Objective To study the anatomical structure and the distribution of the right posterior sectional Glissonean pedicle so as to provide the anatomical basis for liver resection of the right posterior section.Method By studying the morphological features of the right posterior sectional Glissonean pedicle through peeling and dissecting 20 adult corpses without liver pathological.Result In 95％ of the right posterior sectional Glissonean pedicles there were shared branches.The angle between the GRL/GRA was 81.4° ± 13.8°.In 30％,the right posterior sectional Glissonean pedicle presented as a Y or a V.In a Y shaped,the angle between G6/G7 was 71 ° ±3.92°.The shapes of 70％ of the right posterior sectional Glissonean pedicle presented as a C.The number of branches at the tertiary level was between 3-8.Conclusion The distribution of the right posterior sectional of the Glissonean pedicle did not entirely fit the description of Couinaud's segments.Obvious individual differences existed.Under this circumstance,understanding the anatomy of the right posterior sectional Glissonean pedicle before carrying out partial hepatectomy would be helpful in reducing surgical risks and postoperative complications.

Objective To analyze the prevalence and clinical features of cytomegalovirus (CMV)infection in patients with systemic lupus erythematosus (SLE).Methods Patients with SLE in Peking University Third Hospital from 2013 to 2015 and age and sex matched healthy controls were enrolled.All patients were detected for CMV antibody,CMV DNA and CMV PP65 in the blood.The prevalence of CMV infection and the clinical characteristics were analyzed using Chi-square test.Results Altogether 349 SLE patients and 209 healthy controls were enrolled.In SLE group,the positive rate of CMV IgG was 90.3％ (315/349),which was similar to that of the control group,while the positive rate of CMV IgM was 8.0％ (28/349),which wassignificantly higher than controls 1.4％(3/209) (x2=10.811,P=0.001),and the active CMV infection rate was 69.1％(241/349).Those in the active phase of SLE were more likely to have active CMV infection when compared with those in remission [75.4％(93/256) vs 51.6％(48/93),x2=18.049,P＜0.01].The percentage [43.2％(104/241)] of severe patients in those with active CMV infection was much higher than that in those without CMV infection 9.2％(10/108) (x2=38.953,P＜0.01).Those SLE patients had active CMV infection were clinically more severe and the most common clinical manifestation were proteinuria/hemoturia,cytopenia and fever.Conclusion In SLE patients,the positive rate of CMV IgM is significantly higher than healthy control and the prevalence of active CMV infection is high,especially in those at active disease.Those with active CMV infection are clinically more severe but have no features of active CMV infection,which indicates that the CMV infection might be a trigger of SLE activity.

Objective:The study was aimed to investigate the bone mineral density (BMD) status of newly diagnosed systemic lupus erythematous (SLE) patients.Methods:Newly diagnosed SLE patients and healthy controls in Peking University Third Hospital from 2014 to 2018 were enrolled into this cross-sectional study. Medical records including systemic lupus erythematosus disease activity index (SLEDAI)-2000 and BMD of the lumbar vertebrae and hips measured by dual-energy X-ray absorptiometry were collected. Patients were divided into normal and low BMD groups. Parameters were compared by Student- t test, Mann-Whitney U test and χ 2 test. Results:Eighty-nine patients and 20 healthy controls were included. Approximately 52.8% of the SLE patients had low BMD. Compared to the healthy control group, the BMD of lumbar spine and hip was obviously lower than in the newly diagnosed SLE group[(0.97±0.14) g/cm 2, (1.08±0.10) g/cm 2, t=3.548, P<0.01; (0.88±0.15) g/cm 2, (1.00±0.08) g/cm 2, t=3.878, P<0.01]. The BMD of lumbar spine and hip in the low BMD group was lower than that in the normal BMD group [(0.88±0.10) g/cm 2, (0.80±0.11) g/cm 2; (1.07±0.11) g/cm 2, (0.97±0.13) g/cm 2, respectively]. Compared with the normal BMD group, the body mass index (BMI) was significantly lower [(19.2±2.0) kg/m 2, (23.2±3.6) kg/m 2 respectively, t=3.678, P<0.01], the disease duration was longer [(45.7±7.7) weeks, (16.0±19.5) weeks, respectively, t=-3.306, P<0.01). Patients with low BMD tended to have lower 25-hydroxy-vitamin-D(25-OH-VD 3) level and higher bone metabolism marker levels (Degradation products of collagen B) [(9±5) nmol/L vs (12±7) nmol/L, t=1.385, P>0.05; 0.62(0.21, 1.61) ng/ml vs 0.43(0.19, 0.88) ng/ml, Z=0.624, P>0.05], although their differences didn't reach the statistical significant difference. Conclusion:Newly diagnosed SLE patients' BMD is lower than the healthy people. About 52.8% newly diagnosed untreated SLE patients have low BMD. Lower BMI and longer disease duration are their clinical characteristics. High bone metabolism marker levels, low 25-hydroxy-vitamin-D level might have clinical significance, although the current findings do not find statistically significant difference. Large sample size is required for subsequent research analysis.

