control group,miRNA-933 siRNA significantly downregulated the apoptosis rate of LX-2 cells(P=0.031 9),and miRNA-933 mimic significantly upregulated the apoptosis rate of LX-2 cells(P=0.005 5).Western blot showed that compared with the negative control group,miRNA-933 siRNA could inhibit the expression of Caspase-3(P=0.006 7)and poly(ADP-ribose)polymerase-1(PARP-1)(P=0.003 0)and upregulate the expression of B-cell lymphoma-2(Bcl-2)in LX-2 cells(P=0.002 0),while miRNA-933 mimic could significantly upregulate the expression of Caspase-3(P=0.011 8)and PARP-1(P=0.049 5)and downregulated the expression of Bcl-2(P=0.002 1).Cell proliferation assay showed that compared with the negative control group,miRNA-933 siRNA could promote the proliferation of LX-2 cells(P=0.011 5),while on the contrary,miRNA-933 mimic could inhibit the proliferation of LX-2 cells(P=0.001 2).Western blot and quantitative real-time PCR showed that miRNA-933 siRNA significantly inhibited the expression of Kruppel-like factor 6(KLF6)and downregulated the expression of activating transcription factor 4(ATF4),activating transcription factor 3(ATF3),and C/EBP homologous protein(CHOP),while miRNA-933 mimic promoted the expression of the above proteins(all P<0.05).Conclusion This study shows that miRNA-933 may promote cell apoptosis and inhibit cell activation and proliferation by promoting the activation of the KLF6/ATF4/ATF3/CHOP/Bcl-2 signal axis in LX-2 cells.

Objective:To explore the prognostic predictive value of neutrophil/lymphocyte ratio (NLR) combined with prognostic nutritional index (PNI) in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).Methods:Clinical data from 149 HBV-ACLF patients admitted to the infectious diseases Department of the General Hospital of Ningxia Medical University were retrospectively analyzed. Demographic data of the enrolled patients and the initial clinical-related data after admission were collected. Patients were divided into survival (93 cases) and death groups (56 cases) according to their prognostic condition 90 days after discharge. Demographic and clinical differences were compared between the two groups data. Receiver operating characteristic (ROC) curves were plotted to determine the optimal cutoff values for NLR and PNI in predicting the 90-day mortality rate of HBV-ACLF patients. The COX regression model was used to conduct univariate and multivariate analyses to investigate the correlation between NLR and PNI and the prognosis of HBV-ACLF patients. Kaplan-Meier survival analysis was used to explore the effects of NLR and PNI on the survival of HBV-ACLF patients.Results:The death group NLR was higher than that of the survival group, while the PNI was lower than that of the survival group, with a statistically significant difference. The area under the receiver operating characteristic curve (0.842, 95% CI: 0.779-0.906) showed patients with adverse prognosis assessed by NLR combined with PNI had a superior prognosis than that of the Model for End-Stage Liver Disease (MELD) and its combined serum sodium (MELD-Na) and Child-Turcotte-Pugh (CTP) scores. COX regression analysis showed that NLR≥3.03 and MELD score were independent risk factors affecting the prognosis of HBV-ACLF patients. PNI > 36.13 was a protective factor for evaluating the prognosis of HBV-ACLF patients. Conclusion:NLR combined with PNI can enhance the prognostic predictive value of HBV-ACLF.