A new method of determination of COHb is reported in this paper by two- wavelength second-derivative spectrophotometry.Blood was diluted with a solution of THAM containing Na_2S_2O_4.The second-derivative spectrum was measured in the region of 500-600 nm and the derivative absorbance differerce ?Ax was deter mined at the wavelengths of 564 nm and 576 nm.Then the solution was satura- ted with CO gas.The second-derivative spectrum of COHb was measured in the same region.The derivative absorbance difference ?A_(100) was determined at the same wavelengths.The COHb in blood was calculated by the ratio of ?Ax to ?A_(100).The results of determination of COHb in standard blood samples were in good agreement with the theoretical values.

Objective:To observe the clinical effect of elemene injection in the perioperative treatment of esophageal cancer.Methods:A total of 180 patients with esophageal cancer who underwent surgical treatment in the Affiliated Hospital of Hebei University from January 2017 to July 2018 were selected and divided into the experimental group ( n=90) and the control group ( n=90) according to the random sequence number generated by the computer. In the experimental group, the thoracic cavity was rinsed and the elemene was instilled and intravenously instilled. The control group was treated with normal saline. Safety indexes, short-term efficacy indexes, immune indexes, tumor marker levels and long-term benefit indexes were observed in the two groups. Results:The incidences of leukocytosis, thrombocytopenia, low hemoglobin, elevated creatinine, transaminase elevation, nausea and vomiting in the experimental group were 43.33% (39/90), 0 (0/90), 5.55% (5/90), 6.67% (6/90), 4.44% (4/90) and 0 (0/90), those in the control group were 53.33% (48/90), 1.11% (1/90), 2.22% (2/90), 4.44% (4/90), 7.78% (7/90) and 1.11% (1/90), and there were no significant differences between the two groups ( χ2=1.802, P=0.179; P=1.000; χ2=0.595, P=0.441; χ2=0.424, P=0.515; χ2=0.871, P=0.351; P=1.000). The postoperative extubation time in the experimental group was (173.36±41.09) h, the postoperative hospital stay was (14.82±4.35) d, the Karnofsky functional status (KPS) score was 81.43±3.89, and those in the control group was (175.76±40.46) h, (15.34±5.22) d and 80.49±2.67, respectively. The differences between the two groups were not statistically significant ( t=-0.395, P=0.695; t=-0.726, P=0.472; t=1.890, P=0.061). The total amount of drainage fluid in the experimental group was (665.39±201.31) ml, and the incidence of anastomotic fistula was 1.11% (1/90), which were significantly lower than those in the control group [(732.67±213.84) ml and 8.89% (8/90)], with statistically significant differences ( t=-2.173, P=0.032; χ2=4.211, P=0.040). Before treatment, there were no statistically significant differences in immune function between the two groups (all P>0.05). One week after surgery, there was no statistically significant difference in CD3 + between the two groups [(55.45±6.96)% vs. (53.71±6.54)%, t=1.728, P=0.087]; CD4 + , CD4 + /CD8 + and NK cells in the experimental group were higher than those in the control group, and the differences were statistically significant [(29.43±5.05)% vs. (25.92±8.06)%, t=3.501, P=0.001; 1.30±0.21 vs. 1.23±0.20, t=0.229, P=0.028; (254.20±15.21)/μl vs. (237.05±10.73)/μl, t=2.741, P=0.007]. The levels of tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) in the experimental group were (1.37±0.18) ng/ml, (1.26±0.28) ng/ml, (0.89±0.17) ng/ml and (1.06±0.24) ng/ml, significantly lower than those in the control group [(2.86±0.42) ng/ml, (2.92±0.45) ng/ml, (2.38±1.55) ng/ml, (2.82±0.15) ng/ml], and the differences were statistically significant ( t=13.928, P=0.014; t=19.728, P=0.011; t=17.924, P=0.006; t=16.625, P=0.003). The 1-year recurrence rate was 2.22% (2/90) in the experimental group, and the half-year mortality rate was 1.11% (1/90) in the experimental group, and 5.56% (5/90) and 2.22% (2/90) in the control group, with no statistically significant differences ( χ2=0.595, P=0.441; χ2=0.000, P=1.000). Conclusion:Elemene tumor-free sequential treatment combined with postoperative intravenous drip has a positive effect on postoperative recovery of patients with esophageal cancer, which can prevent the occurrence of postoperative anastomotic fistula, improve patients′ immune function, reduce the levels of tumor markers, and it is safe and feasible.

