Objective To establish a prognostic nomogram based on preoperative serum prealbumin levels for predicting overall survival(OS)in patients with unresectable hepatocellular carcinoma(HCC)treated with transcatheter arterial chemoembolization(TACE).Methods A total of 1 041 patients with unresectable HCC,who received TACE treatment at five medical centers in Suzhou city of China between January 2007 and December 2018,were divided into a training cohort(n=768)and a validation cohort(n=273).Cox regression analysis was used to analyzed the independent factors affecting one-,2-,and 3-year OS,based on which the nomogram was constructed,and validation of the nomogram was conducted in an internal test sequence.The performance of the nomogram was evaluated by concordance index(C-index),area under the receiver operating characteristic curve(AUC),calibration curve,and judgment curve analysis(DCA).Results COX regression analysis showed that AFP,BCLC,HBV,intrahepatic vascular invasion,number of tumors,PALB,PS,and tumor size were the independent risk factors affecting OS in patients with unresectable HCC treated with TACE.The C-index in the nomogram was 0.739(95％CI:0.719-0.759)for the training cohort and 0.715(95％CI:0.678-0.752)for the verification cohort.The AUCs of one-,2-,and 3-year OS in the training cohort were 0.877,0.794,and 0.799 respectively,which in the verification cohort were 0.840,0.741,and 0.671 respectively.The AUC-ROC values of the nomogram were higher than those of other traditional scoring systems,indicating that the nomogram had a good discriminatory power.The calibration curves demonstrated that a strong agreement existed between the predicted values of the nomogram and the actual observed values,and the DCA showed that the nomogram had high potential clinical utilization.The nomogram risk score revealed that the survival rate of patients in the low-risk group was significantly higher than that of patients in the high-risk group.Conclusion The nomogram based on preoperative serum prealbumin levels has excellent ability in predicting the prognosis of patients with unresectable HCC treated with TACE.

Objective:To evaluate the effectiveness and safety of the home-made umbrella-shaped Octoparms inferior vena cava filter in the prevention of pulmonary embolism.Methods:A multicenter, randomized, positive parallel controlled, non-inferiority clinical trial was conducted in ten hospitals in China from October 2017 to March 2019. A total of 188 subjects were enrolled according to the same inclusion and exclusion criteria in different institutes. The 188 subjects were randomly divided into the trial group or the control group according to 1∶1 by the central randomization system, with 94 cases in each group. Octoparms inferior vena cava filter was used in the trial group, and the Celect inferior vena cava filter in the control group. The primary effective index was clinical success rate,including the clinical success rate of filter placement and filter retrieval. The secondary index included the rate of manual success of the delivery sheath system,incidence of pulmonary embolism(within 6 months), incidence of filter fracture,migration (>20 mm),tilt(>15°) on insertion/retrieval,and the situation of inferior vena cava flow(within 6 months). Safety evaluation included the incidence of filter related complications and device-related adverse events immediately after surgery and during follow-up.Results:The success rate of implantation was 100% in 188 subjects. Filter retrieval was performed in 87 cases (92.55%) in the trial group and 91 cases (96.81%) in the control group. The clinical success rate of the trial group was 97.87%(92/94) and that of the control group 98.94%(93/94). There was no significant difference between the two groups (χ 2=0.77, P=0.380). The success rate of delivery sheath system was 96.81%(91/94) and 98.94%(93/94) in the trail group and the control group,respectively. There was no significant difference between the two groups( P=0.621). There was 1 case (1.22%) of new asymptomatic pulmonary embolism in the trial group after filter placement and 2 cases (2.44%) in the control group. There was no significant difference between the two groups ( P>0.05). No filter fracture or migration (>20 mm) occurred in either group. The tilting of filter (>15°) was found in 1 case (1.06%) in the test group and 1 case (1.06%) in the control group when the filter was placed. The tilting of filter (>15°) was found in 0 case in the test group and 2 cases (2.44%) in the control group when the filter was retrieved. There was no significant difference between the two groups ( P>0.05). Inferior vena cava thrombosis before filter retrieval was found in 5 cases (5.75%) in trial group and 3 cases (3.30%) in control group. There was no significant difference between the two groups ( P=0.489). There were no immediate serious complications during filter placement/removal in either group. No filter obstruction,migration,deformation,penetration and occlusion of inferior vena cava. The incidence of device-related adverse events was low in both group. There was no significant difference between the two groups ( P>0.05). Conclusion:The home-made umbrella-shaped Octoparms inferior vena cava filter is effective and safe in preventing pulmonary embolism, and is not worse than Celect filter.

