Objective:To explore the value and related mechanism of preoperative serum sialic acid (SA) on evaluating microvascular invasion (MVI) in patients with intrahepatic cholangiocarcinoma (ICC).Methods:A total of 91 patients who underwent surgical resection and were pathologically diagnosed with ICC from December 2020 to September 2024 at the Oriental Hepatobiliary Surgery Hospital affiliated to the Naval Medical University were included in this retrospective analysis. The patients were divided into non-MVI (41 cases) and MVI groups (50 cases). The general data and laboratory examination indexes were collected and analyzed. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for predicting MVI. The predictive value of serum indicators for MVI was evaluated by receiver operating characteristic curves. The correlation between MVI and SA was analyzed by point-biserial correlation. ICC cells stably overexpressing β-galactoside α2, 6-sialyltransferase 1 (ST6GAL1) were generated through lentiviral transfection. ST6GAL1 protein expression and mRNA expression were detected by Western blot and quantitative real-time polymerase chain reaction, respectively. Sambucus nigra (SNA) lectin fluorescence staining was used to detect α2, 6-sialylation levels on cells. Cell migration ability was assessed by wound healing and Transwell assays, and cell proliferation was evaluated by colony formation assays.Results:Compared with the non-MVI group, patients in the MVI group exhibited significantly higher levels of fibrinogen, aspartate aminotransferase, gamma-glutamyl transferase, alkaline phosphatase, SA and 5′-nucleotidase (5′-NT) (all P<0.05). Multivariate logistic regression analysis revealed that SA ( OR=1.01,95% CI 1.01-1.02, P=0.023) was the only independent predictor for MVI. The area under curve of SA in predicting MVI was 0.757 (95% CI 0.640-0.870), sensitivity 67.65%, specificity 77.78%. SA was positively correlated with MVI ( r=0.443, P<0.001). ICC cells overexpressing ST6GAL1 were featured with increased mean fluorescence intensity of SNA lectin, and increased level of α2, 6-sialylation on the cell surface (both P<0.05). The number of colonies formed by hypersialylated ICC cells was also increased ( P<0.05), and both the migration rate and the number of migrating cells were significantly higher ( P<0.05). Conclusions:Serum SA is an independent predictor for MVI in ICC patients. Hypersialylation in ICC cells is associated with higher malignancy.

Objective:To establish a quality and safety evaluation index system for the daytime chemotherapy in the Day Medical Management Quality Control Center of Fujian Province, providing references for objectively evaluating the quality of day chemotherapy.Methods:From December 2023 to August 2024, this study screened the initial indexes of the quality and safety evaluation index system for daytime chemotherapy through literature search and expert discussions. An index system and its weights were determined by using two rounds of Delphi method and precedence chart method. The quality of daytime chemotherapy services in 8 hospitals was evaluated by using a thousand point scale checklist based on this index system.Results:The expert motivation of both rounds of Delphi method was 100%, and the expert authority coefficient was 0.92. The quality and safety evaluation index system for daytime chemotherapy included 3 first-level indicators, 13 second-level indicators, and 54 third-level indicators; Among them, the weights of the first-level indicator included structure quality, process quality, and result quality were 0.334, 0.556, and 0.110, respectively. The quality and safety scores of daytime chemotherapy in 8 hospitals ranged from 812 to 980 points, with an average of 933 points.Conclusions:The quality and safety evaluation index system for daytime chemotherapy could objectively and comprehensively evaluate the quality and safety of hospital daytime chemotherapy.

