Alveolar echinococcosis is a kind of parasitic disease caused by Echinococcus multilocularis infecting the human body. It is characterized by tumor-like, invasive growth, serious disease and high fatality rate. Even though the number of patients is limited, they require life-long treatment because of the serious condition, many complications, and treatment difficulties. At present, there are three clinical treatment options for alveolar echinococcosis, including surgical treatment(radical hepatectomy, palliative resection, liver transplantation), intervention treatment(ultrasound or CT-guided intervention, endoscopic intervention), and anti-infective drug treatment. This article analyzes the advantages and disadvantages of the above-mentioned schemes, and provides a basis for correct selection of treatment methods for alveolar echinococcosis.

Objective To observe the formation process with 3.0 T MRI dynamically, and to discuss the feasibility of molecular imaging studies on restenosis. Methods The models were built with balloon (2.0 F) injury which were separated into restenosis group (n=48) and control group (n=48). Zero h, 24 h, 1 week, 2 week, 4 week and 8 week after surgery, 3.0 T MRI scanning (T1WI, T2WI, PDWI) was performed respectively, the vascular of injured side were obtained for HE staining to observe the pathological changes, to analyze the measurement of neointimal area (IA), intimal proliferation index (IHI), lumen area (LA) and stenosis rates, correlation between HE staining measurements and MR images were analyzed. Two weeks after the injury, the restenosis model of rats (n=8) and control rats (n=8) were injected ultrasmall superparamagntiec iron oxide (USPIO,1 mmol/kg) by tail vein, respectively. 3.0 T MRI scanning (T2WI) was underwent at 0 h and 24 h after injection, the change of the arterial wall T2 signal was quantitatively analyzed and the relative signal intensity (rSI) and relative change rate (rSIC) of the vessel wall were calculated. Reference to MRI images, corresponding line segments were taken for Perl's blue staining and immunohistochemically staining of macrophages. One-way ANOVA, Pearson and t test were used for statistical analysis. Results In the early?term (0 h,24 h), the wall and surrounding high signal organization boundary was not clear, there was no obvious morphological change of the lumen. In the medium?term (1, 2 week), signal of the injured wall increased with different extents, wall thickening and luminal narrowing was progressive, the inwall was coarse. In the later?term (4, 8 week) wall signal got slightly lower, wall thickness, lumen change were not significant, the wall area and LA were significantly associated with pathologic measurement result (r value were 0.978, 0.732; P<0.05). In the control group, signal of wall and lumen morphological change were not significant among the different time points. IA were (0.131 ± 0.011) mm2, (0.588 ± 0.017) mm2, (1.061 ± 0.033) mm2, (1.192 ± 0.034) mm2;1, 2, 4, 8 week after injury, respectively, IHI were 0.235 ± 0.022, 0.578 ± 0.013, 0.715 ± 0.011, 0.737 ± 0.009, respectively, stenosis rates were (5.586 ± 0.987)%, (25.395 ± 1.112)%, (40.019 ± 1.298)%, (41.890 ± 0.951)%, respectively, difference between groups were statistically (P<0.05). In the control group, there was no significant differences of medium area, luminal stenosis and neointimal formation respectively at different time points (P>0.05). rSI was 1.582±0.051 after the injection of USPIO, then 24 h after injection of USPIO, T2 signal of the vessel wall was reduced significantly, rSI was 1.260 ± 0.088, rSIC was (-20.249 ± 6.489) % with statistical difference (t value was 8.924,P<0.05). But there was no statistical difference in control rats (P>0.05). Perl's staining combined with immunohistochemical staining confirmed that the iron particles were taken by the macrophage's phagocytosis just in the neointimal. Conclusion 3.0 T MRI is capable of demonstrating the vessel wall and lumen changes dynamically, and the measurements are correlated with pathological results. USPIO can be consumed by macrophages in the neointimal, resulting in T2 signal of the vessel wall decreased significantly.

Objective To investigate the value of echocardiographic Tei index combined with serum high-sensitivity cardiac troponin T(hs-cTnT) on monitoring cardiac toxicity associated with anthracycline chemotherapy drug in patients with diffuse large B-cell lymphoma(DLBCL).Methods PW-Tei index,TDI-Tei index of left/right ventricles and radionuclide cardiac measurement were acquired from 56 patients with DLBCL before,after the completion of 2-4 cycle(100-200 mg/m2) and 6-8 cycle(300-400 mg/m2) of the regimen,part of them received serum hs-cTnT detection at the same time.Cardiac toxicity event was defined as a relative reduction of radionuclide left ventricular ejection fraction(LVEF) of ≥10％ during the regime or an absolute radionuclide LVEF≤50％ after the complete chemotherapy.Results Compared with baseline,left ventricular PW-Tei index significantly increased after whole cures [(0.36-± 0.12) vs (0.44 ±0.13) vs (0.40 ± 0.13),P =0.002].After complete regimen,serum hs-cTnT level elevated significantly [(0.006 ± 0.006)tg/L vs (0.012 ± 0.007) μg/L vs (0.020±0.013)tμg/L,P =0.001].The sensitivity,specificity and area under ROC curve of early diagnosis of anthracycline-induced cardiotoxicity with elevated serum hs-cTnT in 2-4 cycle and increased left ventricular PW-Tei index in 6-8cycle detected together were 75％,85％,0.736 and 92％,50％,0.675,respectively(all P ＜0.05).Conclusions Echocardiographic PW-Tei index combined with serum hs-cTnT is a simple method and can be easily obtained in outpatient settings to monitor early cardiac toxicity induced by anthracycline therapy.