Objective In this study,Knoevenagel derivatives of curcumin were synthesized,and their oil-water partition coefficient were determined.Our aim is to provide an experimental basis for further development of curcumin derivatives.Methods Two Knoevenagel derivatives of curcumin,including 4-(thiophen-2-ylidene)curcumin(3a)and 4-(pyridine-4-ylidene)curcumin(3b),were obtained by using the methylene group of curcumin as the modification site and purified by column chromatography.The structures of these derivatives were confirmed by nuclear magnetic resonance spectroscopy(NMR),infrared(IR)and high-resolution liquid mass spectrometry(HRLC-MS).The oil-water partition coefficient of the derivatives in n-octanol aqueous solution was determined by quantitative analysis using HPLC.Results Knoevenagel derivatives of curcumin were successfully synthesis.The oil-water partition coefficients(lgPap)of curcumin derivatives 3a and 3b are 0.96 and 0.82,respectively.Compared with the oil-water partition coefficient of curcumin(lgPap=3.85),it suggested that curcumin derivatives showed better water solubility than curcumin.Conclusion Compared to the curcumin prototype,Knoevenagel derivatives of curcumin increased water solubility and improved bioavailability.Thus,it may provide experimental basis for introducing heteroarylene moiety of the methylene position of curcumin to enhance pharmacological activity.

OBJECTIVETo study the repair effect of low intensity pulsed ultrasound (LIPUS) irradiating combined with guided bone regeneration (GBR) on the defect of Beagle dog canines periodontal bone.

METHODSFour canine teeth of every beagle dog (8 beagle dogs) were randomly distributed: Group 1 (LIPUS disposal + GBR+ autogenous bone graft group), group 2 (LIPUS disposal + autogenous bone graft group), group 3 (GBR + autogenous bone graft group), blank control group. The model of periodontal bone defect was established in the 1/3 part of the root buccal area. According to the group division, autogenous bone were grafted, group 1 and group 2 were disposed by LIPUS 20 min x d(-1). The intensity of ultrasound were 30 mW x cm(-2). Group 1 and group 3 were injected with Bio-Gide collagen membrane. The beagle dogs were executed at 6 and 8 weeks of the disposal of LIPUS and then Micro-CT test and analysis were conducted to periodontal bone defect area of each group.

RESULTSBy clinical observation, there were different degrees of shrinkages of the area of periodontal bone defect in each group. The Micro-CT test analysis indicated that there was a statistical difference among the number, the thickness as well as the size of bone trabecula of each group (P < 0.05). However, there was no statistical difference (P > 0.05) in terms of bone issue measurement index between 6 to B weeks of each group. Group 1 had the most new bone.

CONCLUSIONLIPUS has the potential to promote the repair of periodontal bone defect. Therefore the combination of LIPUS and GBR may be more conducive to the repair and regeneration of periodontal bone defect.

Objective:To investigate the correlation between serum cystatin C (CysC) and clinical and pathological features of IgA nephropathy.Methods:Four hundred and twenty-one cases of primary IgA nephropathy diagnosed by renal biopsy in Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2010 to January 2021 were retrospectively analyzed. According to the serum CysC level at the time of renal biopsy, the patients were divided into high serum CysC group and normal serum CysC group, and the clinical data and pathological indices of the patients were compared. Spearman correlation analysis was used to analyze the correlation between estimated glomerular filtration rate (eGFR) and serum CysC. The clinicopathological factors related to the serum CysC level were analyzed by multiple linear regression. The area under the receiver operator characteristic curve (AUC) was used to evaluate the ability of serum CysC level to predict related pathological injury.Results:The age, prevalence of hypertension, serum creatinine, urea and uric acid levels of high serum CysC group were significantly higher than those of normal serum CysC group, while the eGFR level was significantly lower than that of normal serum CysC group ( P<0.05). Spearman correlation analysis showed that serum CysC was negatively correlated with eGFR ( r=-0.744, P<0.001). In terms of pathological injury, the degree of renal tubular atrophy and renal interstitial fibrosis (T) and renal arteriole wall thickening (A) in high serum CysC group were more serious than those in normal serum CysC group ( P<0.05). Multiple linear regression analysis showed that the prevalence of hypertension, serum creatinine, urea, uric acid, T and A were correlated with serum CysC levels (standard regression coefficient β=0.048, 0.299, 0.260, 0.134, 0.195, 0.068, respectively, P<0.05). After adding serum CysC on the basis of clinical features, the prediction efficiency of renal tubular atrophy and renal interstitial fibrosis was higher (AUC were 0.829 [95% CI 0.787-0.870], 0.847 [95% CI 0.808-0.886], P<0.05). Conclusions:Patients with older age, hypertension, poor renal function and severe pathological damage are more likely to have elevated serum CysC levels. Serum CysC was related to the prevalence of hypertension, creatinine, urea, uric acid, T and A. Combined with serum CysC level can effectively improve the ability prediction of T.

