Objective To evaluate the effects of interferon therapy after curative surgical intervention on improving prognosis of patients with hepatitis C-related hepatocellular carcinoma (HCC).Methods We searched randomized clinical trials from 1990 to 2015 on interferon therapy after curative surgical intervention in patients with hepatitis C-related HCC from the Cochrane Library,the Cochrane Database of Systematic Reviews,MEDLINE and Embase.A Meta-analysis was carried out using Revman 5.Results There were 7 studies included in this research.The results showed that interferon therapy after curative surgical intervention in patients with hepatitis C-related HCC reduced the recurrence rate of HCC at 3 years (RR =0.84,95％ CI 0.73 ～0.97,P ＜0.05).The therapy could not improve the 3-year survival rate in these patients (RR =1.04,95％ CI 0.90 ～ 1.21,P ＞ 0.05).Stratified subgroup analyses showed interferon therapy after liver resection reduced the recurrence rate (RR =0.62,95 ％ CI 0.39 ～ 1.00,P =0.05).For patients with tumors less than 3 cm,interferon therapy reduced the recurrence rate (RR =0.82,95％ CI 0.69 ～ 0.98,P ＜ 0.05).Conclusion Interferon therapy after curative surgical intervention improved prognosis in patients with hepatitis C-related HCC.

Inductively coupled plasma mass spectrometry (ICP-MS) technology has the advantages of high sensitivity, wide linear range, good stability, and simple operation, which plays important roles in multi-element quantitative analysis, isotope analysis, speciation analysis and so on. ICP-MS technology can accurately and simultaneously determinate trace elements and toxic elements in different types of human samples, which is important for the diagnosis and treatment of clinical related diseases. Its combination with laser ablation, chromatography and other injection and/or separation technology makes its application much wider.

Objective:Analysis of the oxidative products of DNA and RNA in patients with hypertension by determination of 8-oxo Gsn and 8-oxo dGsn, respectively.Methods:This is an observational study. During August and December, 2018, 139 hypertension patients without other chronic diseases with an average age of (49.6±12.4) years old, and 139 apparently healthy volunteers without hypertension with an average age of (48.5±11.7) years old were recruited. Fasting morning urine were collected. The oxidative products of DNA: 8-oxo Gsn and the products of RNA: 8-oxo dGsn were analyzed using liquid chromatography tandem mass spectrometry. Urine Cr(U-Cr), and other serum biomarkers such as ALT, Cr, UA, Glu, TG, TC were analyzed using automatic biochemical analyzers.Results:of 8-oxo Gsn and 8-oxo dGsn were presented as median(quartile). Statistical analysis was performed using SPSS 22.0 and GraphPad Prism 5. Nonparametric test was used to compare the difference of 8-oxo Gsn and 8-oxo dGsn between the hypertension patients and the healthy controls. Results The DNA and RNA oxidative products of 8-oxo Gsn and 8-oxo dGsn in patients with hypertension and their U-Cr-corrected 8-oxo Gsn/U-Cr and 8-oxo dGsn/U-Cr were 14.38(10.39-19.91)ng/ml, 12.97(7.92-18.96)ng/ml, 1.10(0.88-1.38)μg/μmol and 0.96(0.75-1.30) μg/μmol, respectively, which were significantly higher than those in the healthy controls: 11.95(7.52-18.01) ng/ml, 10.12(6.42-15.04) ng/ml, 0.86(0.59-1.21) μg/μmol and 0.72(0.50-1.02) μg/μmol, respectively. After grouped by sex, 8-oxo Gsn in males, 8-oxo Gsn and 8-oxo dGsn in females showed no significant difference between patients with hypertension and healthy controls, however, after U-Cr correction, both males′ and females′ 8-oxo Gsn/U-Cr and 8-oxo dGsn/U-Cr in patients with hypertension were higher than that in the healthy controls.Conclusion:The oxidative products of DNA and RNA in patients with hypertension were significantly higher than that in healthy controls.

