Objective To explore the clinical application value of transcatheter arterial chemoembolization (TACE) combined with CT-guided percutaneous acetic acid injection (PAI) in treatment of huge hepatocellular carcinoma (HCC). Methods Forty-three patients with huge HCC were randomly divided into two group. Twenty-one patients in group A underwent routine one course for TACE (three times), and the interval of TACEs was one month. Twenty-two patients in group B underwent TACE combined with PAI, and CT-guided PAI was performed once a week since 2-3 weeks after first TACE, and one course included 6-9 times of PAI. Postoperative follow-up was conducted (including AFP, the size of tumor, etc.). One course of treatment was repeated in case of tumor recurred. Results At the 1st month after treatment, no statistical difference was found of AFP positive rate between two groups. Statistical difference of total effective rate was found between two groups (38.10% vs 77.27%). The 1-, 2- and 3-year survival rate In group A was 47.62%, 23.81% and 9.52%, respectively, while in group B was 81.82%, 54.55% and 36.36%, respectively, and significant differences were found between the two groups for the same period. Conclusion TACE combined with PAI is safe and more effective than TACE alone in the treatment of huge HCC.

Objectives To investigate the distribution of Schistosoma japonicum infected Oncomelania snails in the marshland of Dangting Lake region,and explore the effects of gradient and vegetation on the distribution of the infected snails.Methods Three marshland areas in upstream and downstream of Dongting Lake were selected.The snail distribution was investigated and the ground elevation was assessed (Wusong's elevation of zero)and the vegetation types were also recorded from 1987-1989 and 2009.Results In the 3 types of snail habitats of the marshland,the average rate of areas with infected snails was 35.5%,and the snails mainly distributed beside the embankment and slope zone.More infected snails were found in the high altitude and steep slope zone,while no infected snails were found in the low altitude and flat slope zone,and reed areas as well.Conclusion The Schistosoma japonicum infected snails in the marshland of Dongting Lake mainly distribute beside the embankment and slope zoon,and are correlated with the water level in flood seasons and the activities of definitive hosts.

The preparation and certification of five China Sea and continental shelf sediment reference materials MSCS-1- 5 are reported. The raw samples were collected separately from the East China Sea and the South China Sea. First,they were ground by a ball mill to a homogenous powder of less than 74μm,then these samples was further processed by an ultra-fine processing technique,a jet mill,to form an ultra-fine powder. The particle size distribution of the samples was determined with a laser particle-analyser,their average particle size is < 4μm. The homogeneity was tested by high-precision WD-XRF and the minimum sampling mass is 5 mg,which was confirmed by XRF,ICP-AES and ICP-MS. Twelve laboratories participated in the cooperative study and 60 constituents were determined. 50 and 51 components were certified as certified values and 1 and 2 components as reference values respectively for MSCS-1 and MSCS-2,52 constituents were certified as certified values for MSCS-3,4 and 5. The sum of the major and minor components in the five reference materials MSCS-1 -5 is 99.9% ,99.6% ,100.4% ,100.1% and 99.7% ,respectively.

Objective To evaluate the correlation between the degree of cochlea endolymphatic hydrops(EH) and hearing loss and symptoms in patients with unilateral Meniere's disease. Methods Fifty seven patients with unilateral Meniere's patients were retrospectively quantitatively analyzed, which evaluated the correlation between the cochlea EH and hearing loss and symptoms. The affected ears in the experimental group(57 ears) and the asymptomatic ears in the control group(57 ears), were confirmed by bilateral intratympanic Gd-DTPA injection and 3D real IR MRI scan after 24 h. The maximum length of endolymph space and labyrinth chamber along the modiolus cochleae and their ratio which represented the endolymph space proportion of each turn(R1, the basal turn;R2, the middle turn;R3, the apical turn) were calculated. And the paired t test was used to compare the differences in EH degree between the experimental and control group;Pearson correlation analysis was used to analyze the correlation between the cochlea EH degree and hearing loss and duration of symptoms. Results R1, R1 and R3 of ipsilateral cochlea were higher than normal cochlea(ipsilateral R1:0.354±0.097 vs. normal R1:0.185±0.031, P<0.01;ipsilateral R2:0.445 ± 0.098 vs. normal R2:0.201 ± 0.046, P<0.01;ipsilateral R3:0.467 ± 0.102 vs. normal R3:0.221 ± 0.053, P<0.01). A positive correlation was found between the degree of EH in each turn and high-frequency hearing loss(r=0.275, 0.281, 0.329, respectively;all P<0.05), whereas no correlation was found between the extent of EH and the time of vertigo, tinnitus and hearing loss(P>0.05). In addition, there was a correlation between the degree of EH in the apical turn and low, medium, high-frequency hearing loss(r=0.271, 0.269, 0.329, respectively; all P<0.05). Conclusions The degree of cochlea EH in the basal and second turn showed great relevance with the high-frequency hearing loss, and the apical turn EH degree was relevant with the low, medium, high-frequency hearing loss, but there was no correlation between the EH degree of each turn, ages and symptoms.

Graves′ ophthalmopathy is a complex autoimmune disease characterized by inflammation and the orbital connective/adipose tissue with infiltration. About 3% to 7% of patients with Graves′ ophthalmopathy can have severe or very severe course of disease. In severe forms of Graves′ ophthalmopathy, there might occur considerable exophthalmos complicated in some cases with corneal ulceration due to incomplete closure of the eyelids and (or) pressure on optic nerve leading to neuropathy (dysthyroid optic neuropathy). The patient′s visual acuity and the color perception decreased sharply , which seriously affected the patients quality of life. In this paper, we explore effective therapies by compared the effects of high-dose intravenous steroids for the treatment of sight-threatening Graves′ ophthalmopathy in 2 cases.