Objective:To study a deep learning-based dual-modality fundus camera which was used to study retinal blood oxygen saturation and vascular morphology changes in eyes with branch retinal vein occlusion (BRVO).Methods:A prospective study. From May to October 2020, 31 patients (31 eyes) of BRVO (BRVO group) and 20 healthy volunteers (20 eyes) with matched gender and age (control group) were included in the study. Among 31 patients (31 eyes) in BRVO group, 20 patients (20 eyes) received one intravitreal injection of anti-vascular endothelial growth factor drugs before, and 11 patients (11 eyes) did not receive any treatment. They were divided into treatment group and untreated group accordingly. Retinal images were collected with a dual-modality fundus camera; arterial and vein segments were segmented in the macular region of interest (MROI) using deep learning; the optical density ratio was used to calculate retinal blood oxygen saturation (SO 2) on the affected and non-involved sides of the eyes in the control group and patients in the BRVO group, and calculated the diameter, curvature, fractal dimension and density of arteriovenous in MROI. Quantitative data were compared between groups using one-way analysis of variance. Results:There was a statistically significant difference in arterial SO 2 (SO 2 -A) in the MROI between the affected eyes, the fellow eyes in the BRVO group and the control group ( F=4.925, P<0.001), but there was no difference in the venous SO 2 (SO 2-V) ( F=0.607, P=0.178). Compared with the control group, the SO 2-A in the MROI of the affected side and the non-involved side of the untreated group was increased, and the difference was statistically significant ( F=4.925, P=0.012); there was no significant difference in SO 2-V ( F=0.607, P=0.550). There was no significant difference in SO 2-A and SO 2-V in the MROI between the affected side, the non-involved side in the treatment group and the control group ( F=0.159, 1.701; P=0.854, 0.197). There was no significant difference in SO 2-A and SO 2-V in MROI between the affected side of the treatment group, the untreated group and the control group ( F=2.553, 0.265; P=0.088, 0.546). The ophthalmic artery diameter, arterial curvature, arterial fractal dimension, vein fractal dimension, arterial density, and vein density were compared in the untreated group, the treatment group, and the control group, and the differences were statistically significant ( F=3.527, 3.322, 7.251, 26.128, 4.782, 5.612; P=0.047, 0.044, 0.002, <0.001, 0.013, 0.006); there was no significant difference in vein diameter and vein curvature ( F=2.132, 1.199; P=0.143, 0.321). Conclusion:Arterial SO 2 in BRVO patients is higher than that in healthy eyes, it decreases after anti-anti-vascular endothelial growth factor drugs treatment, SO 2-V is unchanged.

Objective The Kellinghaus grading method was used to manually read and grade the thin-layer CT of sternal end of clavicle,and a variety of traditional statistical methods as well as machine learning methods were used to construct age estimation models for adolescents and adults in early adulthood,to explore the value of the application of machine learning technology in the study of age estimation of the Han Chinese population in Sichuan.Methods Thin-section CT images of the chest were retrospectively collected from 491 individuals aged 10～30 years,and the collected samples were assigned a reading grade with reference to the Kellinghaus grading method.10%of the xases were randomly selected as the test set,and the remaining data were used as the training set to construct a variety of traditional statistical regression models and machine learning models for estimating the age of adolescents and adults in early adulthood,and the performance of the models was evaluated by using the mean absolute error(MAE).Results The statistical regression model with the best efficacy was the cubic regression model,with an MAE value of 1.34 for males and 1.57 for females;of the three machine learning models,the Random Forest model had the best predictive efficacy for males,with an MAE value of 1.39,and the Support Vector model had the best predictive efficacy for females,with an MAE value of 1.51.Conclusion In the construction of age estimation models for sternal end of clavicle,the machine learning model has a certain improvement in the accuracy of age prediction,but there is no obvious advantage compared with the traditional statistical regression model,and the use of the machine learning method in age estimation based on sternal end of clavicle still needs further exploration.