Objective:To establish and validate an LC-MS/MS method for simultaneous determination of Aβ 1-42, Aβ 1-40, and Aβ 1-38 in cerebrospinal fluid. Additionally, the consistency between this method and three mainstream detection methods was evaluated.Methods:This study involved method establishment, validation, and consistency evaluation. The N15 labeled β-amyloid protein was used as the internal standard. Extraction was performed using Waters MCX 96-wells solid phase extraction plate, and the eluent was collected to QuanRecovery MaxPeak 700 μl plate. At the positive ion mode, the multi-reaction ion monitoring mode based on electric spray ionization is chosen for the determination of CSF Aβ 1-42, Aβ 1-40, and Aβ 1-38. Referring to the CLSI C62-A and EP-15A3 guidelines, the method is evaluated and verified, including quantitation of limit (LOQ), linearity, recovery, precision, and accuracy. In addition, a total of 57 clinical residual CSF samples were collected and the concentrations of Aβ 1-42 and Aβ 1-40 were determined based on manual INNOTEST ELISA assay and Lumipulse G and Roche Elecsys fully automated biochemical analyzers. The comparison analysis and deviation evaluation were conducted by passing-bablok and Bland Altman methods.Results:The analysis time of this method is 8 min, and the LOQ of Aβ 1-42, Aβ1-40 and Aβ1-38 is 0.1 ng/ml, 0.5 ng/ml, and 0.1 ng/ml, respectively, and the linear range can meet the needs of clinical detection. Respectively, the recovery is 86.2%-93.8%, 100.9%-103.9% and 103.3%-107.1%; the total imprecision is 4.7%-7.4%, 3.5%-4.6% and 5.2%-10.9%. The measured values of Aβ 1-42 certified reference materials are all within the allowable uncertainty requirements. Moreover, the carryover rate of three analytes was all≤0.11%. In addition, the correlations of Aβ 1-42 and Aβ1-40 in CSF between this LC-MS/MS method and the INNOTEST ELISA method, Lumipulse G and Roche Elecsys fully automated biochemical analyzers were all deemed good, with correlation coefficient (r) ranging from 0.920 to 0.970. However, the measured values between the four methods were remarkably different.Conclusion:We established and validated a robust method based on LC-MS/MS technology for simultaneous determination of Aβ 1-42, Aβ 1-40, and Aβ 1-38 in CSF. The method is accurate, simple, and suitable for clinical measurements. However, despite good correlations, there were substantial differences in the measurement results of Aβ 1-42 and Aβ 1-40 among different analytical platforms, indicating the need for further promotion of harmonization and standardization processes for AD classic biomarkers.

A young female patient with acne and elevated testosterone level underwent plasma steroid hormones testing and found a significant increase in aldosterone. We excluded testing interference and verified the absence of hypertension, hypokalemia, and adrenal occupancy, as well as primary and secondary hyperaldosteronism. During follow-up, a temporal correlation was found between aldosterone levels and the use of drospirenone and ethinylestradiol tablets. It was observed that the combination of drospirenone and ethinylestradiol could lead to the increase of aldosterone level and the concentration ratio of aldosterone to direct renin through different mechanisms. Drospirenone exerts an antagonistic effect on mineralocorticoid receptor to prevent the development of hypertension or hypokalemia. In clinical practice, it is necessary to pay attention to the effect of this drug on screening markers for primary aldosteronism. In the laboratory examination, when female patients with no symptoms of hypertension and hypokalemia but with elevated aldosterone levels are encountered, it can be verified whether they have a history of use of compound estrogen-progestin such as drospirenone and ethinylestradiol tablets, and appropriate tips are provided in the report.

OBJECTIVETo investigate whether transplantation of autologous peripheral blood CD34+ stem cells is a viable approach for treating patients with advanced cirrhosis,which is currently hindered by a shortage in liver donors.

METHODSA total of 100 patients with advanced cirrhosis and who had failed to respond to conservative therapy were recruited for transplantation of autologous peripheral blood CD34+ stem cells.The success of transplantation was investigated 6-and 12-months later by measuring markers of liver biosynthesis function (coagulation,albumin level,indocyanine green clearance,Child-Pugh score) and assessing pathological changes (Knodell score) and morphologic changes in the liver tissue.Complications were also recorded during follow-up.