Objective:To explore the value and related mechanism of preoperative serum sialic acid (SA) on evaluating microvascular invasion (MVI) in patients with intrahepatic cholangiocarcinoma (ICC).Methods:A total of 91 patients who underwent surgical resection and were pathologically diagnosed with ICC from December 2020 to September 2024 at the Oriental Hepatobiliary Surgery Hospital affiliated to the Naval Medical University were included in this retrospective analysis. The patients were divided into non-MVI (41 cases) and MVI groups (50 cases). The general data and laboratory examination indexes were collected and analyzed. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for predicting MVI. The predictive value of serum indicators for MVI was evaluated by receiver operating characteristic curves. The correlation between MVI and SA was analyzed by point-biserial correlation. ICC cells stably overexpressing β-galactoside α2, 6-sialyltransferase 1 (ST6GAL1) were generated through lentiviral transfection. ST6GAL1 protein expression and mRNA expression were detected by Western blot and quantitative real-time polymerase chain reaction, respectively. Sambucus nigra (SNA) lectin fluorescence staining was used to detect α2, 6-sialylation levels on cells. Cell migration ability was assessed by wound healing and Transwell assays, and cell proliferation was evaluated by colony formation assays.Results:Compared with the non-MVI group, patients in the MVI group exhibited significantly higher levels of fibrinogen, aspartate aminotransferase, gamma-glutamyl transferase, alkaline phosphatase, SA and 5′-nucleotidase (5′-NT) (all P<0.05). Multivariate logistic regression analysis revealed that SA ( OR=1.01,95% CI 1.01-1.02, P=0.023) was the only independent predictor for MVI. The area under curve of SA in predicting MVI was 0.757 (95% CI 0.640-0.870), sensitivity 67.65%, specificity 77.78%. SA was positively correlated with MVI ( r=0.443, P<0.001). ICC cells overexpressing ST6GAL1 were featured with increased mean fluorescence intensity of SNA lectin, and increased level of α2, 6-sialylation on the cell surface (both P<0.05). The number of colonies formed by hypersialylated ICC cells was also increased ( P<0.05), and both the migration rate and the number of migrating cells were significantly higher ( P<0.05). Conclusions:Serum SA is an independent predictor for MVI in ICC patients. Hypersialylation in ICC cells is associated with higher malignancy.

Objective:To establish a quality and safety evaluation index system for the daytime chemotherapy in the Day Medical Management Quality Control Center of Fujian Province, providing references for objectively evaluating the quality of day chemotherapy.Methods:From December 2023 to August 2024, this study screened the initial indexes of the quality and safety evaluation index system for daytime chemotherapy through literature search and expert discussions. An index system and its weights were determined by using two rounds of Delphi method and precedence chart method. The quality of daytime chemotherapy services in 8 hospitals was evaluated by using a thousand point scale checklist based on this index system.Results:The expert motivation of both rounds of Delphi method was 100%, and the expert authority coefficient was 0.92. The quality and safety evaluation index system for daytime chemotherapy included 3 first-level indicators, 13 second-level indicators, and 54 third-level indicators; Among them, the weights of the first-level indicator included structure quality, process quality, and result quality were 0.334, 0.556, and 0.110, respectively. The quality and safety scores of daytime chemotherapy in 8 hospitals ranged from 812 to 980 points, with an average of 933 points.Conclusions:The quality and safety evaluation index system for daytime chemotherapy could objectively and comprehensively evaluate the quality and safety of hospital daytime chemotherapy.

Objective To investigate the therapeutic effect hyperbaric oxygen ( HBO) combined with Gubentongluofang on IgA nephropathy ( IgAN) in mice and possible molecular mechanism involved .Methods The murine α1k1-CD89 Tg transgene IgAN model was developed , and the animals were randomly divided into the control group , the model group , the calcitriol group , the Chinese herbal medicine group and the Chinese herbal medicine +HBO group.The expression levels of IgA, abnormal glycosylated IgA1, interleukin 6 ( IL-6 ) and tumor necrosis factor-α( TNF-α) of peripheral blood were detected , and the expressions of C1GalT1 and Cosmc protein in intestinal mucosa , kidney damage ( urine protein, serum creatinine and urea nitrogen) and blood urea nitrogen ( BUN) as well were detected for further analyses .Results As compared with those of the control group before treatment , the levels of IgA, abnormal glycosylation IgA1, IL-6 and TNF-in peripheral blood were significantly increased in the model group , the calcitriol group , the Chinese herbal medicine group and the Chinese herbal medicine +HBO group (P<0.05), and no significant differences could be noted in the levels of Scr and BUN in various groups ( P >0.05).After treatment, the levels of urine protein, IgA1, abnormal glycosylated IgA1, IL-6 and TNF-all significantly reduced in the calcitriol group , the Chinese herbal medicine group and the Chinese herbal medicine +HBO group, as compared with the model group(P<0.05), and the rate of reduction in the Chinese herbal medicine group was greater than that of the calcitriol group, but lower than that of the Chinese herbal medicine +HBO group (P<0.05).Intestinal mucosal tissues of the mice in various groups were collected after treatment for further analyses .As compared with the control group , C1GalT1 and Cosmc expression levels in intestinal mucosa in the model group decreased significantly.When compared with those in the model group , the C1GalT1 and Cosmc expression levels in the calcitriol group , the Chinese herbal medicine group , as well as the Chinese herbal medicine +HBO group increased considerably , with the increase in the Chinese herbal medicine +HBO group being most significant (P<0.05).Conclusion HBO could enhance the therapeutic effect of Gubentongluofang on IgAN , it might be closely associated with the down-regulation of IL-6 and TNF-and inhibition of abnormal activation of B cells and promotion of CIGALT1 and Cosmc expression .

