Objective To investigate the predictive value of the combined tumor burden score (TBS) and platelet-albumin-bilirubin (PALBI) score model for postoperative tumor recurrence in liver transplant recipients with hepatocellular carcinoma (HCC). Methods The general information of 158 recipients diagnosed with HCC and underwent liver transplantation at the 900th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from 2008 to 2021 was collected. Lasso regression analysis combined with multivariate Cox regression analysis were used to identify independent risk factors for postoperative tumor recurrence after liver transplantation with HCC. A nomogram prediction model was constructed based on variables selected by Lasso regression analysis, and the predictive performance of the model was verified by calibration curve and clinical decision curve. The optimal cut-off values for postoperative tumor recurrence in liver transplant recipients with HCC were determined by receiver operating characteristic (ROC) curve, and Kaplan-Meier analysis was used to compare survival differences among different groups. Results Among the 158 liver transplant recipients with HCC, 82 experienced tumor recurrence, with a recurrence rate of 51.9% and a median tumor-free survival time of 10 (4, 25) months. Results of Lasso regression analysis and multivariate Cox regression analysis showed that alpha-fetoprotein (AFP) ≥400 ng/mL, TBS and PALBI score were all independent risk factors for postoperative tumor recurrence in liver transplant recipients with HCC (all P<0.05). The combined high TBS-high PALBI score showed the highest predictive value (hazard ratio 6.909, 95% confidence interval 3.067-15.563, P<0.001). A nomogram prediction model was constructed based on six variables selected by Lasso regression analysis. Calibration curve showed good consistency between the model's predicted results and the ideal curve. Decision curve analysis indicated that the nomogram prediction model provided the highest clinical benefit for predicting 1-year tumor-free survival after liver transplantation with HCC. Time-dependent ROC curves at 1, 3 and 5 years after surgery showed that TBS-PALBI model had good predictive performance, with no significant difference in area under the curve (AUC) compared with TBS-PALBI-AFP model. The optimal cut-off values for predicting postoperative tumor recurrence were determined by ROC curve, with a PALBI score cut-off of −2.334 and a TBS cut-off of 5.305. Recipients were divided into a low TBS-low PALBI score group (n=47) and a low/high TBS-low/high PALBI score group (at least one score was high) (n=111). Kaplan-Meier survival analysis showed that the low TBS-low PALBI score group had a higher tumor-free survival rate than the low/high TBS-low/high PALBI score group, with a significant difference (P<0.05). Conclusions TBS-PALBI model provides a novel, simple and effective tool for assessing the prognosis of liver transplant recipients with HCC. The nomogram model constructed based on this has significant advantages in predictive performance and may serve as a reference for guiding individualized treatment plans and improving clinical outcomes.

Objective:To study the impact of early blood concentrations of tacrolimus on the survival of patients after liver transplantation.Methods:Clinical data of 159 patients with liver diseases undergoing classic orthotopic liver transplantation at the Department of Hepatobiliary Surgery, the 900th Hospital of the Joint Logistics Support Force between January 2010 and December 2019 were retrospectively analyzed, including 123 males and 36 females, aged (48.0±12.2) years. According to survival status, patients were divided into the surviving group ( n=108) and death group ( n=51). Inverse probability of treatment weighting (IPTW) was applied to adjust for confounding factors by weighting covariates between the two groups. Univariate and multivariate Cox regression analysis were used to examine the relationship between early tacrolimus concentrations and mortality, and restrict cubic spline (RCS) curves were employed to assess the nonlinear relationship further. Results:After IPTW weighting, multivariate Cox regression analysis indicated that early tacrolimus concentration ( HR=2.479, 95% CI: 1.354-4.537, P<0.001) and preoperative international normalized ratio ( HR=0.358, 95% CI: 0.162-0.792, P=0.011) levels were risk factors for post-transplant survival. The RCS curve revealed that the optimal thresholds for early tacrolimus concentration were 6.30 ng/ml and 8.28 ng/ml ( P<0.001). Patients were therefore divided into the optimal concentration group ( n=60) and the non-optimal concentration group ( n=99). After IPTW weighting, the optimal concentration group comprised 102 cases, and the non-optimal concentration group included 212 cases. The 1-year, 3-year and 5-year survival rates in the optimal concentration group and the non-optimal concentration group were 97.06%, 81.37% and 75.49%, and 86.32%, 64.62% and 50.94%, respecitvely ( χ2=8.37, P<0.001). Conclusion:Early tacrolimus concentration is an independent risk factor for post-transplant survival. A tacrolimus concentration >8.28 ng/ml or <6.30 ng/ml is associated with a relatively higher mortality rate.