Background and purpose:Microsatellite instability (MSI) status is commonly applied to predict the prognosis and chemosensitivity in stage Ⅱ and stage Ⅲ colorectal cancer patients. However, researches of its function on metastasis colorectal cancer are limited. This study investigated its value on prognosis and chemosensitivity in metastatic colorectal cancer (CRC) patients.Methods:We retrospectively investigated tumor tissues from metastasis CRC patients who were treated with oxaliplatin and 5-FU-based therapy regimens (FOLFOX and XELOX). Immunostaining of proteins of the mismatch repair genehMLH1,hMSH2,hMSH6 andhPMS2 was performed. Prognostic value and chemosensitivity in patients with MSI status were also determined.Results:Clinical features from 113 patients were analyzed. No cor-relation of overall survival (OS) and chemosensitivity with MSI status was found. We further investigated 79 patients with synchronous metastasis and palliatively tumor resection. Median progression free survival (PFS) from 22 MSI patients was significant longer than that in 57 MSS patients (19.9 monthsvs 7 months,P=0.005). No significant difference was seen in OS comparison (P=0.07). MSI status was also an independent prognostic factors of PFS by Cox multivariate analysis (MSS/MSI,HR=2.079,P=0.043). Moreover, in this group, MSI patients had improved disease control rate (59.1%vs 31.6%, P=0.025) in chemosensitivity analysis than MSS patients.Conclusion:A better PFS in MSI patients with synchronous metastasis and palliative tumor resection was found after treated with oxaliplatin and 5-FU-based therapy and a better chemosensitivity in MSI patients was also found.

OBJECTIVE: To explore the genetic basis of three children with unexplained mental retardation/developmental delay. METHODS: Peripheral venous blood samples were collected for routine G-banding karyotyping analysis and chromosomal microarray analysis (CMA). Whole exome sequencing (WES) was also carried out for patient 3. RESULTS: The karyotypes of the 3 children were normal. The result of CMA analysis of patient 1 was arr[GRCh37]: 2q22/3(145 128 071-145 159 029)×1, with a 31 kb deletion, which was predicted to be a pathogenic copy number variation. The deletion has involved exons 8 to 10 of the ZEB2 gene. Patient 2 was arr[hg19]:2q22.3 (145 071 457-146 881 759)×1, with a 1.81 Mb deletion involving the ZEB2 and GTDC1 genes. Patient 3 was arr[GRCh37]: 9p23p23(11 698 261-12 106 261)×1, with a 408 kb deletion containing no disease-associated gene. WES has identified a c.2102C>A (p.Ser701*) variant in exon 8 of the ZEB2 gene, which was included in ClinVar database and rated as pathogenic, and verified by Sanger sequencing as a de novo variant. CONCLUSION For the substantial clinical and genetic heterogeneity of Mowat-Wilson-syndrome, CMA and WES are helpful to identify the etiology of children with developmental delay/mental retardation of unknown causes, particularly those with peculiar facial features and multiple congenital malformations.
Child ; DNA Copy Number Variations ; Facies ; Glycosyltransferases/genetics* ; Hirschsprung Disease ; Humans ; Intellectual Disability/genetics* ; Microcephaly/genetics*

OBJECTIVE: To analyze the genotype and clinical phenotype of a 3-month-old female infant featuring unresponsiveness. METHODS: The infant was subjected to genetic testing, and her clinical features were compared with syndromes associated with variants of the candidate gene. RESULTS: The patient has featured long fingers, long and overlapped toes, musk-like face, blepharophimosis, ptosis, and lacrimal duct anomaly. She was found to harbor a heterozygous de novo variant NM_012330.3: c.3040C>T (p.Gln1014*) in exon 16 of the KAT6B gene. Her clinical phenotype and genotype have both conformed to Say-Barber-Biesecker-Young-Simpson syndrome (SBBYSS). CONCLUSION The child was diagnosed with SBBYSS syndrome due to the c.3040C>T (p.Gln1014*) variant of the the KAT6B gene. Discovery of the unique features has expanded the phenotypic spectrum of this syndrome.
Female ; Humans ; Blepharophimosis/genetics* ; Blepharoptosis ; Genotype ; Histone Acetyltransferases ; Infant