Objective:To study the expression level of CD73 in cutaneous melanoma and its clinical significance, and to explore its role and molecular mechanism in the occurrence and development of melanoma.Methods:Expression level of the gene NT5E in melanoma was analyzed according to RNA sequencing data from the CCLE database. CD73 expression level was tested in 145 melanoma tissues and corresponding para-tumor tissues by immunohistochemistry tissue microarray. The samples came from 78 male and 67 female patients who received surgical resection and were pathologically diagnosed as melanoma in the department of plastic surgery in Zhongshan Hospital from January of 2008 to December of 2017. The relationship between CD73 expression level and clinicopathological features as well as prognosis was analyzed. Melanoma cell line was transfected with CD73 gene overexpression lentivirus and negative control vectors, respectively. The transfection efficiency was verified by qRT-PCR and Western blot. CCK-8, wound healing and Transwell assays were used to evaluate the proliferation, migration and invasion abilities of the overexpression group and control group. Subcutaneous xenograft tumor models were established in nude mice to assess the tumorigenicity of the two groups. Transcriptome sequencing, GO and KEGG analyses were performed. The expression levels of pAKT and pGSK3β were detected by Western blot. The measurement data were expressed as Mean ±SD. Independent sample t-test was used for comparison between the two groups, and One-way ANOVA was employed for multi-group comparisons. The chi-square test was used for the categorical variables. P<0.05 was considered as statistically significant difference. Results:The expression of CD73 in melanoma was higher than that in para-tumor tissues ( P< 0.05). Higher expression level of CD73 was associated with higher Clark grade ( P= 0.014) and clinical stage ( P= 0.040). The overall survival and disease-free survival of patients with high-CD73-expression were significantly lower than those of patients with low-CD73-expression. CD73 expression, Clark grade and clinical stage are independent risk factors for the poor prognosis of patients with melanoma. Overexpression of CD73 significantly enhanced the proliferation, migration and invasion of melanoma cells in vitro and the tumorigenicity in vivo( P< 0.05). Transcriptome sequencing showed that CD73 was involved in several tumor related signaling pathways, among which the expression of pAKT and pGSK3β was elevated( P< 0.05). Conclusions:CD73 promotes the proliferation, migration and invasion of melanoma cells in vitro and the tumorigenicity in vivo through activating AKT signaling. CD73 is expected to become a new prognostic biomarker and therapeutic target for melanoma.

Objective To evaluate the effect of modulating gut microbiota for improving brain injury in rats with post-stroke depression.Methods Adult SD rats were randomized into normal control,middle cerebral artery occlusion(MCAO),post-stroke depression(PSD),PSD with fecal transplantation,PSD with antibiotics(rifaximin),PSD with probiotics(lactobacilli),and PSD with fluoxetine treatment groups(n=9).Neurological function scores of the rats were determined,and the changes in sugar water preference and immobility time in forced swimming test were observed;plasma levels of trimethylamine N-oxide(TMAO)and hydrogen sulfide(H2S)were detected with ELISA,Occludin,and the expressions of occludin,caudin-5 and IgG proteins I the brain tissues were determined using Western blotting.Results Compared with those in the control group,the rats in MCAO and PSD groups had significantly increased neurological function scores,TMAO level,the ratio of TMAO/H2S,and immobility time in forced swimming test with a lowered level of H2S(P<0.05).These changes were more obvious in PSD rats,which also exhibited a reduced sugar water preference with increased IgG protein and decreased occluding and caudin-5 expressions in the brain tissue(P<0.05).TMAO/H2S ratio in PSD rats was positively correlated with neurological function score(R2=0.3235,P=0.0269)and immobility time in swimming(R2=0.6290,P=0.0004)and negatively with sugar water preference(R2=-0.4534,P=0.0059).Treatment with fecal transplantation,antibiotics,probiotics and fluoxetine all significantly reduced neurological function scores,immobility time in forced swimming,TMAO/H2S ratio,and IgG protein expression and increased sugar water preference and brain occludin and caudin-5 expressions of the PSD rats(P<0.05).Conclusion In PSD rats,TMAO/H2S ratio is correlated with neurological function score,immobility time in forced swimming and sugar water preference,and modulating intestinal flora can improve neurological function and depressive symptoms and improve the integrity of the blood-brain barrier.