Objective:To study the impact of early blood concentrations of tacrolimus on the survival of patients after liver transplantation.Methods:Clinical data of 159 patients with liver diseases undergoing classic orthotopic liver transplantation at the Department of Hepatobiliary Surgery, the 900th Hospital of the Joint Logistics Support Force between January 2010 and December 2019 were retrospectively analyzed, including 123 males and 36 females, aged (48.0±12.2) years. According to survival status, patients were divided into the surviving group ( n=108) and death group ( n=51). Inverse probability of treatment weighting (IPTW) was applied to adjust for confounding factors by weighting covariates between the two groups. Univariate and multivariate Cox regression analysis were used to examine the relationship between early tacrolimus concentrations and mortality, and restrict cubic spline (RCS) curves were employed to assess the nonlinear relationship further. Results:After IPTW weighting, multivariate Cox regression analysis indicated that early tacrolimus concentration ( HR=2.479, 95% CI: 1.354-4.537, P<0.001) and preoperative international normalized ratio ( HR=0.358, 95% CI: 0.162-0.792, P=0.011) levels were risk factors for post-transplant survival. The RCS curve revealed that the optimal thresholds for early tacrolimus concentration were 6.30 ng/ml and 8.28 ng/ml ( P<0.001). Patients were therefore divided into the optimal concentration group ( n=60) and the non-optimal concentration group ( n=99). After IPTW weighting, the optimal concentration group comprised 102 cases, and the non-optimal concentration group included 212 cases. The 1-year, 3-year and 5-year survival rates in the optimal concentration group and the non-optimal concentration group were 97.06%, 81.37% and 75.49%, and 86.32%, 64.62% and 50.94%, respecitvely ( χ2=8.37, P<0.001). Conclusion:Early tacrolimus concentration is an independent risk factor for post-transplant survival. A tacrolimus concentration >8.28 ng/ml or <6.30 ng/ml is associated with a relatively higher mortality rate.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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To analyze the genetic characteristics of a polio-I highly variant vaccine recombinant virus in Shandong Province (China) in 2011 and to identify isolates from healthy contacts, two stool specimens from one patient with acute flaccid paralysis (AFP) and 40 stool specimens from his contacts were collected for virus isolation. The complete genome of poliovirus and VP1 coding region of the non-polio enterovirus were sequenced. Homologous comparison and phylogenetic analyses based on VP1 sequences were undertaken among coxsackievirus (CV) B1, CV-B3 isolates, and those in GenBank. One poliovirus (P1/11186), CV-A4 and CV-A8 were isolated from the AFP patient; one CV-A2, Echovirus 3 (E-3), E-12 and E-14, ten CV-B1, and five CV-B3 strains were isolated from his contacts. These results led us to believe that there may be a human enterovirus epidemic in this area, and that surveillance must be enhanced. P1/11186 was a type-1 vaccine-related poliovirus; it combined with type-2 and type-3 polioviruses in 2A and 3A regions, respectively. There were 25 nucleotide mutations with 9 amino-acid alterations in the entire genome. There were 8 nucleotide mutations with 5 amino-acid alterations in the VP1 region compared with the corresponding Sabin strains. Homology analyses suggested that the ten CV-B1 isolates had 97.0%-100% nucleotide and 98.9%-100% amino-acid identities with each other, as well as 92.6%-100% nucleotide and 99.2%-100% amino-acid identities among the five CV-B3 isolates. Phylogenetic analyses on the complete sequences of VP1 among CV-B1 and CV-B3 isolates showed that Shandong strains, together with strains from other provinces in China, had a close relationship and belonged to the same group.
Base Sequence ; Capsid Proteins ; genetics ; immunology ; Child, Preschool ; China ; Humans ; Male ; Molecular Sequence Data ; Phylogeny ; Poliomyelitis ; etiology ; prevention & control ; virology ; Poliovirus ; classification ; genetics ; immunology ; isolation & purification ; Poliovirus Vaccines ; adverse effects ; genetics ; immunology