Objective To investigate the therapeutic effect hyperbaric oxygen ( HBO) combined with Gubentongluofang on IgA nephropathy ( IgAN) in mice and possible molecular mechanism involved .Methods The murine α1k1-CD89 Tg transgene IgAN model was developed , and the animals were randomly divided into the control group , the model group , the calcitriol group , the Chinese herbal medicine group and the Chinese herbal medicine +HBO group.The expression levels of IgA, abnormal glycosylated IgA1, interleukin 6 ( IL-6 ) and tumor necrosis factor-α( TNF-α) of peripheral blood were detected , and the expressions of C1GalT1 and Cosmc protein in intestinal mucosa , kidney damage ( urine protein, serum creatinine and urea nitrogen) and blood urea nitrogen ( BUN) as well were detected for further analyses .Results As compared with those of the control group before treatment , the levels of IgA, abnormal glycosylation IgA1, IL-6 and TNF-in peripheral blood were significantly increased in the model group , the calcitriol group , the Chinese herbal medicine group and the Chinese herbal medicine +HBO group (P<0.05), and no significant differences could be noted in the levels of Scr and BUN in various groups ( P >0.05).After treatment, the levels of urine protein, IgA1, abnormal glycosylated IgA1, IL-6 and TNF-all significantly reduced in the calcitriol group , the Chinese herbal medicine group and the Chinese herbal medicine +HBO group, as compared with the model group(P<0.05), and the rate of reduction in the Chinese herbal medicine group was greater than that of the calcitriol group, but lower than that of the Chinese herbal medicine +HBO group (P<0.05).Intestinal mucosal tissues of the mice in various groups were collected after treatment for further analyses .As compared with the control group , C1GalT1 and Cosmc expression levels in intestinal mucosa in the model group decreased significantly.When compared with those in the model group , the C1GalT1 and Cosmc expression levels in the calcitriol group , the Chinese herbal medicine group , as well as the Chinese herbal medicine +HBO group increased considerably , with the increase in the Chinese herbal medicine +HBO group being most significant (P<0.05).Conclusion HBO could enhance the therapeutic effect of Gubentongluofang on IgAN , it might be closely associated with the down-regulation of IL-6 and TNF-and inhibition of abnormal activation of B cells and promotion of CIGALT1 and Cosmc expression .

Objective To analyze the effect of edaravone combined with statins on levels of serum homocysteine (Hcy),C-reactive protein (CRP) and total cholesterol (TC),triglyceride (TG),high-density lipoprotein HDL),low-density lipoprotein cholesterol (LDL-C) in patients with ischemic stroke.Methods A total of 63 patients with ischemic stroke in our hospital were divided into two groups,27 cases in control group were given atorvastatin,and 36 patients in the observation group were given edaravone treatment in addition.The levels of Hcy,TG,TC,HDL and low LDL-C were detected.At the same time,stroke scale of NIHSS,Barthel index of daily living ability,Self Anxiety Scale (SAS) and Self Depression Scale (SDS) were recorded at 14 days before and after treatment.Results The observation group had lower Hcy,CRP and LDL-C levels,while higher HDL level.Total effective rate in the observation group was significantly higher than the control group (88.89％ vs.77.78％,P ＜0.05).The observation group had higher Barthel index and lower SAS,SDS scores than the control group (P ＜ 0.05).Conclusion Edaravone combined with atorvastatin can significantly improve patients' treatment outcomes,and improve prognosis and life ability.

Objective To analyze the effect of edaravone combined with statins on levels of serum homocysteine (Hcy),C-reactive protein (CRP) and total cholesterol (TC),triglyceride (TG),high-density lipoprotein HDL),low-density lipoprotein cholesterol (LDL-C) in patients with ischemic stroke.Methods A total of 63 patients with ischemic stroke in our hospital were divided into two groups,27 cases in control group were given atorvastatin,and 36 patients in the observation group were given edaravone treatment in addition.The levels of Hcy,TG,TC,HDL and low LDL-C were detected.At the same time,stroke scale of NIHSS,Barthel index of daily living ability,Self Anxiety Scale (SAS) and Self Depression Scale (SDS) were recorded at 14 days before and after treatment.Results The observation group had lower Hcy,CRP and LDL-C levels,while higher HDL level.Total effective rate in the observation group was significantly higher than the control group (88.89％ vs.77.78％,P ＜0.05).The observation group had higher Barthel index and lower SAS,SDS scores than the control group (P ＜ 0.05).Conclusion Edaravone combined with atorvastatin can significantly improve patients' treatment outcomes,and improve prognosis and life ability.

