ObjectiveTo investigate the influence of different diagnostic criteria on the short-term prognosis of patients with acute-on-chronic liver failure （ACLF）. MethodsA total of 115 ACLF patients who were hospitalized in Department of Gastroenterology， The Second Affiliated Hospital of Kunming Medical University， from January 2018 to January 2022 were enrolled， and all patients received internal medical treatment combined with artificial liver therapy. According to the guidelines， the patients were divided into CMA guideline group （Diagnostic and treatment guidelines for liver failure by Chinese Medical Association）（n=100）， APASL guideline group （Consensus statements of Asian Pacific Association for the Study of the Liver）（n=94）， and EASL guideline group （Criteria proposed by European Association for the Study of the Liver）（n=36）. The above three guidelines were compared in terms of 90-day mortality rate. A one-way analysis of variance was used for comprision of continuous date between groups； the chi-square test was used for comprision of categorical date between groups. The receiver operating characteristic （ROC） curve of related variables. ResultsThe 90-day mortality rate was 50.0% in the CMA guideline group， 51.1% in the APASL guideline group， and 77.8% in the EASL guideline group， and the EASL guideline group had a significantly higher 90-day mortality rate than the CMA guideline group （χ²=8.351， P=0.004） and the APASL guideline group （χ²=7.650， P=0.006）. EASL guideline had a sensitivity of 22.2% and a specificity of 92.3% in predicting the risk of short-term mortality， with an area under the ROC curve was 0.576. ConclusionACLF patients who meet EASL guideline tend to have a worse short-term prognosis， and this guideline may help to identify patients at a relatively high risk of short-term death.

Objective: To establish a method for simultaneous and rapid detecting of the polymorphisms in Cytochrome P450 2C9 (CYP2C9), CYP2C19, CYP4F2, Vitamin K epoxide reductase (VKORC1) and ATP-binding cassette subfamily B member1 (ABCB1) gene, which were associated with warfarin and clopidogrel, based on liquid phase chip technology. Methods: Method establishment. The eight gene sequences near targeted sites related to warfarin and clopidogrel were found in Genbank, and the specific primers and probes were designed. Through multiple PCR amplification, followed by allele specific primer extension (ASPE), and MagPlex-Tag microspheres hybridization, the suspension array Luminex 200 system step-by-step, the genotypes were determined by fluorescence signal. The reaction system was optimized and its methodological evaluation was performed. 260 patients with antithrombotic therapy from Dongguan houjie hospital were recruited in this study form June 2017 to December 2018. The eight genotypes of the 260 patients were detected by the established method, and the results were compared with the sequencing results. Results: The results of 260 samples showed that allelic median fluorescence intensity (MFI) ratios of homozygotes (mutant/wild-type) were all greater than 0.9 or less than 0.1, and all the allelic MFI ratios of heterozygotes were between 0.3 and 0.6. The within run and between run coefficients of variance for allelic MFI ratios were lower than 6.4% and 10.9%, respectively. The minimum DNA template requirements was 0.75ng. The genotypes of 260 patients determined by the established method were completely concordant with the sequencing results. Conclusion A method was established successfully for rapid detecting the genotypes which associated with warfarin and clopidogrel based on liquid phase chip technology.

Objective To analyze MRI and CT features of struma ovarii (SO).Methods CT and MRI findings of 14 patients with pathologically confirmed single SO were retrospectively analyzed.The morphology,size,density/signal intensity and enhancement pattern of lesions were analyzed.Results All the tumors appeared as well-defined cystic-solid masses,11 were multilobulated and 3 were round-like.Thirteen lesions were multicystic,and 1 was unilocular.The solid components appeared as thickness septa or wall in 11 and as nodule in 3 lesions.The maximum diameter of the tumors were 3-34 cm,with an average size of (11.34±2.24)cm.MRI showed extremely low signal intensity regions in cyst portion of 7 masses on T2WI without enhancement,while obvious enhancement in solid potion.CT showed high attenuation in cyst portion of 7 masses without enhancement,CT value were 57-90 HU,whereas the solid potion obviously enhanced,and CT values were 145-270 HU.Plaque-like calcification on the walls or nodules were observed in 4 patients.Conclusion CT and MRI findings of SO have certain characteristics,which are helpful for diagnosis and differential diagnosis.

Objective To study the effects of 5-azacytidine’s demethylation for P16 gene on hemangioma cell’s proliferation and apoptosis.Methods Bisulfite sequencing PCR was applied to detect P16 gene′s promoter methylation status in 5-azacytidine treated and untreated EOMA cell line.RT-PCR and western blot were used to detect the P16 gene mRNA and protein expressions.Flow cytometry was used to detect cell proliferation, cell cycle and cell apoptosis.The differences of P16 gene′s promoter methylation status,mRNA and protein expressions,cell proliferation,cell cycle and apoptosis in two groups were compared. Results The methylation rates in 1st and 13th CGs were 0%after 5-azacytidine treatment in EOMA hemangioma cell line,which were lower than in untreated cells.The mRNA and protein expressions increased after 5-azacytidine treatment,which were significantly higher than in untreated cells.The absorbance,S phase and G2/M phase and PI after 5-azacytidine treatment were lower than untreated cells,while the G0/G1 phase and apoptosis rates were higher.Conclusion The P16 gene promoter is hypermethylated in hemangioma cells with silent gene expressions.5-azacytidine could reverse P16 gene′s promoter methylation and silent gene expressions,which inhibit hemangioma cell’s proliferation and promote apoptosis.