Objective:To investigate the drug resistance and related gene expression of Acinetobacter baumannii (AB) among the patients in pediatric intensive care unit (PICU). Methods:Drug resistance of 311 clinical cultured AB strains in PICU of Shengjing Hospital of China Medical University between January 2014 to December 2018 were analyzed retrospectively. According to the results of drug resistance test, all strains were divided into carbapenem-resistant Acinetobacter baumannii (CRAB) and non-carbapenem-resistant Acinetobacter baumannii (non-CRAB). The CRAB closely related genes were tested by real time quantitative polymerase chain reaction (RT-PCR). Comparison between the groups was analyzed by t test, Mann-Whitney U test, Chi-square test or Fisher exact test. Multivariate logistic regression was used for multivariate statistics. Results:A total of 166 patients with 311 AB strains were enrolled in this research, including 101 males and 65 females. The children′s age ranged from 1 month to 14 years. The main primary diseases of 166 children were severe pneumonia (66/166, 39.8%), central nervous system infection (28/166, 16.9%), and trauma (17/166, 10.2%). Drug sensitivity tests showed that AB was sensitive to tigecycline (280/311, 90.0%), amikacin (250/311, 80.4%), and cefoperazone-sulbactam (193/311, 62.1%). However, most of AB strains were resistant to ciprofloxacin (247/311, 79.4%), ampicillin (244/311, 78.5%), and ceftazidime (245/311, 78.8%). In 311 isolated strains, 82.6% (257/311) strains were CRAB, and 65.9% (205/311) strains were multidrug-resistant Acinetobacter baumannii (MDRAB). Carbapenems were used more often in CRAB group than non-CRAB group before Acinetobacter baumannii cultured (26.2% (34/130) vs. 8.3% (3/36), χ2 =5.169, P=0.023), and more patients in CRAB group used the third-generation cephalosporins for more than 7 days (43.8% (57/130) vs. 22.2% (8/36), χ2 =5.533, P=0.019). Other broad-spectrum antibiotics or combined antibiotics in CRAB group were also more frequently used than in non-CRAB group (47.7% (62/130) vs. 13.9% (5/36), 46.9%(61/130) vs. 22.2%(8/36); χ2 =13.383, 7.082; P<0.01, P=0.008). More patients in CRAB group received interventional procedures than those in non-CRAB group (75.4% (98/130) vs. 50.0% (18/36), χ2 =8.631, P=0.003). Multivariate logistic regression showed that using carbapenem antibiotics ( OR=3.179, 95% CI 1.247-8.107, P=0.015) and interventional procedures ( OR=5.107, 95% CI 1.446-18.042, P=0.011) were independent risk factors for causing CRAB. Both IPM and OXA-24 genes had high expressions in CRAB and non-CRAB groups (89.2% (116/130) vs. 86.1% (31/36), P=0.565; 77.7% (101/130) vs. 72.2% (26/36), P=0.49). VIM and OXA-58 genes were not detected in any group. The expression rates of OXA-23, OXA-51, and efflux pump-related genes AdeABC and AdeFGH in CRAB group were significantly higher than in non-CRAB group (all P<0.01). Conclusions:In PICU, the proportions of CRAB and MDRAB were high and most of AB strains are only sensitive to tigecycline, amikacin, cefoperazone or sulbactam. Using carbapenems and interventional operation are independent risk factors for causing CRAB. Compared with non-CRAB, CRAB had higher expression of β-lactamase-related genes OXA-23 and OXA-51, and efflux pump-related genes AdeABC and AdeFGH.

Inflammatory bowel disease (IBD) is a chronic intestinal disease with painful clinical manifestations and high risks of cancerization. With no curative therapy for IBD at present, the development of effective therapeutics is highly advocated. Drug delivery systems have been extensively studied to transmit therapeutics to inflamed colon sites through the enhanced permeability and retention (EPR) effect caused by the inflammation. However, the drug still could not achieve effective concentration value that merely utilized on EPR effect and display better therapeutic efficacy in the inflamed region because of nontargeted drug release. Substantial researches have shown that some specific receptors and cell adhesion molecules highly expresses on the surface of colonic endothelial and/or immune cells when IBD occurs, ligand-modified drug delivery systems targeting such receptors and cell adhesion molecules can specifically deliver drug into inflamed sites and obtain great curative effects. This review introduces the overexpressed receptors and cell adhesion molecules in inflamed colon sites and retrospects the drug delivery systems functionalized by related ligands. Finally, challenges and future directions in this field are presented to advance the development of the receptor-mediated targeted drug delivery systems for the therapy of IBD.