Objective:To establish and verify a simple clinical prediction model for obstructive sleep apnea syndrome(OSAS)in children.Methods:The clinical data of 95 children aged 2-12 years underwent polysomnography(PSG)were screened.The subjects with OAHI≤1 were included into non-OSAS group(n=22)and those with OAHI＞1 into OSAS group(n=73).Gender,age,body mass index(BMI),night pulse minimum oxygen saturation(SpO2),tonsil grading and adenoid grading of the 2 groups were compared and analyzed.Binary Logistic regression analysis was used to statistically analyze the data and establish a clinical prediction model for OSAS in children.Results:There was significant difference in age,BMI,SpO2,tonsil grading and adenoid grading between the 2 groups(P＜0.05),there was no significant gender difference(P＞0.05).The model equation was as follows:X=2.366-0.769(age-continuous variable)+0.248(BMI-continuous variable)-3.413(SPO2-continuous variable)+2.104(tonsil grade Ⅲ-Ⅳ"yes").The result of internally validated Hosmer-Lemeshow test was P=0.612(P＞0.05),AUC was 0.821(0.713-0.929,P＜0.01),sensi-tivity was 83.3％,specificity was 76.4％.The accuracy of external validation was 73.8％,the AUC was 0.805(0.664-0.943,P＜0.01),the sensitivity was 84.6％and the specificity was 75％.Conclusion:The predictive model may have good predictive efficacy for 2-12 years old children with OSAS,and may assist clinicians in diagnosing children with OSAS.

Objective:To investigate the efficiency and safety of pneumatic retinopexy for rhegmatogenous retinal detachment (RRD).Methods:A prospective case series study. From January 2020 to December 2021, 27 eyes of 27 RRD patients in Joint Shantou International Eye Center were included. Among them, there were 10 males and 17 females; the mean age was 36.0±11.8 years old. There was recurrent retinal detachment in 4 eyes. Best corrected visual acuity (BCVA) and optical coherence tomography were performed. According to whether the retina was successfully reattached after a single intravitreal injection, the patients were divided into a single operation group and a second operation group. All eyes underwent pneumatic retinopexy, the patients received intravitreal injection of 0.3-0.5 ml 100% C 3F 8. On the next day, laser photocoagulation was performed around the retinal breaks. The mean follow-up time was 15.0±6.0 months. Outcome measures included single operation success rate, the BCVA at the last follow up and complications. The age, gender, extent of retinal detachment, number of retinal breaks, and preoperative and postoperative BCVA of patients in the single operation group and the second operation group were compared using Mann-Whiteney test or Fisher's exact test. Results:Twenty of the 27 eyes (74.1%, 20/27) had retinal reattachment after single operation, 7 of the 27 eyes (25.9%, 7/27) had retinal reattachment after the second operation. Among the 7 eyes, retinal detachment recurrence after operation, retinal detachment recurrence after tear opening, and retinal detachment recurrence with new tears occurred in 1, 4, and 2 eyes, respectively; retinas were all reattached after scleral buckling or vitrectomy. The BCVA was stable and improved in 14 and 13 eyes, respectively. Compared with the single operation group, the retinal detachment in the second operation group was wider and the BCVA before operation was worse, the differences were statistically significant ( Z=-2.842,-2.233; P<0.05). Transient intraocular pressure elevation occurred in 5 eyes; no complications such as infectious endophthalmitis, intraocular hemorrhage and lens damage occurred. Conclusion:Pneumatic retinopexy is safe and effective in the treatment of RRD.

Objective:To explore whether transjugular intrahepatic portosystemic shunt (TIPS) can improve the prognosis of esophagogastric variceal bleeding (EGVB) combined with sarcopenia in cirrhotic patients.Methods:A retrospective cohort study was performed. A total of 464 cases with cirrhotic EGVB who received standard or TIPS treatment between January 2017 and December 2019 were selected. Regular follow-up was performed for the long-term after treatment. The primary outcome was transplantation-free survival. The secondary endpoints were rebleeding and overt hepatic encephalopathy (OHE). The obtained data were statistically analyzed. The t-test and Wilcoxon rank-sum test were used to compare continuous variables between groups. The χ2 test, or Fisher's exact probability test, was used to compare categorical variables between groups. Results:The age of the included patients was 55.27±13.86 years, and 286 cases were male. There were 203 cases of combined sarcopenia and 261 cases of non-combined sarcopenia. The median follow-up period was 43 months. The two groups had no statistically significant difference in follow-up time. There was no statistically significant difference in transplant-free survival between the TIPS group and the standard treatment group in the overall cohort ( HR=1.31, 95% CI: 0.97-1.78, P=0.08). The TIPS patient group with cirrhosis combined with sarcopenia had longer transplant-free survival (median survival: 47.76 vs. 52.45, χ2=4.09; HR=1.55, 95 CI: 1.01~2.38, P=0.04). There was no statistically significant difference in transplant-free survival between the two kinds of treatments for patients without sarcopenia ( HR=1.22, 95% CI: 0.78~1.88, P=0.39). Rebleeding time was prolonged in TIPS patients with or without sarcopenia combination (patients without combined sarcopenia: median rebleeding time: 39.48 vs. 53.61, χ2=18.68; R=2.47, 95 CI: 1.67~3.65, P<0.01; patients with sarcopenia: median rebleeding time: 39.91 vs. 50.68, χ2=12.36; HR=2.20, 95 CI: 1.42~3.40, P<0.01). TIPS patients had an increased 1-year OHE incidence rate compared to the standard treatment group (sarcopenia patients: 6.93% vs. 16.67%, χ2=3.87, P=0.049; patients without sarcopenia combination: 2.19% vs. 9.68%, χ2=8.85, P=0.01). There was no statistically significant difference in the long-term OHE incidence rate between the two kinds of treatment groups ( P>0.05). Conclusion:TIPS can significantly prolong transplant-free survival compared to standard treatment as a secondary prevention of EGVB concomitant with sarcopenia in patients with cirrhosis. However, its advantage is not prominent for patients with cirrhosis in EGVB without sarcopenia.

