Objective To investigate the clinical value of thromboelastography (TEG) in monitoring the coagulation function change after plasma supplementation in the patients with severe liver cirrhosis diges-tive tract hemorrhage.Methods A total of 48 patients with high risk and extreme high risk liver cirrhosis a-cute upper digestive hemorrhage receiving the treatment in ICU of this hospital from February 2020 to March 2023 were selected as the study subjects.After plasma infusion with the dose of 10 mL/kg,the coagulation function status was detected.The patients were divided into the TEG group (n=20) and the control group (n=28) according to different detection modes of coagulation function.The TEG group simultaneously detec-ted TEG and traditional coagulation function detection,while the control group only conducted the traditional coagulation detection.TEG and coagulation function detection indicators after the infusion of plasma were compared between the two groups.The plasma infusion amounts at 24 h after admitting in ICU were recorded and the control status of digestive tract hemorrhage was evaluated.Results The R value in the TEG group was (8.02±6.09)min,the K vale was 2.5(1.3,5.0)min,the coagulation comprehensive index (CI) was-4.70±6.29,the maximal shear stress coefficient (MA) was 50.35±18.84,LY30 was 0.The Pearson corre-lation analysis showed that MA was positively correlated with FIB and PLT (r=0.470,0.526,P<0.05),and the other indexes had no correlation.Compared with the control group,the plasma infusion amounts in the TEG group was more[(419.00±143.18)mL vs. (400.00±137.54)mL],the digestive tract hemorrhage con-trol rate was higher[75.00％(15/20) vs. 53.57％(15/28)],but the differences were not statistically signifi-cant (P>0.05).The multiple linear regression was MA=-3.427+11.200×Ln(PLT)+10.230×Ln(FIB).Con-clusion In the patients with severe lever cirrhosis acute upper gastrointestinal bleeding,TEG could earlier find the co-agulation function improvement situation after plasma supplementation than the traditional coagulation detection.

Objective To explore the clinical value of laparoscopic radical cystectomy based on fascia anatomy for bladder cancer treatment.Methods The clinical data of 51 patients with bladder cancer who underwent 3D laparoscopic radical cystectomy during Jan.2015 and Jun.2022 were retrospectively analyzed.The surgery was performed based on membrane anatomy technology along four longitudinal and two transverse planes to complete the radical cystectomy.The pelvic plexus was preserved for patients with normal preoperative sexual function.Results All surgeries were completed without conversion to open operation.The mean operation time was(502.52±108.99)min,mean intraoperative blood loss was(275.96±155.18)mL,mean postoperative drainage time was(4.14±2.41)d,and the mean postoperative hospital stay was(16.37±4.85)d.The mean number of lymph nodes removed was(17.98±11.48).The mean postoperative follow-up was(30.27±19.39)months.At the last follow-up,no Clavien ≥grade 3 complications were observed.The estimated overall survival(OS),tumor-specific survival(TSS),and recurrence-free survival(RFS)were 82.4％,92.2％,and 88.2％,respectively.The lymph node positive patients had shorter OS and RFS(60.0％,60.0％)than the lymph node negative patients(84.8％,91.3％).Among the 19 male patients who underwent radical cystectomy with pre-exposure and preservation of pelvic plexus,daytime and nocturnal continence rate were 83.3％and 72.2％,respectively,and 17 patients recovered potency within 6 months postoperatively.Conclusion Laparoscopic radical cystectomy based on fascia anatomy is safe and effective in laparoscopic radical cystectomy,with standardized surgical procedure,satisfactory oncological outcomes,little hemorrhage,few complications and fast recovery.

Objective To research the proper bicarbonate concentration for shipboard seawater reverse osmosis ( RO) remineralization. Methods Comprehensive analyses were made on the effects of HCO3- l on the desalination corrosion index, the methods of shipboard seawater reverse osmosis remineralization and related remineralization criteria. Then, the range of proper bicarbonate concentration of soft water remineralization was recommended for shipboard seawater reverse osmosis remineralization from different angles, which was verified by municipal drinking water quality survey results. Results HCO3- concentration greater than 90 mg/L could significantly reduce corrosiveness of desalinated water. Nevertheless, the contribution ration for Langelier index ( LSI) was debased when HCO3- was greater than 90 mg/L. At present, the minimum quality criteria for HCO3-concentration was equal or greater than 30mg/L proposed by most countries. Shipboard desalination remineralization was more preferable with direct addition of agent, but the dissolution of bicarbonate was quite low in water. Conclusion In consideration of the shipboard environment and support capability, the applicable bicarbonate concentration of shipboard RO desalination remineralization was 30-90 mg/L, which was within the range of drinking water bicarbonate concentration for 50％ of the cities in our country.