RESULTSThe 1-year cumulative survival rate was 100%. Fifty-two patients with massive ascites showed gradual reduction and disappearance of the ascites.Four patients experienced upper gastrointestinal bleeding and three patients developed with hepatic encephalopathy (I-II degree) at 3 months post-transplantation.All patients showed significantly improved liver biosynthesis function,liver elasticity and Knodell score after transplantation (P less than 0.05).

CONCLUSIONAutologous peripheral blood CD34+ stem cell transplantation is a safe and effective treatment for advanced cirrhosis,and has high cost-benefit since it improves liver function,liver histology,and quality of life.

Extrachromosomal DNA (ecDNA) is a small segment of circular DNA located outside the chromosome, which has the function of self-replication. Recently, amplification of oncogenes on ecDNA has been proved to be a common phenomenon in tumor cells, and has some characteristics worth studying, such as correlation with patients' poor prognosis. Multiple chromosomal events are involved in the formation of ecDNA, and its amplification can directly increase the number of DNA copies of extra-chromosomal oncogenes and accelerate the generation and development of tumors. Moreover, the segregation pattern of unequal transmission of parental ecDNA cells to offspring not only increases tumor heterogeneity, but also enhances tumor adaptation to environment and response to therapy. This article reviews the current status and potential significance of ecDNA in tumor cells.
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Background: Thyroid diseases are highly prevalent worldwide, but their diagnosis remains a challenge. We established reference intervals (RIs) for thyroid-associated hormones and evaluated the prevalence of thyroid diseases in China. Methods: After excluding outliers based on the results of ultrasound screening, thyroid antibody tests, and the Tukey method, the medical records of 20,303 euthyroid adults, who visited the Department of Health Care at Peking Union Medical College Hospital from January 2014 to December 2018, were analyzed. Thyroid-associated hormones were measured by the Siemens Advia Centaur XP analyzer. The RIs for thyroid-associated hormones were calculated according to the CLSI C28-A3 guidelines, and were compared with the RIs provided by Siemens. The prevalence of thyroid diseases over the five years was evaluated and compared using the chi-square test. Results: The RIs for thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), and total triiodothyronine (TT3) were 0.71–4.92 mIU/L, 12.2–20.1 pmol/L, 3.9–6.0 pmol/L, 65.6–135.1 nmol/L, and 1.2–2.2 nmol/L, respectively. The RIs of all hormones except TT4 differed significantly between males and females. The RIs of TSH increased with increasing age. The prevalence of overt hypothyroidism, overt hyperthyroidism, subclinical hypothyroidism, and subclinical hyperthyroidism was 0.5% and 0.8%, 0.2% and 0.6%, 3.8% and 6.1%, and 3.3% and 4.7% in males and females, respectively, which differed from those provided by Siemens. Conclusions Sex-specific RIs were established for thyroid-associated hormones, and the prevalence of thyroid diseases was determined in the Chinese population.

