Objective To investigate the relationship between the level of hand grip strength(HGS)-based cachexia index(H-CXI)and all-cause mortality in a population with abnormal liver function.Methods The study was based on the America National Health and Nutrition Examination Survey(NHANES)data from 2011～2014,which included 2 752 cases of people with abnormal liver function and followed up until December 31,2019,using Kaplan-Meier survival analysis and COX regression modeling to assess the relationship between H-CXI levels and all-cause mortality,and restricted cubic spline analysis to explore the nonlinear relationship.Results There were 244 all-cause deaths during a mean follow-up time of 82.70±3.86 months.H-CXI was ana-lyzed as a categorical variable(quartiles),and Cox regression analyses showed that in model 2,the risk of all-cause mortality was reduced in groups Q2,Q3 and Q4 compared with group Q1(HR=0.41,95%CI:0.21～0.82,P=0.012 1;HR=0.34,95%CI:0.16～0.69,P=0.003 1;HR=0.24,95%CI:0.09～0.67,P=0.006 3).Subgroup analyses revealed an interaction between stroke and all-cause mortality,and restricted cubic spline revealed a nonlinear relationship between H-CXI levels and all-cause mortality.Con-clusion H-CXI levels are negatively associated with the risk of all-cause mortality in people with abnormal liver function,and attention to H-CXI levels is needed in clinical practice to prevent adverse health outcomes.

Objective To investigate the relationship between the level of hand grip strength(HGS)-based cachexia index(H-CXI)and all-cause mortality in a population with abnormal liver function.Methods The study was based on the America National Health and Nutrition Examination Survey(NHANES)data from 2011～2014,which included 2 752 cases of people with abnormal liver function and followed up until December 31,2019,using Kaplan-Meier survival analysis and COX regression modeling to assess the relationship between H-CXI levels and all-cause mortality,and restricted cubic spline analysis to explore the nonlinear relationship.Results There were 244 all-cause deaths during a mean follow-up time of 82.70±3.86 months.H-CXI was ana-lyzed as a categorical variable(quartiles),and Cox regression analyses showed that in model 2,the risk of all-cause mortality was reduced in groups Q2,Q3 and Q4 compared with group Q1(HR=0.41,95%CI:0.21～0.82,P=0.012 1;HR=0.34,95%CI:0.16～0.69,P=0.003 1;HR=0.24,95%CI:0.09～0.67,P=0.006 3).Subgroup analyses revealed an interaction between stroke and all-cause mortality,and restricted cubic spline revealed a nonlinear relationship between H-CXI levels and all-cause mortality.Con-clusion H-CXI levels are negatively associated with the risk of all-cause mortality in people with abnormal liver function,and attention to H-CXI levels is needed in clinical practice to prevent adverse health outcomes.

Esophageal stent implantation is the most commonly used clinical treatment for malignant esophageal obstruction.Driven by several biotechnological advances,great progress has been made in the clinical application of esophageal stents in the past few years.Therefore,it is extremely important for interventional physicians to have a thorough understanding of the mechanical properties and material properties of various esophageal stents.More and more clinical evidences indicate that esophageal stents,especially 125I radioactive esophageal stent,possess exceptional targeted drug delivery capabilities,which enables the physicians to formulated an individualized diagnosis and treatment plan that is more suitable for the patient's situation,so as to significantly improve the therapeutic accuracy.This review aims to systematically introduce the respective advantages of different esophageal stents,to discuss the biggest problems faced in the current clinical work,and to summarize the latest advances in cancer treatment,including the fields of both basic experimental study and clinical research.This review also explicates the design ideas and working principles of various esophageal stents in detail,discusses the development prospect of stent surface modification technology such as covered stents and drug-eluting stents,and makes judgment of the effectiveness and safety of these types of stents in alleviating malignant esophageal obstruction.

Inflammation plays an important role in the development of acute lung injury (ALI). Severe pulmonary inflammation can cause acute respiratory distress syndrome (ARDS) or even death. Expression of proinflammatory interleukin-1β(IL-1β) and inducible nitric oxide synthase (iNOS) in the process of pulmonary inflammation will further exacerbate the severity of ALI. The purpose of this study was to explore the effect of Palrnatine (Pa) on lipopolysaccharide (LPS)-induced mouse ALI and its underlying mechanism. Pa, a natural product, has a wide range of pharmacological activities with the potential to protect against lung injury. Western blotting and quantitative real-time polymerase chain reaction (qRT-PCR) assays were performed to detect the expression and translation of inflammatory genes and proteins in vitro and in vivo. Immunoprecipitation was used to detect the degree of P65 translocation into the nucleus. We also used molecular modeling to further clarify the mechanism of action. The results showed that Pa pretreatment could significantly inhibit the expression and secretion of the inflammatory cytokine IL-1β, and significantly reduce the protein level of the proinflammatory protease iNOS, in both in vivo and in vitro models induced by LPS. Further mechanism studies showed that Pa could significantly inhibit the activation of the protein kinase B (Akt)/nuclear factor-κB (NF-κB) signaling pathway in the LPS-induced ALI mode and in LPS-induced RAW264.7 cells. Through molecular dynamics simulation, we observed that Pa was bound to the catalytic pocket of Akt and effectively inhibited the biological activity of Akt. These results indicated that Pa significantly relieves LPS-induced ALI by activating the Akt/NF-κB signaling pathway.