Objective To study dIe ESBLs and plasmid-mediated AmpC enzymes in E.Coli and Klebsiella spp. with CLSI ESBL-screening test positive,confirmation test negative but cefepime susceptible.Methods Antimierobial susceptibility testing were performed by Kirby-Bauer(K-B)method.The genes encoding ESBLs and plasmid-mediated AmpC enzymes were detected by PCR Transfer of ESBLs or plagmid-mediated AmpC resistance was studied by conjugation experiments.The homology of donor (E.coli),recipient(E.coli J53)and their transconjugants were analyzed by ERIC-PCR DNA fingerprints of E.coli and Klebsiella pneumoniae were analyzed by PFGE as recommended bv PulseNet protocoL Results Of 18 isolates from Huashan Hospital,11 were E.coli.6 were Klebsiella pneumoniae and 1 was Klebsiella oxytoca.Antimicrobial susceptibility testing indicated all of 18 isolates were positive on the CLSI ESBL screening test but negative on the confirmation test.and all of isolates were susceptible to cefepime(a zoneof-inhibition diameter of≥18 mm wag considered to indicate susceptible).PCR results indicated that 9 of the 11 E.coli isolates predued CMY-2 AmpC enzyme.TEM,SHV,CTX-M,PER,VEB or SFO type β-lactamages were not identified.Of 6 Klebsiella pneumoniae isolates.5 were DHA-1 AmpC-producing strains.4 of the 5 DHA-1 AmpC-producing strains were coexistence of broad-speetrumβ-lactamaae or extended-spectrumβ-lactamase.including two producing SHV-11 and two producing CTX-M-14 and SHV-62 type ESBL respectively.One Klebsiella oxytoca wag also DHA-1 AmpC producing strain.Conjugation experiments indicated that both ESBLs and AmpC enzymes could be transfefred from donor to recipient.PFGE indicated that the DNA fingerprints of K.pneumoniae were difierent but seven CMY-2 AmpC-producing E.coli isolates from general surgieal ward were similar.Concluslons The main mechanism of antibiotic resistance in CLSI ESBLs-screening test-positive but eefepime.susceptible E.coli and KIebsiellaspp.is production of plagmid-mediated AmpC enzymes.Some strains produce both AmpC enzyme and ESBLs.Such strains should be reported as resistant to cefepime.The results suggest that laboratories should routinely conduct research on the ESBLs and plnsmid.mediated AmpC enzymes in Enterobacteriaceae in order to report antimicrobial susceptibility testing results more correcdy.

Objective To investigate the resistance of clinical isolates from Shanghai Huashan Hospital in 2005.Methods Antimicrobial susceptibility test was carried out by Kirby-Bauer method.Results were analyzed according to CLSI 2005.Results Of the 3 896 clinical isolates,gram negative bacilli and gram positive cocci accounted for 68.1% and 31.9% respectively.About 93.2%(465/499)of S.aureus isolates were identified as methicillin-resistant Staphylococcus,94.9%(260/274)of coagulase negative Staphylococcus(CNS)isolates were methicillin-resistant.No vancomycin-resistant strain was found.The resistance rates of E.faecalis and E.faecium to high level gentamicin(120 ?g)were 67.4% and 82.8% respectively.Two strains of VRE were isolated.Both were VanA type.ESBLs-producing strains accounted for 47.6%(206/433)in E.coli and 69.6%(391/562)in Klebsiella spp(K.pneumoniae and K.oxytoca).Isolates of Enterobacteriaceae were still highly sensitive to imipenem and meropenem,resistance rates being 0-4% except Citrobacter isolates,9.1% of which were resistant.However,39.3% and 59.6% of P.aeruginosa strains were resistant to the above carbapenems,respectively.Conclusions The prevalence of MRSA and MRCNS is very high.ESBLs are prevalent in E.coli and Klebsiella spp.Two glycopeptide-resistant E.faecium isolates are identified firstly in Huashan Hospital.Our data will be useful for rational use of antimicrobial agents in the treatment of bacterial infections.