Objective:To evaluate the clinical efficacy of different treatment methods for chronic pancreatitis based on M-ANNHEIM system.Methods:The retrospective cross-sectional study was conducted. The clinicopathological data of 177 patients with chronic pancreatitis from two medical centers between July 2008 and July 2018 were collected, including 95 in the Sichuan Provincial People′s Hospital and 82 in the West China Hospital of Sichuan University. There were 100 males and 77 females, aged (49±5)years, with a range from 29 to 72 years. The M-ANNHEIM system was used to decide clinical stages of chronic pancreatitis. Patients in different clinical stages received drug, endoscopic or surgical treatment. Observation indicators: (1) general data and follow-up of patients; (2) treatment of patients in asymptomatic stage; (3) treatment of patients in stage Ⅰ; (4)treatment of patients in stage Ⅱ; (5) treatment of patients in stage Ⅲ; (6) treatment of patients in stage Ⅳ; (7) aggravation and new-onset of diabetes; (8) complications. Follow-up using outpatient examination, telephone, mail, and Sojump was performed to collect data for M-ANNHEIM system up to December 2018. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed by the AVONA. Repeated measurement data were analyzed using repeated ANOVA. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Results:(1) General data and follow-up of patients: there were 11, 72, 55, 31, and 8 patients with chronic pancreatitis classified as asymptomatic stage, stage Ⅰ, stage Ⅱ, stage Ⅲ, stage Ⅳ of M-ANNHEIM system before treatment. Of the 177 patients, 49, 49, and 79 patients underwent drug, endoscopic and surgical treatment, respectively. All the 177 patients were followed up for (2.4±0.5)years. (2) Treatment of patients in asymptomatic stage: 11 patients in asymptomatic stage underwent drug treatment. The M-ANNHEIM score was 1.91±0.21 before treatment, and 1.27±0.14, 1.73±0.19, 2.09±0.16 at 1 month, 12 months, 24 months after treatment, respectively. (3) Treatment of patients in stage Ⅰ: of the 72 patients in stage Ⅰ, 13 underwent drug treatment, 26 underwent endoscopic treatment, and 33 underwent surgical treatment. The M-ANNHEIM score of patients undergoing drug treatment was 8.11±1.05 before treatment, and 6.31±0.31, 7.69±0.24, 10.00±0.23 at 1 month, 12 months, 24 months after treatment, respectively. The M-ANNHEIM score of patients undergoing endoscopic treatment was 8.42±0.93 before treatment, and 5.13±0.25, 6.89±0.20, 8.27±0.24 at 1 month, 12 months, 24 months after treatment, respectively. The M-ANNHEIM score of patients undergoing surgical treatment was 8.13±0.77 before treatment, and 4.79±0.15, 5.42±0.22, 7.76±0.20 at 1 month, 12 months, 24 months after treatment, respectively. There was no significant difference in M-ANNHEIM score before treatment between patients receiving different treatments ( F=1.23, P>0.05). For patients in M-ANNHEIM stage Ⅰ, at 1 month after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment ( F=2.94, 4.98, P<0.05); there was no significant difference in M-ANNHEIM score between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=1.26, P>0.05). At 12 months after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment, between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=2.43, 5.99, 4.80, P<0.05). At 24 months after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment ( F=4.61, 6.29, P<0.05); there was no significant difference in M-ANNHEIM score between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=1.63, P>0.05). (4) Treatment of patients in stage Ⅱ: of the 55 patients in stage Ⅱ, 8 underwent drug treatment, 15 underwent endoscopic treatment, and 32 underwent surgical treatment. The M-ANNHEIM score of patients undergoing drug treatment was 12.61±1.16 before treatment, and 11.63±0.26, 12.57±0.30, 14.50±0.27 at 1 month, 12 months, 24 months after treatment, respectively. The above indicators of patients undergoing endoscopic treatment was 12.42±1.43, 8.47±0.24, 11.07±0.21, 11.93±0.30, respectively. The above indicators of patients undergoing surgical treatment was 12.53±1.22, 8.78±0.15, 9.94±0.21, 11.00±0.24, respectively. There was no significant difference in M-ANNHEIM score before treatment between patients receiving different treatments ( F=1.38, P>0.05). For patients in M-ANNHEIM stage Ⅱ, at 1 month after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment ( F=8.37, 8.48, P<0.05); there was no significant difference in M-ANNHEIM score between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=1.13, P>0.05). At 12 months after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment, between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=4.13, 8.48, 3.33, P<0.05). At 24 months after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment, between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=5.61, 6.83, 2.26, P<0.05). (5) Treatment of patients in stage Ⅲ: of the 31 patients in stage Ⅲ, 9 underwent drug treatment, 8 underwent endoscopic treatment, and 14 underwent surgical treatment. The M-ANNHEIM score of patients undergoing drug treatment was 17.25±0.89 before treatment, and 17.11±0.35, 18.44±0.41, 17.33±0.44 at 1 month, 12 months, 24 months after treatment, respectively. The above indicators of patients undergoing endoscopic treatment was 17.38±1.06, 15.00±0.53, 16.50±0.33, 16.88±0.44, respectively. The above indicators of patients undergoing surgical treatment was 17.63±1.06, 14.64±0.34, 16.00±0.35, 16.57±0.33, respectively. There was no significant difference in M-ANNHEIM score before treatment between patients receiving different treatments ( F=1.19, P>0.05). For patients in M-ANNHEIM stage Ⅲ, at 1 month after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment ( F=3.37, 4.82, P<0.05); there was no significant difference in M-ANNHEIM score between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=0.59, P>0.05). At 12 months after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment ( F=3.63, 4.48, P<0.05); there was no significant difference in M-ANNHEIM score between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=0.95, P>0.05). At 24 months after treatment, there was no significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment, between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=0.73, 1.41, 0.55, P>0.05). (6) Treatment of patients in stage Ⅳ: 8 patients in stage Ⅳ underwent drug treatment. The M-ANNHEIM score of patients was 17.94±0.59 before treatment, and 18.01±0.34, 17.54±0.19, 17.34±0.26, 17.88±0.43 at 1 month, 6 months, 12 months, 24 months after treatment, respectively. (7) Aggravation and new-onset of diabetes: of 49 patients undergoing endoscopic treatment, 17 had diabetes before treatment, 5 had aggravated diabetes and 11 had new-onset of diabetes after treatment. Of 79 patients undergoing surgical treatment, 31 had diabetes before treatment, 21 had aggravated diabetes and 7 had new-onset of diabetes after treatment. There were significant differences in the aggravation and new-onset of diabetes between the two groups ( χ2=2.07, 2.04, P<0.05). (8) Complications: 49 patients undergoing drug treatment had no treatment related complications. Of 49 patients undergoing endoscopic treatment, 4 patients with stent related complications were cured after replacing stent under endoscopy, 6 patients had acute pancreatitis, 2 had gastrointestinal bleeding including 1 patient was cured after endoscopic hemostasis, other patients with complications were improved after symptomatic and supportive treatment. Of 79 patients undergoing surgical treatment, 17 had pancreatic leakage (including 11 of biochemical leakage, 5 of grade B pancreatic leakage, and 1 of grade C pancreatic leakage), 3 had postoperative gastroparesis, 3 had intraabdominal infection, 1 had deep venous thrombosis, 2 had hemorrhage of which 1 combined with grade C pancreatic leakage was improved after open hemostasis and 1 was improved after interventional treatment, other patients with complications were improved after symptomatic and supportive treatment. Conclusions:For chronic pancreatitis, individualized treatment should be formulated according to the different stages. M-ANNHEIM score system can be used the evaluate clinical efficacies of drug treatment, endoscopic treatment, and surgical treatment.