Objective To research the proper bicarbonate concentration for shipboard seawater reverse osmosis ( RO) remineralization. Methods Comprehensive analyses were made on the effects of HCO3- l on the desalination corrosion index, the methods of shipboard seawater reverse osmosis remineralization and related remineralization criteria. Then, the range of proper bicarbonate concentration of soft water remineralization was recommended for shipboard seawater reverse osmosis remineralization from different angles, which was verified by municipal drinking water quality survey results. Results HCO3- concentration greater than 90 mg/L could significantly reduce corrosiveness of desalinated water. Nevertheless, the contribution ration for Langelier index ( LSI) was debased when HCO3- was greater than 90 mg/L. At present, the minimum quality criteria for HCO3-concentration was equal or greater than 30mg/L proposed by most countries. Shipboard desalination remineralization was more preferable with direct addition of agent, but the dissolution of bicarbonate was quite low in water. Conclusion In consideration of the shipboard environment and support capability, the applicable bicarbonate concentration of shipboard RO desalination remineralization was 30-90 mg/L, which was within the range of drinking water bicarbonate concentration for 50％ of the cities in our country.

Objective: To investigate the value of short tandem repeat (STR) genotyping in the diagnostic workup of molar and non-molar gestations with correlation of histological characteristics. Methods: Six hundred and fifty-six cases were selected based on clinically suspected hydropic abortion and/or molar pregnancy from July 2015 to September 2017 at Beijing Obstetrics and Gynecology Hospital. DNA was extracted from dissected chorionic villi and paired maternal endometrial FFPE tissue samples by Simplex OUP™ FFPE DNA Tissue Kit. STR genotyping was performed by PowerPlex 16 HS system. Results: DNA genotyping was informative in 649 of 656 cases, leading to identification of 215 hydatidiform mole gestations and 434 non-molar gestations. Most of non-molar gestations (375 cases, 86.4%) were diploid hydropic abortion. Various trisomy syndromes were found (53 cases, 12.2%), including trisomy 2, 3, 4, 7, 8, 13, 16 and 21. Only 2(0.5%) digynic triploid gestations were detected. Moreover, 4 cases (0.9%) of uniparental disomies (homologous or heterologous) were found. There were 196 cases with histologic diagnostic suspicious of hydatidiform moles were accurate sub-classified. Among them, 59 cases hydatidiform moles were under-diagnosed as diploid hydropic abortions, and 28 cases diploid hydropic abortions were over-diagnosed as hydatidiform moles.Compared with partial moles(PHM), there were no specific histomorphological features between the various types of non-molar gestations and partial moles for definitive diagnostic separation. There was no significant difference in the expression of p57^kip2 among PHM, trisomy and diploid hydropic abortions group (P=0.247). Conclusions STR genotyping can distinguish non-molar gestations from early hydatidiform moles, and efficiently avoid misdiagnosis based only on histological evaluation. Therefore, using STR genotyping, not only can the overdiagnosis of non-molar pregnancy be avoided, but also individualized management can be offered to patients including monitoring of serum hCG.

Objective: To investigate the frequency of KRAS mutation in mucinous epithelial lesions of the endometrium, and analyze the correlation between KRAS mutation and the clinicopathologic features. Methods: The cohort included forty-three cases of mucinous epithelial lesions of the endometrium selected from July 2015 to October 2017 from Beijing Obstetrics and Gynecology Hospital, and 22 control cases. Genomic DNA was extracted from formalin-fixed paraffin-embedded tissue sections. Polymerase chain reaction amplification for KRAS exons 2 and 3 was performed, followed by sequencing using capillary electrophoresis. The Fisher exact test was used to compare the prevalence of KRAS mutation among the different groups. Results: The patients′age ranged from 33 to 77 years [mean (55.12±9.34) years, median 55 years]. None of the eight cases of endometrial hyperplasia with mucinous differentiation without atypia showed KRAS mutation. The frequency of KRAS mutations was 1/10 in endometrial atypical hyperplasia, 1/12 in endometrioid carcinoma, 4/11 in endometrial atypical hyperplasia with mucinous differentiation (EAHMD), 6/15 in endometrioid carcinoma with mucinous differentiation (ECMD) and 8/9 in mucinous carcinoma (MC), respectively. The differences were statistically significant between MC versus EC (P<0.01) and MC versus ECMD (P<0.05). Conclusion The high frequency of KRAS mutation in EAHMD, ECMD and MC indicates that KRAS mutational activation is implicated in the pathogenesis of endometrial mucinous carcinoma.