Objective:To observe the therapeutic effect and safety of warfarin on patients with atrial fibrillation. Methods:A total of 126 patients with atrial fibrillation from our hospital during Jun 2012-Jun 2013 were selected. According to hiding number random method,they were divided into aspirin group (n=63)and warfarin group (n=63).Coagulation function,blood lipid levels and end-point events were compared between two groups.Results:Compared with aspirin group,after treatment,there were significant reductions in levels of total cholesterol [(5.8 ±0.5)mmol/L vs.(5.2±0.7)mmol/L],triglyceride [(2.6±0.4)mmol/L vs.(2.4±0.3)mmol/L]and low density lipoprotein cholesterol [(2.7±0.5)mmol/L vs.(2.4±0.3)mmol/L],significant rise in level of high den-sity lipoprotein cholesterol [(1.1±0.2)mmol/L vs.(1.3±0.2)mmol/L],prothrombin time [(28.3±11.7)s vs. (36.9±10.4)s]and it′s international normalized ratio [(1.9±0.4)vs.(2.4±0.5)]in warfarin group,P <0.05 all.Incidence rate of endpoint events such as cerebral infarction and peripheral artery embolism etc.in warfarin group was significantly lower than that of aspirin group (3.17% vs.23.81%,P <0.01).The incidence rates of complications were 23.81% and 26.98% in warfarin group and aspirin group respectively,and they had no signifi-cant difference,P >0.05. Conclusion:For atrial fibrillation,the therapeutic effect and safety of warfarin is better than that of aspirin,is worth extending.

OBJECTIVE: To explore the 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET-CT) manifestations and functions in patients with primary hyperparathyroidism (pHPT). 
 METHOD: The diagnosis of 1 case of double parathyroid adenomas secondary to pPTH was reported and the related literature was reviewed.
 RESULTS: PET-CT showed two nodus shadow with slightly lower density compared with muscle, clear boundary and uniform density. Simultaneously, images also showed multiple enhanced FDG uptake of bone lesions in skeletal system. The maximum standard uptake values for ¹⁸F-FDG in the destructive bone lesions were more than 10. 
 CONCLUSION ¹⁸F-FDG PET-CT is a well-established imaging technique for the diagnosis in pHPT. It not only can clearly visualize systemic lesions and accurately assess the extent of the disease, but also can accurately localize parathyroid adenoma. After resection of parathyroid adenoma, FDG PET-CT imaging can be useful to see the response to treatment and osteoblastic changes in brown tumor.
Fluorodeoxyglucose F18 ; Humans ; Hyperparathyroidism, Primary ; diagnosis ; Positron-Emission Tomography ; Tomography, X-Ray Computed

Objective To investigate the correlation between the characteristics of the computed tomography (CT) perfusion parameters and the expression of D2-40 with lymphatic vessel density (LVD) in cervical carcinomas.Methods A total of 42 patients with cervical carcinoma was divided into two groups with and without lymph node metastasis.Patients were evaluated with CT perfusion scan before operation.Monoclonal antibody D2-40 was used for immunohistochemistry to detect the LVD in the carcinoma tissue specimen.CT perfusion parameters and LVD of two groups were compared,and their relationship was analyzed.Results CT perfusion parameters including blood flow (BF),peak enhancement image (PEI),and blood volume (BV) in the lymph node metastasis group were significantly higher than those in the no lymph node metastasis group (t =-2.206,-2.29,-2.336,P ＜ 0.05).The time to peak (TTP) was significantly lower in the lymph node metastasis group than the no node metastasis group (t =6.908,P ＜ 0.01).The LVD in the lymph node metastasis group was significantly higher than the no lymph node metastasis group (t =-5.092,P ＜ 0.01).The CT perfusion parameters (BF,PEI,BV) and LVD of cervical carcinomas had a significantly positive correlation (r =0.65,0.56,0.61,P ＜ 0.01).The TTP and LVD had a significantly negative correlation(r =-0.55,P ＜ 0.01).Conclusions CT perfusion imaging and higher LVD help to diagnose the lymph node metastasis of a cervical carcinoma,and have important guidance role in the surgical options for cervical cancers.

Objective To investigate the application of PBL and LBL teaching in medical imag-ing teach-ing. Methods Totally 124 five-year clinical students were divided into two groups:PBL teaching (n=57)and LBL teaching(n=67). Teaching in PBL group was conducted through the following 6 proce-dures:grouping-giving cases-asking questions-establishing hypothesis-collecting data-hypoth-esis testing-team summarizing. Teaching in LBL group was conducted mainly by teachers with multime-dia, course-ware,wall charts,models,samples,etc and finally summarized by teachers. Effect was eval-uated by reading test,closed-book exam and questionnaire survey. t test was employed to do statically analysis,with P≤0.05 being statistical differences. Results Reading test score ((82.4±14.8)vs (74.5±9.7))and case analysis score((13.9±5.1)vs (10.2±6.1))were higher in PBL group than in LBL group(P≤0.05). Most students in PBL group appreciated the teaching method. Conclusions PBL teaching can help improve the clinical analysis of students and is welcomed by students. Moreover, PBL,as a supplement of traditional teaching,can initiate the learning interests and enhance the innova-tion of students.