Objective To investigate the value of CEUS quantitative analysis in diagnosis of different pathological stages of small hepatocellular carcinoma (HCC).Methods Data of 112 patients with HCC confirmed by surgical or biopsy were analyzed retrospectively.All the diameter of single tumor or the sum of the largest two lesions in multiple tumors were within 3 cm.Three groups were classified based on the Edmonson stage:High differentiation group (n=50,stage Ⅰ or Ⅱ),median differentiation group (n=30,stage Ⅲ),low differentiation group (n=32,stage Ⅳ).Qontraxt ultrasound imaging analysis software was utilized to measure CEUS parameters,including the maximum intensity of tumor (TMAX),nontumor's intensity (NT),maximum intensity of nontumor (NTMAX),appear time,time to peak,washout time,and the ratio of TMAX/NT and TMAX/NTMAX were calculated.The differences among the three groups was compared by statistics test.Results The values of TMAX,TMAX/NTMAX and washout time were statistically different among the three groups (all P＜0.05).The maximum values of TMAX,TMAX/NTMAX and the shortest washout time were found in the low differentiation group.And the minimum values of TMAX,TMAX/NTMAX and the longest washout time were found in the high differentiation group.There were no statistical differences of NT,NTMAX,TMAX/NT,appear time and time to peak among the three groups (all P＞0.05).Conclusion The quantitative parameters of CEUS is helpful in distinguishing different Edmonson stage of small HCC.

Objective: To investigate chronic kidney disease (CKD) and its risk factors in people receiving physical examination. Methods: hTis retrospective study included people over 20 years old who had physical examination in the Health Management Center of Third Xiangya Hospital from Janurary 2008 to June 2011. CKD and its risk factors as well as questionnaire were recorded. hTe risk factors were analyzed by multivariate logistic analysis. CKD was deifned by kidney damage (microalbuminuria≥30 mg/L) and/or hematuria and/or reduced kidney function [evaluate glomerular ifltration rate (eGFR)<60mL/(min.1.73 m2)]. We counted eGFR according to the modiifcation of diet in renal disease (MDRD). Results: A total of 5 708 physical examination reports were included. The detection rate of albuminuria, reduced renal function and hematuria was 25.0%, 1.7% and 1.1%. hTe detection rate of CKD was 25.6%, and detection rate of CKD stage 1-5 was 17.8%, 6.7%, 1.1%, 0 and 0, respectively. Multivariate logistic analysis indicated that diabetes mellitus, hypertension, hypercholesterolemia, male, age, and smoking were the risk factors for CKD. Increasing physical activity was the protective factor against CKD. Conclusion: High prevalence of CKD in people receiving physical examination is found in Changsha, especially stage 1 and 2 CKD. Physical examination is important to screen CKD. Stopping smoking, control of blood glucose, blood pressure, blood lipids and increasing physical activity may help reduce the prevalence of CKD.

Objective To study the effect of positive lymph node number on the survival of patients with esophageal carcinoma. Methods From July 1995 to July 2005, a total of 11,447 resected lymph nodes were obtained from 1140 patients who underwent curative resection of the primary tumor with systematic lymphadenectomy at Shanxi cancer hospital. The survivals were analysed by life tables and Kaplan-Meier methods, the related factors of lymph node metastasis were assessed by Chi-square test. Results The number of positive lymph nodes was negatively related to survival rates of esophageal carcinoma. According to the number of lymph nodes resected (≥8 nodes versus <8 nodes), there was significant difference in metastatic lymph node ratio. Conclusion The number of positive lymph node can reflect the prognosis of patients better. The authors suggest that the modification of the tumor-lymphnode-metastasis (TNM) staging classification (TNM) to include the number of positive lymph nodes in the N1 category.

Objective To investigate the effect of tumor length and number of positive lymph nodes and the ratio of positive lymph nodes on survival in patients with esophageal squamous cell carcinoma.Methods From July 1995 to July 2005, a total of 6,691 resected lymph nodes were obtained from 526patients who underwent curative resection of the primary tumour with systematic lymphadenectomy. The survivals were analysed by life tables and Kaplan-Meier methods. Results Among patients with regional disease, the number of positive lymph nodes (＞3) was related to an increasing risk. The proportion of positive lymph nodes compared with the number of lymph nodes dissected (20 %) conferred an increased risk. The tumor length (≤5 cm, 5 cm ＜ length ＜ 7 cm, ＞7 cm) was related to an increasing risk (84.74 %, 47.79 %,36.90 %, 35.52 %; 73.41%, 46.29 %, 23.87 %, 20.64 %; 64.44 %, 13.92 %, 0, 0). Conclusion Tumor length,the number of positive lymph nodes, and the ratio of positive lymph nodes are important prognostic factors for survival in patients with esophageal carcinoma. The PTNM classification system for patients with esophageal carcinoma might consider adding number of positive lymph nodes as an important prognostic factor.