BACKGROUND: Degeneration of the annulus fibrosus (AF), an important structure of the intervertebral disc, is one of the main causes of degenerative disc disease. Fabrication of scaffolds replicating the stratified microstructure of the AF is critical for the successful regeneration of AF. METHODS: In this study, we cultured rabbit AF-derived stem cells (AFSCs) using fabricated electrospun fibrous poly-Llactic acid scaffolds with different diameters. We applied cyclic tensile strain (CTS) on the scaffolds to regulate the differentiation of AFSCs into specific cell types that resided at the inner, middle, and outer zones of the AF. RESULTS: We found that the morphologies of AFSCs on the smaller-fiber-diameter scaffolds were nearly round, whereas spindle-like cells morphologies were observed on large-diameter scaffolds. CTS enhanced these phenomena and made the cells slender. The expression levels of collagen-I in cells increased as a function of the fiber diameter, whereas collagen-II and aggrecan exhibited opposite trends. Moreover, the application of CTS upregulated the gene expressions of collagen-I, collagen-II, and aggrecan. CONCLUSION Overlaying the scaffolds with different CTS-stimulated cells could eventually lead to engineered AF tissues with hierarchical structures that approximated the native AF tissue. Thus, the proposed methodologies could be potentially applied for AF regeneration.

Objective To evaluate the clinical and radiographic outcomes of locking plate plus endosteal fibular allograft augmentation for unstable proximal humeral fractures with comminuted medial column.Methods We retrospectively analyzed the 48 patients who had been treated by locking plate plus endosteal fibular allograft augmentation and fully followed up for unstable proximal humeral fractures with comminuted medial column between June 2014 and March 2016.They were 12 men and 36 women,with an average age of 64.3 years (from 33 to 87 years).By the Neer classification,7 cases were two-part fractures,21 three-part fractures and 20 four-part fractures.Postoperative assessments included Constant-Murley scores,shoulder scores of Quick Disabilities of the Arm,Shoulder and Hand (Quick DASH),Short Form Health Survey (SF12),humeral head height loss,change in humeral neck shaft angle,postoperative complications and revision rate.Results Their follow-ups averaged 16.7 months (from 12 to 30 months).Their final follow-ups showed a mean Constant score of 83.3 (from 67 to 98),a mean DASH shoulder score of 18.9 (from 6.6 to 49.9),and a mean SF12 of 82.8 (from 56 to 98).Postoperatively,the humeral head height loss averaged 1.2 mm (from 0.1 to 3.4 mm) and the neck-shaft angle 3.1° (from 0.1° to 9.1°).Complications happened in 5 cases (10.4％):loss of reduction in one and screw penetration out of the articular surface in 4.Conclusion Locking plate along with endosteal fibular strut allograft augmentation is a promising technique for the treatment of proximal humeral fractures with comminuted medial column because fibular strut allograft may enhance mechanical stability of the humeral head,maintain fracture reduction,reduce humeral head height loss and complications to ensure good clinical outcomes.

BACKGROUND: Degeneration of the annulus fibrosus (AF), an important structure of the intervertebral disc, is one of the main causes of degenerative disc disease. Fabrication of scaffolds replicating the stratified microstructure of the AF is critical for the successful regeneration of AF. METHODS: In this study, we cultured rabbit AF-derived stem cells (AFSCs) using fabricated electrospun fibrous poly-Llactic acid scaffolds with different diameters. We applied cyclic tensile strain (CTS) on the scaffolds to regulate the differentiation of AFSCs into specific cell types that resided at the inner, middle, and outer zones of the AF. RESULTS: We found that the morphologies of AFSCs on the smaller-fiber-diameter scaffolds were nearly round, whereas spindle-like cells morphologies were observed on large-diameter scaffolds. CTS enhanced these phenomena and made the cells slender. The expression levels of collagen-I in cells increased as a function of the fiber diameter, whereas collagen-II and aggrecan exhibited opposite trends. Moreover, the application of CTS upregulated the gene expressions of collagen-I, collagen-II, and aggrecan. CONCLUSION Overlaying the scaffolds with different CTS-stimulated cells could eventually lead to engineered AF tissues with hierarchical structures that approximated the native AF tissue. Thus, the proposed methodologies could be potentially applied for AF regeneration.

Objective:To improve the teaching quality of Medical Microbiology by optimizing the teaching method,adjusting the teaching content and reforming the assessment model.Methods:The students of grade 2020 and 2021 of the same major were divided into the control group and the reform group.The control group received the traditional teaching method.The reform group received the"online + offline"blended teaching method,which integrates online learning resources and ideological and political education into the theoretical content of the curriculum.And the whole process assessment system was applied to the teaching method.The teaching quality was evaluated by the whole process examination results and questionnaire survey.Results:Compared with the control group,the score in the reform group was significantly improved(P＜0.01).Results of the questionnaire survey showed that students'satisfaction with the mixed teaching method reached 97.5% .The integration of hot issues of microbiology and curriculum ideological and political education significantly improved students'learning interest,and more students wanted to engage in the work of microbiology related fields in the future.Conclusion:The practice results show that optimizing the teaching method,adjusting the teaching content and reforming the assessment mode can stimulate the students'learning interest,improve the students'independent learning ability and improve the teaching quality.