Objective To investigate the accuracy of liver stiffness (LS) as a noninvasive index in predicting hepatic venous pressure gradient (HVPG) in patients with decompensated liver cirrhosis and the value of LS in the diagnosis of decompensated liver cirrhosis. Methods A retrospective analysis was performed for the clinical data of 88 patients with decompensated cirrhosis due to viral hepatitis or decompensated alcoholic cirrhosis who received both HVPG measurement and LS measurement by acoustic radiation force impulse (ARFI) in Department of Gastroenterology, Nanjing Drum Tower Hospital, from April 2013 to June 2021, and according to HVPG, the patients were divided into serious portal hypertension (SPH) (HVPG≥20 mmHg) group with 24 patients and non-SPH (HVPG < 20 mmHg) group with 64 patients. The two groups were compared in terms of LS, spleen stiffness, portal vein velocity, and related biochemical parameters. The t -test or the Mann-Whitney U rank sum test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. A Pearson correlation analysis was used to investigate the correlation of different noninvasive indices with HVPG, and a Logistic regression analysis was used to investigate the association of different noninvasive indices with the risk of SPH. Receiver operating characteristic (ROC) curves were plotted for different noninvasive indices in predicting HVPG≥20 mmHg, and the area under the ROC curve (AUC), sensitivity, specificity, maximum Youden index, and corresponding cut-off value were calculated to investigate the value of each index in predicting SPH. Results Among the 88 patients, 76 had decompensated cirrhosis due to viral hepatitis and 12 had decompensated alcoholic cirrhosis. There were no significant differences between the SPH group and the non-SPH group in age, sex, white blood cell count, hemoglobin, platelet count, prothrombin time, alanine aminotransferase, aspartate aminotransferase, albumin, serum sodium, creatinine, Child-Pugh class, and spleen stiffness, while there was a significant difference in LS between the two groups ( t =-3.970, P < 0.01). The correlation analysis showed that HVPG was positively correlated with LS ( r =0.458, P < 0.001). The Logistic regression analysis showed that LS was a risk factor for SPH (odds ratio=3.941, 95% confidence interval: 1.245-12.476, P =0.020). The ROC curve analysis showed that LS had an AUC of 0.751 in predicting the onset of SPH, with a sensitivity of 54.17% and a specificity of 90.63% at the optimal cut-off value of 2.295 m/s. Conclusion In patients with decompensated cirrhosis, LS measured by ARFI is correlated with HVPG and has a certain value in the non-invasive diagnosis of decompensated cirrhosis with HVPG≥20 mmHg.

To investigate the molecular mechanism of resveratrol inhibiting the metastasis of liver cancer . HepG2 and Huh7 cells were treated with different concentrations of resveratrol, and the cell viability was determined by CCK-8 assay to determine the optimal concentration of resveratrol for subsequent experiments. The expressions of miR-186-5p in liver cancer tissues and liver cancer cells were determined by quantitative real-time RT-PCR. The migration and invasion of HepG2 and Huh7 cells were detected by wound healing assay and Transwell assay, and the expression levels of epithelial-mesenchymal transition (EMT) related proteins were determined by Western blotting. Resveratrol with concentration of had no effect on the viability of HepG2 and Huh7 cells, so the concentration of resveratrol in subsequent experiments was 6.25 μmol/L. Resveratrol inhibited the wound healing and invasion of liver cancer cells; increased the expression of E-cadherin, and decreased the expression of vimentin and Twist1. The expression of miR-186-5p was significantly down-regulated in liver cancer tissues and cells compared with the adjacent tissues and normal liver cells (both <0.05). Furthermore, resveratrol induced the expression of miR-186-5p in liver cancer cells (both <0.01). Overexpression of miR-186-5p suppressed the migration, invasion and EMT of liver cancer cells. Knockdown of miR-186-5p blocked the inhibition effects of resveratrol on the migration, invasion and EMT of liver cancer cells. Resveratrol could inhibit the metastasis of liver cancer , which might be associated with up-regulating miR-186-5p.
Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Epithelial-Mesenchymal Transition ; Gene Expression Regulation, Neoplastic ; Hep G2 Cells ; Humans ; Liver Neoplasms/genetics* ; MicroRNAs/genetics* ; Neoplasm Invasiveness/genetics* ; Resveratrol/pharmacology*