OBJECTIVE: To investigate the relationship between high-normal blood pressure and chronic kidney disease (CKD) in occupational physical examination population in Changsha. METHODS: With a convenient sampling method, a cross-sectional survey of representative sample of 11 274 white collar workers was conducted in Changsha between March 2011 and May 2011 in a large comprehensive hospital. All subjects were assigned into 4 groups: a normal blood pressure group, a high-normal blood pressure group, an undiagnosed hypertension group, and a diagnosed hypertension group. Anthropometry, blood pressure, blood sample and urine sample were measured with standard instruments and methodology for all the subjects. Multiple logistic regression analysis was used to identify risk factors for CKD. RESULTS: The prevalence of CKD in the normal blood pressure, high-normal blood pressure, undiagnosed hypertension, and diagnosed hypertension were 3.31%, 6.60%, 11.78%, and 17.35%, respectively. The prevalence of CKD in males was significantly higher than that in females (P<0.01). For males with high-normal blood pressure, the CKD risk was significantly greater (OR, 1.30; 95% CI:1.03 - 1.63) than those with optimal blood pressure. The logistic regression analysis showed that there was an additive effect of hyperuricemia on CKD risk in men with high-normal blood pressure compared with men with optimal blood pressure (OR, 2.25; 95% CI, 1.59 - 3.19; P<0.05). CONCLUSION The prevalence of CKD in people with the high-normal blood pressure is 6.60% in occupational physical examination population in Changsha. CKD is a high risk for men with highnormal blood pressure and hyperuricemia is an independent risk factor.
Blood Pressure ; China ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; epidemiology ; Hyperuricemia ; epidemiology ; Male ; Physical Examination ; Prevalence ; Renal Insufficiency, Chronic ; epidemiology ; Risk Factors

Objective To evaluate the value of shear wave elastography(SWE) in the diagnosis of gastroesophageal varices in patients with hepatitis B-related hepatocellular carcinoma(HCC). Methods From October 2016 to May 2017,a total of 325 patients with hepatitis B-related HCC received conventional ultrasonography and SWE examinations in Shanghai Eastern Hepatobiliary Surgery Hospital were selected. The basic clinical data,conventional ultrasonography,SWE examination parameters and gastroscopy results of 192 patients were successfully collected. The training group ( 120 cases) and the validation group (72 cases) were divided from these patients according to the time order of entering the study.The gastroscopy results were used as the gold standard and the training group were analyzed using univariate and multivariate analysis.A new GOV diagnostic model was established and the diagnosis value of which were validated and evaluated in the validation group. Results Among 9 parameters studied,the maximum flow velocity of the portal vein,the thickness of the spleen and the stiffness of the spleen were independent factors affecting GOV in patients with hepatitis B-related HCC with odds ratio of 0.755(95% CI 0.617-0.924),1.375(95%CI 1.171-1.614) and 1.093(95% CI 1.043 -1.145),respectively(all P < 0.01).T he area under ROC curve of GOV diagnostic model that containd these 3 parameters diagnosing GOV in validation group was 0.914 (95% CI,0.832~0.995).The -1.49 was the best cut-off value with sensitivity,specificity,positive predictive value,negative predivtive value and coincidence rate of 79.0%,92.5%,91.3%,81.5% and 85.8%,respectively. Conclusions The GOV diagnostic model established by combining SWE and conventional ultrasonography is of certain value in diagnosis of GOV in patients with hepatitis B-related HCC yet needs further validation.

OBJECTIVETo investigate the effects of Egb761, an extract of ginkgo biloba , and dipyridamole on inducible NO synthase (iNOS) in rabbits after myocardial ischemia-reperfusion injury.

METHODSAfter being established into ischemia-reperfusion injury model, 35 rabbits were divided randomly into 5 groups: Group A (the sham group), Group B (the model group), Group C (treated with dipyridamole 0.8 mg/kg), Group D (treated with Egb761, 40 mg/kg), and Group E (treated with Egb761 40 mg/kg combined with dipyridamole 0.8 mg/kg), all the medications were administered by intravenous injection 30 min after reperfusion. After administration, myocardial iNOS mRNA expression was detected by RT-PCR and western blot.

RESULTSMyocardial iNOS mRNA transcriptive expression in the 5 groups were A 0, B 157.11 +/- 17.73, C 202.6 +/- 21.84, D 356.13 +/- 24.18 and E 562.34 +/- 35.19 respectively, showing significant difference between the treated groups and group B (P <0.01). The translative expression of myocardial iNOS in the 5 groups were A 34.24 +/- 15.78, B 75.70 +/- 13.71, C 116.89 +/- 22.57, D 143.75 +/- 16.05 and E 195.09 +/- 22.25 respectively, showing significant difference between the treated groups and group B as well (P < 0.05, P < 0.01).