Objective To research and propose the proper calcium concentration for shipboard seawater reverse osmosis remineralization.Methods Comprehensive analyses were made on the calcium nutrient intake of adults,the effects of [Ca2+] level on the desalination corrosion index,the methods of shipboard seawater reverse osmosis remineralization and related remineralization criteria.Then,the range of proper calcium concentration of soft water remineralization was recommended for shipboard seawater reverse osmosis remineralization from different angels,which was verified by municipal drinking water quality survey results.Results Food was the main source of human calcium intake.[Ca2 +] concentration elevation could significantly reduce the corrosiveness of desalinated water,however,the contribution ratio for Langelier index (LSI) was debased when [Ca2+] reached 41 mg/L.Shipboard desalination remineralization was more preferable with direct added agential.At present,for the sake of health,the minimum quality criteria for [Ca2+] in soft water was 16 mg/L.Calcium chloride was commonly used for desalinated water remineralization,with the maximum permitted concentration being 36 mg/L.Conclusions In consideration of the shipboard environment and support capability comprehensively,the applicable calcium concentration of shipboard RO desalination remineralization was 16-36 mg/L,which was within the range of drinking water calcium concentration for 57％ of the cities of our countries.

Objective To research and propose the proper calcium concentration for shipboard seawater reverse osmosis remineralization.Methods Comprehensive analyses were made on the calcium nutrient intake of adults,the effects of [Ca2+] level on the desalination corrosion index,the methods of shipboard seawater reverse osmosis remineralization and related remineralization criteria.Then,the range of proper calcium concentration of soft water remineralization was recommended for shipboard seawater reverse osmosis remineralization from different angels,which was verified by municipal drinking water quality survey results.Results Food was the main source of human calcium intake.[Ca2 +] concentration elevation could significantly reduce the corrosiveness of desalinated water,however,the contribution ratio for Langelier index (LSI) was debased when [Ca2+] reached 41 mg/L.Shipboard desalination remineralization was more preferable with direct added agential.At present,for the sake of health,the minimum quality criteria for [Ca2+] in soft water was 16 mg/L.Calcium chloride was commonly used for desalinated water remineralization,with the maximum permitted concentration being 36 mg/L.Conclusions In consideration of the shipboard environment and support capability comprehensively,the applicable calcium concentration of shipboard RO desalination remineralization was 16-36 mg/L,which was within the range of drinking water calcium concentration for 57％ of the cities of our countries.

Female ; Humans ; Hydatidiform Mole ; diagnosis ; Pregnancy ; Uterine Neoplasms ; diagnosis

Purpose To investigate the application value in diagnosis of pleural effusion by cell block combined with immunohisto-chemistry. Methods 60 cases of pleural effusion were collected, and paraffin-embedded cell block was prepared and immunohisto-chemistry was used to detect the expression of CK7, TTF-1, E-cadherin, CEA and Calretinin. Results By use of cell block combined with immunohistochemistry, malignant detected rate was higher than that of the conventional centrifugal smear. There was statistical significance in the expression of CK7, TTF-1, E-cadherin, CEA and Calretinin between pleural effusion lung adenocarcinoma and reac-tive hyperplasia mesothelial cells (P<0. 05). CK7, TTF-1, E-cadherin and CEA were highly expressed in pleural effusion of lung ad-enocarcinoma cell. Calretinin was highly expressed in hyperplastic mesothelial cells. Conclusion Cell block and immunohistochemi-cal technique combination in the differential diagnosis of difficult pleural effusion has important clinical significance. It is worthy of popularization and further clinical application.