Objective To assess the clinical value of percutaneous bone cement fusion in treating stress fracture of vertebral body that is adjacent to pseudoarthrosis in patients with ankylosing spondylitis.Methods The clinical data of 4 ankylosing spondylitis patients with stress fracture of vertebral body adjacent to pseudoarthrosis,which was treated with percutaneous bone cement fusion,were retrospectively analyzed.Bone cement fusion through injection of bone cement was performed for 4 vertebral segments.Visual analogue scale (VAS) of pain and Oswesty disability index (ODI) were determined before and after operation,the results were compared,and the improvements of pain and daily activity were evaluated.Results The operation was successfully accomplished in all the 4 patients.The mean used amount of bone cement for each vertebral segment was 14.5 ml.Small amount of bone cement extravasation was observed in one patient,but no severe clinical complication occurred.The mean VAS score decreased from preoperative 9 points to postoperative 3.5 points;ODI score decreased from preoperative 43.8 points to postoperative 14.5 points.After the treatment,the pain was obviously relieved and the daily activity was markedly improved.Conclusion For the treatment of stress fracture of vertebral body that is adjacent to pseudoarthrosis in patients with ankylosing spondylitis,percutaneous bone cement fusion is minimally-invasive,safe and effective.

Objective To study the mechanical properties and degradation behavior of biodegradable silicon-covered magnesium alloy stent in vitro,to investigate the technical feasibility of its implantation into rabbit esophagus and to observe the tissue reaction in vivo.Methods The mechanical compression recovery properties and the degradation behavior of biodegradable silicon-covered magnesium alloy stent were tested in vitro.A total of 30 healthy Holland rabbits were randomly divided into silicon-covered magnesium alloy stent group (n=15) and control group (n=15).For rabbits in the silicon-covered magnesium alloy stent group fluoroscopy-guided insertion of the stent into the lower third segment of esophagus was conducted,while for rabbits in the control group no intervention was adopted.One,2 and 4 weeks after the implantation of the stent,esophagography was performed for all rabbits of both groups,and each time every 5 rabbits from both groups were sacrificed,the specimens were collected and sent for histological examinations.Results In vitro test indicated that biodegradable silicon-covered magnesium alloy stent had good flexibility and elasticity,and in phosphate-buffered saline with pH 4.0 or pH 7.4 it degraded more slowly than bare magnesium alloy stent.In vivo test showed that the stent implantation could be well tolerated by all experimental rabbits.Before stent insertion the esophageal diameter was(9.2±0.8) mm,and at one,2 and 4 weeks after stent insertion the esophageal diameters were (9.7±0.7) mm,(9.6±0.8) mm and (9.6±0.5) mm respectively (P＞0.05).In the silicon-covered magnesium alloy stent group,stent displacement occurred in 6 rabbits in one week (n=l),2weeks (n=1) and 4 weeks (n=4).After stent implantation,the tissue reactions such as esophageal wall injury,collagen deposition,etc.were not obviously different from those in the control group (P＞0.05).Conclusion It is technically feasible to insert silicon-covered magnesium alloy stent into the rabbit's esophagus,the stent can provide sufficient support for at least 2 weeks,the stent displacement rate is low and acceptable,and no severe esophageal wall injury and collagen deposition are observed.

Stent implantation plays a more and more important role in the treatment of benign esophageal stenosis. Metal stents are most commonly used in the clinical practice, which can be classified into permanent stents and temporary retrieval stents. Permanent implantation of metal stents is easy to cause complications such as inflammatory hyperplasia, in-stent restenosis, perforation, bleeding, etc. Temporary retrieval stents should be removed with one week after it is implanted in order to avoid esophageal scar tissue repair and in-stent tissue hyperplasia, which can cause difficulty in its removing and produce higher recurrence rate of esophageal restenosis. Clinically, drug-eluting stents have already been used in cardiovascular system procedures, but at present the gastrointestinal drug-eluting stents are still in development and animal experiment stage. Biodegradable magnesium alloy stents have been widely employed in cardiovascular system procedures. With the rapid development of biological engineering materials, drug-eluting magnesium alloy stent has become a hot spot and the frontier in research field. This paper aims to make a comprehensive review about the current research status and prospect of the drug-eluting magnesium alloy stents, focusing on the stent technology, stent molding, coating modification, and the treatment of drug-eluting.