CONCLUSIONBoth Egb761 and dipyridamole could increase myocardial iNOS expression in transcriptive and translative levels in rabbits after myocardial ischemia-reperfusion injury, and the combined treatment of them shows a more significant effect.

Animals ; Dipyridamole ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Ginkgo biloba ; Male ; Myocardial Reperfusion Injury ; drug therapy ; enzymology ; genetics ; Myocardium ; enzymology ; Nitric Oxide Synthase Type II ; biosynthesis ; genetics ; Phytotherapy ; RNA, Messenger ; biosynthesis ; genetics ; Rabbits ; Random Allocation ; Transcription, Genetic

Objective To investigate the effect of expression of Cullin 4B (CUL4B) on the prognosis of patients after liver transplantation for hepatocellular carcinoma (HCC).Methods The retrospective case-control study was conducted.The clinicopathological data of 79 patients who underwent liver transplantation for HCC in the First Affiliated Hospital of Sun Yat-sen University between January 1,2014 and June 30,2015 were collected.The specimens of HCC tissues were collected and embedded in paraffin,and then were detected by immunohistochemistry staining.Observation indicators:(1) expression of CUL4B in HCC tissues;(2) follow-up and survival;(3) prognostic factors analysis after liver transplantation;(4) association between expression of CUL4B and recurrence and metastasis of tumor after liver transplantation.Follow-up using outpatient examination and telephone interview was performed to detect tumor recurrence or metastasis and survival up to June 2018.Measurement data with normal distribution were represented as (x)±s.The comparison between groups of count data was done using the chi-square test.The survival curve drawn using the Kaplan-Meier method,and the survival analysis was done by Log-rank test.The univariate and multivariate analysis were respectively done using the COX regression model.The association analysis was done using the Pearson test.Results (1) Expression of CUL4B in HCC tissues:immunohistochemistry staining showed that CUL4B was mainly expressed in the cytoplasm,with a powerful brownish-yellow staining.The high expression and low expression of CUL4B in HCC tissues were detected in 64 and 15 patients,respectively.(2) Follow-up and survival:79 patients were followed up for 38-56 months,with an average time of 46 months.During the follow-up,37 patients had no tumor recurrence and 42 had tumor recurrence (32 with tumor extrahepatic metastasis and 10 with intrahepatic metastasis);36 had survival and 43 died;the 1-and 3-year overall survival rates were respectively 86.84％ and 63.25％,and 1-and 3-year tumorfree survival rates were respectively 62.31％ and 51.27％.(3) Prognostic factors analysis after liver transplantation:① Results of univariate analysis showed that preoperative alpha-fetoprotein (AFP),Child-Pugh score,maximum tumour dimension,capsular invasion,intravascular tumor thrombus,Edmonson pathological grading and expression of CUL4B were related factors affecting the 3-year overall survival rate of patients after liver transplantation for HCC [Hazard Ratio (HR) =2.17,3.36,3.66,2.43,2.19,3.36,2.84,95％ confidence interval(CI):1.17-4.04,1.53-7.42,2.10-6.42,1.33-4.17,1.08-9.04,1.58-7.59,1.17-6.32,P＜ 0.05].The preoperative alpha-fetoprotein (AFP),Child-Pugh score,maximum tumour dimension,capsular invasion,intravascular tumor thrombus,Edmonson pathological grading and expression of CUL4B were related factors affecting the 3-year tumor-free survival rate of patients after liver transplantation for HCC (HR =2.06,3.72,3.16,2.36,2.83,3.21,1.69,95％CI:1.34-4.85,1.72-8.63,1.79-7.31,1.46-4.86,1.19-8.63,1.19-7.92,1.06-4.87,P＜0.05).② Results of multivariate analysis showed that maximum tumour dimension,intravascular tumor thrombus and expression of CUL4B were independent factors affecting the 3-year overall survival rate of patients after liver transplantation for HCC [Odds ratio(OR) =3.43,3.69,2.81,95％CI:1.16-6.02,1.96-9.38,1.04-9.63,P＜0.05].The maximum tumour dimension,intravascular tumor thrombus and expression of CUL4B were independent factors affecting the 3-year tumor-free survival rate of patients after liver transplantation for HCC (OR=2.25,4.72,2.74,95％C1:1.16-4.02,1.98-9.47,1.03-7.10,P＜ 0.05).The 3-year overall survival rate in patients with high-and low-expressions of CUL4B was respectively 66.7％ and 32.8％,with a statistically significant difference (x2 =5.69,P＜0.05).The 3-year tumor-free survival rate in patients with high-and low-expressions of CUL4B was respectively 73.3％ and 18.6％,with a statistically significant difference (x2 =4.63,P＜0.05).(4) Association between expression of CUL4B and recurrence and metastasis of tumor after liver transplantation:results of Pearson test showed that expression of CUL4B was significantly associated with HCC recurrence and metastasis after liver transplantation (r =0.62,P＜0.05).The further analysis showed that expression of CUL4B was significantly associated with extrahepatic metastasis after liver transplantation (r=0.84,P ＜ 0.05).Conclusion The expression of CUL4B is associated with HCC recurrence after liver transplantation,and it can be as a predictor for HCC recurrence and distant metastasis after liver transplantation.