Objective To observe the clinical efficacy and safety of nifedipine controlled-release tablets on the antihypertensive effect of hypertensive patients under high altitude environment. Methods 42 hypertensive inpatients in the 940th hospital (altitude 1500 ) were set to the plain hypertension group, and 42 cases of hypertensive inpatients in Bayi hospital (altitude 3800 m) were set to the plateau hypertension group. Both groups of patients were given nifedipine controlled-release tablets 30 mg daily, taken orally in the morning for 6 consecutive days. Monitor blood pressure and heart rate three times a day to compare the clinical efficacy and occurrence of adverse drug reactions in the two groups. Results After treatment, the total effective rates of the high-altitude hypertension group and the plain hypertension group were 47.62% (20 cases/42 cases) and 76.19% (32 cases/42 cases) respectively with no statistical difference (P<0.05). The adverse drug reactions of the two groups of patients were tachycardia and palpitations. The incidence of total adverse drug reactions in the high-altitude hypertension group and the plain hypertension group were 14.29% and 11.90% respectively with no statistical difference (P>0.05). Conclusion The high-altitude hypoxic environment could affect the antihypertensive effect of nifedipine controlled-release tablets, which could not control the patient's blood pressure effectively in the short term.

Objective:To explore the clinical characteristics of neurological syndrome associated with anti-glutamic acid decarboxylase (GAD) antibodies (Abs).Methods:Six patients with neurological syndrome associated with anti-GAD-Abs admitted to Department of Neurology, Henan Provincial People's Hospital from January 2019 to October 2022 were chosen. The clinical manifestations, imaging and laboratory results, therapeutic schedules, and follow-up prognoses of these patients were collected and summarized.Results:Three females and 3 males were included, with onset age of (54.3±17.7) years. Three patients had stiff-person syndrome (SPS), 1 had limbic encephalitis+generalized epilepsy, 1 had extralimbic encephalitis+occipital epilepsy, and 1 had cerebellar ataxia who was diagnosed with paraneoplastic syndrome associated with small cell lung cancer. Four patients had elevated level of thyroid peroxidase antibodies, and 1 patient was positive for overlapping anti-gamma aminobutyric acid B receptor antibodies and Amphiphysin antibodies. Two patients with SPS had failed lumbar puncture; 1 had slightly increased white blood cells and proteins in cerebrospinal fluid (CSF); the remaining 3 patients were basically normal. Specific oligoclonal bands in CSF were observed in 2 patients. Brain MRI showed abnormal signals in the bilateral occipital lobes in 1 patient, and no specific inflammatory lesions in other patients. All patients accepted corticosteroids and intravenous immunoglobulin/plasma exchange therapies; except for the one with paraneoplastic syndrome associated with small cell lung cancer, the remaining 5 patients had improved modified Rankin scale (mRs) scores at discharge and received long-term immunotherapy. Two patients with SPS had gradually aggravated symptoms, and mRs scores reached 5 at the last follow-up (one for 3 years and the other one for 2 years).Conclusions:The clinical manifestations of patients with neurological syndrome associated with anti-GAD-Abs include SPS, limbic encephalitis, extralimbic encephalitis, epilepsy and cerebellar ataxia; some of these patients have paraneoplastic syndromes. Immunotherapies are effective except for these patients with paraneoplastic syndromes. Some patients with SPS tend to have a chronic course and a poor prognosis.

Atorvastatin is a blood lipid-lowering drug widely used clinically. Long-term use can prevent and reduce the occurrence of atherosclerotic cardiovascular disease (ASCVD). However, the efficacy of atorvastatin has significant inter-individual differences. Some individuals failed to achieve the expected lipid-lowering target value or had serious adverse reactions, which were related to the genetic diversity between individuals. Genetic variation can lead to differences in drug configuration, clinical efficacy and adverse reactions. The drug metabolism enzymes, drug transporters, drug targets and genetic polymorphisms related to lipid metabolism were reviewed in this paper that affect the drug response of atorvastatin, and from the gene level to explore the reasons for the differences in the pharmacokinetics, pharmacodynamics and susceptibility to adverse reactions of different individuals using atorvastatin.

The plateau environment is characterized by low oxygen, low air pressure, low temperature, and strong ultraviolet rays, etc. Chronic obstructive pulmonary disease (COPD) is a preventable and treatable chronic lung disease. High altitude environment increases COPD prevalence, clinical manifestation and mortality. The therapeutic window of theophylline drugs for COPD is narrow, and the high altitude environment has an influence on the pharmacokinetics of the drugs. This review summarizes the differences in the prevalence, mortality, clinical manifestation and clinical symptoms of COPD in the plateau and plain, providing a basis for identifying the risk factors of COPD in the plateau areas. The effects of plateau hypoxic environment on the pharmacokinetics of COPD drugs were also discussed. It can provide a rationale for more effective prevention and treatment of COPD at high altitude.
Humans ; Altitude ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Oxygen ; Hypoxia

Objective To compare the effects of Autoregressive Integrated Moving Average model-X (ARIMAX) and multivariate Long Short Term Memory Network (multivariate LSTM) in the prediction of daily total death toll in Yancheng City. Methods Based on total death toll data, meteorological data and air quality data from January 1^st, 2014 to June 30^th,2017 in Yancheng City, Jiangsu province, ARIMAX model and multivariate LSTM model were established to predict the daily total death toll from July 1^st,2017 to July 14^th,2017. RMSE, MAE and MAPE were used as evaluation indexes to compare the prediction effects of these two models. Results RMSE, MAE and MAPE of ARIMAX model and multivariate LSTM model were 20.742、15.094、9.921 and 47.182、35.863、19.633, respectively. Conclusion ARIMAX model is better than multivariate LSTM model to predict the daily death toll in Yancheng city.