The authors report one case of primary hepatic neuroendocrine carcinoma associated with multiple liver metastases. A patient was a 41-year-old female. In 2010, B-ultrasound examination revealed that there were multiple space-occupying lesions in the liver, and hepatic hemangiomas was considered to be the diagnosis. Then, the patient was followed up regularly. In Aug. 2013, B-ultrasound examination indicated that the hepatic lesions were significantly enlarged. Multi-detector CT scanning and MRI examination were performed, and still the diagnosis of multiple hepatic hemangiomas was suggested. On CT and MRI the lesion presented as a well-circumscribed hypervascular tumor with “fast-in and slow-out” enhancement pattern. On MRI, the lesion was characterized by multiple nodules. Needle biopsy was carried out, and the pathological and immunohistochemical diagnosis was metastatic neuroendocrine tumor. Systemic examination did not find the primary lesion. Therefore, primary hepatic neuroendocrine carcinoma associated with intra- hepatic metastases was diagnosed. The patient was treated with transcatheter arterial chemoembolization. The drugs used were 100 mg Oxaliplatin+one bottle of gelatin sponge particles(300-500μm)+10 ml iodized oil, and micro-pump infusion of 100 mg oxaliplatin(99 mg/h) through catheter was also employed. Clinically, primary hepatic neuroendocrine carcinoma is extremely rare. In combination with the medical literatures, the authors attempt to make a preliminary discussion on the clinical characteristics, differential diagnosis, treatment and prognosis of primary hepatic neuroendocrine carcinoma.

Objective To investigate the method for effective establishment of nude rat tumor xenograft model of human lung cancer cells A549 in order to provide the experimental basis for tumor-related interventional research in vivo. Methods A549 cell lines were subcutaneously transplanted in nude rats, then single-cell suspension or tumor tissue block were prepared when the tumor lesion was established. The single-cell suspension and tumor tissue block were transplanted into subcutaneous tissue behind ear in rats. The tumor formation rate, growth situation and cell cycle of primary xenograft tumor group, the secondary single-cell suspension group and the secondary tumor block group were evaluated. The results were analyzed. Results The tumor formation rate of the secondary tumor block group was significantly higher than that of the other two groups. The tumor cells quickly proliferated with less tumor variation. Tumor cell cycle analysis indicated that G2/M ratio of the secondary tumor block group was remarkably higher than that of the other two groups. Conclusion Transplantation with tumor tissue block can significantly increase the tumor formation rate of human lung cancer cells A549 in experimental rats. This technique is an effective method for the establishment of nude rat tumor xenograft model.

Objective To compare the inhibiting effect on human lung adenocarcinoma who were treated with gem?citabine combined with cisplatin chemotherapy through either arterial or intravenous route to explore the optimum adminis?tration route. Methods Human lung adenocarcinoma derived A549 cells were transplanted into 40 BALB/c-nu mice to es?tablish lung cancer model. The models were divided into 4 groups:animals in arterial or intravenous chemotherapy groups were treated with gemcitabine 150 mg/kg combined with cisplatin 10 mg/kg through either arterial route or intravenous route. Animals in negative control group were given normal saline through caudal vein while animals in sham operation group were treated with normal saline via arterial route. Then dynamical change of tumor volume and tumor inhibiting rate were assessed , and Bcl-2 and Caspase 3 expressions were investigated using western blot. Finally inhibiting effect were compared between these two different administration routes. Results Transplanted tumors in arterial and intravenous che?motherapy groups (especially in arterial group) were suppressed, in terms of mass of tumor(g:1.91±0.19, 2.61±0.21 vs 4.58± 0.46), compared to the control group (P<0.05). Furthermore, tumor inhibiting rates in arterial chemotherapy group and ve?nous chemotherapy group are 57.6%and 42.4%respectively (P<0.05). Expression of Bcl-2 was down regulated while ex?pression of Caspase-3 was up regulated upon both arterial and intravenous chemotherapy. And arterial route showed much more obvious tumor apoptosis effect than venous route. Conclusion Arterial route of gemcitabine combined with cisplatin for lung adenocarcinoma treatment is more effective to restrain the tumor growth in clinical application.