Objective To explore the association between dust exposure and the incidence of hypertension in male coal miners. Methods Using the method of retrospective cohort study,a hypertension cohort of colliery in Henan Province was established in January 2006. From 2006 to 2017,all the male coal miners in a colliery who were exposed to dust were selected into the exposure group including tunneling, mining,auxiliary and combining workers,and workers from administrative logistics departments who were not exposed to dust were selected into the control group. The eligible participants should satisfy following conditions: working more than one year, with clear and complete record of occupation change, and with complete archives and reliable diagnosis of occupational health surveillance. The exclusion criteria of participants were with hypertension at the baseline of study or with heart,liver,kidney diseases and malignant tumors. A total of 12 647 participants were enrolled in this study (11 663 in the exposure group and 984 in the control group). The follow?up period was from January 2006 to December 2017,with a total follow?up of 89 259.75 person?years. Questionnaires and physical measurements were used to collect general demographic characteristics, occupational exposure history and occupational health surveillance data of all participants. The Cox proportional hazards regression model was used to estimate the association between the dust exposure and the incidence of hypertension. Results During the follow?up period, 2 549 new?onset hypertension patients were identified with an incidence density of hypertension about 2 855.71 per 100 000 person?years. The incidence density of hypertension was 2 967.58 per 100 000 person?years in the exposure group, and 1 643.85 per 100 000 person?years in the control group. The results of multivariate Cox proportional hazards regression model showed that after the adjustment of marriage, age, smoking, alcohol drinking and body mass index,the risk of hypertension was higher in the exposure group compared with the control group ( HR=1.692, 95%CI : 1.410-2.032). Further analysis showed that compared with workers from administrative logistics departments,the risk of hypertension in tunneling,mining and auxiliary working was 1.629(1.345-1.973),1.677(1.374-2.046) and 1.782(1.475-2.151),respectively. Conclusion Dust exposure may increase the risk of hypertension in male coal miners.

Objective To explore the association between dust exposure and the incidence of hypertension in male coal miners. Methods Using the method of retrospective cohort study,a hypertension cohort of colliery in Henan Province was established in January 2006. From 2006 to 2017,all the male coal miners in a colliery who were exposed to dust were selected into the exposure group including tunneling, mining,auxiliary and combining workers,and workers from administrative logistics departments who were not exposed to dust were selected into the control group. The eligible participants should satisfy following conditions: working more than one year, with clear and complete record of occupation change, and with complete archives and reliable diagnosis of occupational health surveillance. The exclusion criteria of participants were with hypertension at the baseline of study or with heart,liver,kidney diseases and malignant tumors. A total of 12 647 participants were enrolled in this study (11 663 in the exposure group and 984 in the control group). The follow?up period was from January 2006 to December 2017,with a total follow?up of 89 259.75 person?years. Questionnaires and physical measurements were used to collect general demographic characteristics, occupational exposure history and occupational health surveillance data of all participants. The Cox proportional hazards regression model was used to estimate the association between the dust exposure and the incidence of hypertension. Results During the follow?up period, 2 549 new?onset hypertension patients were identified with an incidence density of hypertension about 2 855.71 per 100 000 person?years. The incidence density of hypertension was 2 967.58 per 100 000 person?years in the exposure group, and 1 643.85 per 100 000 person?years in the control group. The results of multivariate Cox proportional hazards regression model showed that after the adjustment of marriage, age, smoking, alcohol drinking and body mass index,the risk of hypertension was higher in the exposure group compared with the control group ( HR=1.692, 95%CI : 1.410-2.032). Further analysis showed that compared with workers from administrative logistics departments,the risk of hypertension in tunneling,mining and auxiliary working was 1.629(1.345-1.973),1.677(1.374-2.046) and 1.782(1.475-2.151),respectively. Conclusion Dust exposure may increase the risk of hypertension in male coal miners.