Objective:To evaluate the performance of magnetic beads extraction method (MGE) for the measurement of catecholamine metabolites by liquid chromatography tandem mass spectrometry.Methods:This is a methodological evaluation study. The linearity, limit of quantitation, recovery, precision, and matrix effect of catecholamine metabolites 3-methoxyepinephrine (MN), 3-methoxynorepinephrine (NMN) and 3-methoxytyramine (3-MT) extracted by MGE method were evaluated according to CLSI C62-A. Consensus of method development and validation of liquid chromatography-tandem mass spectrometry in clinical laboratories and other guidelines, 132 clinical residual plasma samples were collected and extracted by automated MGE and traditional solid phase extraction (SPE) method to compare the harmonization of the two extraction methods.Results:The linearity of MN, NMN and 3-MT extracted by automated MGE was>0.99, and the LOQ for MN, NMN and 3-MT were 0.033 5 nmol/L, 0.054 7 nmol/L and 0.011 0 nmol/L, respectively. The repeatability of MN, NMN and 3-MT were 1.3%-5.1%, 2.2%-5.6% and 1.7%-7.1%, respectively. The total imprecision in the laboratory were 1.5%-8.2%, 2.2%-7.7%, 2.1%-11.2%. Although the absolute recovery is low, the average relative recoveries of MN, NMN and 3-MT were 91.5%-108.5%, 92.0%-108.6%, and 89.3%-104.1%, respectively, and the percentage deviation from the expected concentration was within 15%. After isotope internal standard correction, the relative matrix effect is close to 100%, which can compensate for the potential matrix effect. The results of MGE and SPE of MN, NMN and 3-MT showeda good correlation (correlation coefficient r>0.99). The average relative deviations of MN, NMN and 3-MT were 0.2%, -1.4% and 1.0%, respectively. Conclusion:The automatic MGE method hasa good performance in extracting catecholamine metabolites, and is expected to be used in high-throughput analysis of samples in clinical in the future.