Objective To study the effects of Lentinan on bleomycin A5’s inhibition effects in hemangioma-derived endothelial cell. Methods Hemangioma-derived endothelial cell line EOMA were divided into LTN group (only lentinan treatment), BLE group (only bleomycin A 5 treatment), L+B group (Lentinan and bleomycin A5 treatment) and CON group (no lentinan and bleomycin A5 treatment). Cell proliferation, cell cycle, PI and apoptosis were detected and compared among four groups. Results The differences of absorbance in LBE group was significantly higher than that in L+B group after treatment for d 1-d 7 (P<0.05), but both of them were significantly lower than in CON group and LTN group (P<0.05). The G 0/G 1 stage and apoptosis rate in L+B group was significantly higher than in BLE group(P<0.05), while it was significantly lower in S stage, G 2/M stage and PI(P<0.05). Conclusion Lentinan could significantly promote bleomycin A5’s inhibition effects on hemangioma-derived endothelial cell.

Objective To explore the nursing intervention on pregnancy rate and endocrine indexes in obese patients with polycystic ovary syndrome(PCOS)combined with infertility.Meth-ods 40 infertile patients with polycystic ovary syndrome were randomly divided into control group and observation group.Control group was given the therapy of medication induced ovulation while the observation group was given nursing intervention before treatment for four months in advance. The pregnancy rate and endocrine index were compared.Results The pregnancy rate in the ob-servation group was 45%(9 /20)which was significantly higher than 15%(3 /20)in the control group.The difference was statistical significant(P <0.05).Through nursing interventions,obesi-ty,polycystic ovary syndrome,infertility endocrine indexes including testosterone (T),luteinizing hormone (LH),LH /FSH and insulin resistance index (HOMA-IR)had changed compared with the condition before.The difference was significant.Conclusion The systematic nursing inter-vention is significant on polycystic ovary syndrome,particularly for obese women with polycystic o-vary syndrome.It could increase pregnancy rates,endocrine metabolism,lifestyle and mental health,so it is worthy of promotion.

Objective To explore the nursing intervention on pregnancy rate and endocrine indexes in obese patients with polycystic ovary syndrome(PCOS)combined with infertility.Meth-ods 40 infertile patients with polycystic ovary syndrome were randomly divided into control group and observation group.Control group was given the therapy of medication induced ovulation while the observation group was given nursing intervention before treatment for four months in advance. The pregnancy rate and endocrine index were compared.Results The pregnancy rate in the ob-servation group was 45%(9 /20)which was significantly higher than 15%(3 /20)in the control group.The difference was statistical significant(P <0.05).Through nursing interventions,obesi-ty,polycystic ovary syndrome,infertility endocrine indexes including testosterone (T),luteinizing hormone (LH),LH /FSH and insulin resistance index (HOMA-IR)had changed compared with the condition before.The difference was significant.Conclusion The systematic nursing inter-vention is significant on polycystic ovary syndrome,particularly for obese women with polycystic o-vary syndrome.It could increase pregnancy rates,endocrine metabolism,lifestyle and mental health,so it is worthy of promotion.

Objectives To study the mutation spectrum in CYP21A2 gene in patients with 21-hydroxylase deficiency (21-OHD), and to analyze the relationship between genotype and phenotype. Methods Eighteen patients with 21-OHD were identified by neonatal screening of 17α-OH progesterone (17α-OHP). The allele specific PCR-DNA sequencing com-bining with multiplex ligation-dependent probe amplification was applied to determine the genotype in the patients and their parents. Results Six mutations of CYP21A2 gene were identified. I2G (44.4%) and del (33.3%) were the most frequent mutations and also were the most common mutations in salt-wasting form. The detection rate of I172N mutation in simple virilizing form was 75%. Patients were classified into three groups according to the degree of 21-hydroxylase enzymatic compromise caused by the mutation. The serum 17α-OHP, ACTH and T levels which reflected the severity of disease were significantly different among three groups (P<0.05). Conclusions The genetic diagnosis of 21-OHD reveals the consistency between genotype and phenotype.

Objective To develop an intelligent cabinet with constant temperature and adjustable height,which is safer,more scientific and comfortable for heat preservation after surgical operation.Methods According to the demands of microscopic surgery we analyzed the disadvantages of existing equipment in order to seek new materials to solve the current problems.Results Using nanometer electric heating film to control temperature at 30～35 ℃ and adjust temperature in this range.Moreover debugging angle of stainless steel adjustable upholder at 0～45°.Conclusions Nanometer electric heating film is a kind of high safety,reliability and strong stability heating material and can be used for the microscopic surgery insulation.Adjustable lifting upholder makes limbs more comfortable with freely height.It shows that setting temperature at 30～31℃,angel value at 20～25°would be relatively suitable after our experiment.

Objective To discuss the feasibility of Monte Carlo N-particle transport code(MCNP)simulated calculation.Methods The calculation in water phantom was contrasted with the practical measurements and the reported values using the percent depth dose(PDD)curve and normal peak scatter factor.Results There Was no significant difference between calculated and measured results in the 10 cm×10 cm field(t＝-0.41,P>0.05),however,there were significant differences in the 5 cm×5 cm field(t=7.2,P<0.05)and in the 12 cm×12 cm field(t=-4.6,P<0.05).There was no significant difierence between the calculated results and the reported values(t=-1.91,P>0.05).In the same radiation field,the PDD decreased as the depth increased,but increased as the size of the radiation field increased at the same depth.PDD and normal peak scatter factor were both important parameters for calculation of prescribed dose.Conclusions It is possible to establish a set of accurate and comprehensive percent depth doses and normal peak scatter factor parameters so as to provide the basis of clinical use, quality assurance and quality control for radiotherapy.