A retrospective analysis of 7 patients of multiple myeloma (MM) with initial manifestation of bleeding and coagulation abnormalities were performed. Clinical manifestations, laboratory and imaging examinations were collected. The activity of coagulation factors was measured before the treatment. Single factor X deficiency was seen in one patient. Two cases had factor Ⅶ deficiency, while four other patients had multiple factor deficiency. The time from onset of symptoms to diagnosis ranged from 2 to 10 months. After anti-MM treatment started and plasma or coagulation factors were transfused, the prolonged coagulation time returned to normal from 28-84 days. Most of these patients presented large, deep and multiple sites of hematoma, which caused concerns of bone marrow puncture and may direct to other differential diagnoses. This is helpful to improve physicians′ understanding of the special clinical characteristics in MM patients.

Objective:To observe the effect of Buzhongyiqi Decoction on the expression of transforming growth factor β-3(TGFβ-3)and microRNA-30d(miR-30d)in uterosacral ligament tissues in a rat model of pelvic organ prolapse.Methods:According to the number lottery, 16 rats in the blank control group were divided into 2 groups: the A1 group(feeding 4 weeks, n=8)and the A2 group(undergoing the ovariotomy with normal saline gavage for 8 weeks, n=8). The 64 rat models of pelvic organ prolapse were randomly divided into 8 groups(8 rats in each group): the B1 group(feeding 4 weeks), the B2 group(given normal saline via gavage for 8 weeks), the C1 and C2 groups(given Buzhongyiqi Decoction via gavage, 3.5 ml·kg -1·d -1, for 4 and 8 weeks, respectively), the D1 and D2 group(given Buzhongyiqi Decoction via gavage, 7.0 ml·kg -1·d -1, for 4 and 8 weeks, respectively), the E1 and E2 group(given Buzhongyiqi Decoction via gavage, 14.0 ml·kg -1·d -1, for 4 and 8 weeks, respectively). Reverse transcription-polymerase chain reaction(RT-PCR)was used to detect the expression of collagen COL1A1, COL3A1, TGF β-3 and miR-30d in uterosacral ligament tissues. Results:Compared with A1 group, the B1 group showed that the expression of COL1A1 and COL3A1 was decreased and the expression of TGFβ-3 and miR-30d was increased( P<0.01). After 4 weeks treament of Buzhongyiqi Decoction, the expression of COL1A1 was higher in E1 group than in C1 group ( P<0.01), The expression of COL3A1 in group D1 was singificantly higher than that in group C1, The expression of COL3A1 in group E1 was also singificantly higher than that in group D1 .The expression of TGF β-3 was higher in the D1 and E1 groups than in the C1 group( P<0.01). The expression of miR-30d was lower in the D1 and E1 groups than in the C1 group( P<0.01). After 8 weeks of Buzhongyiqi Decoction treatment, the expression of COL1A1 was higher in the D2 group than in the C2 group( P<0.01), while was lower in the E2 group than in the D2 group( P<0.01). The expression of COL3A1 and TGFβ-3 was higher in the D2 group than in the C2 group( P<0.01)and the expression of TGFβ-3 was lower in the E2 group than in the D2 group( P<0.01). The expression of miR-30d was lower in the D2 group than in the C2 group( P<0.01)and was higher in the E2 group than in the D2 group( P<0.01). Compared with the B1 group, the expression of COL1A1, COL3A1 and TGF β-3 was increased in the D1 and E1 groups( P<0.01), the expression of miR-30d was decreased in the C1, D1 and E1 groups( P<0.01). Compared with the B2 group, the expression of COL1A1 and COL3A1 was increased in the D2 and E2 groups, the expression of TGF β-3 was increased and the expression of miR-30d was decreased in the C2, D2 and E2 groups( P<0.01). Conclusions:Buzhongyiqi Decoction can increase the synthesis of collagen COL1A1 and COL3A1 in uterosacral ligament tissues of rats with pelvic organ prolapse, which may be related to the up-regulation of TGF β-3 expression and the down-regulation of miR-30d expression in rat uterosacral ligament tissues.

Acinetobacter baumannii is an important pathogen of clinical infection in critically ill pa﹣tients. The clinical detection rate of Acinetobacter baumannii is increasing and the drug resistance is becoming more and more serious. The selection of antibiotics to antibiotic﹣resistant Acinetobacter baumannii is very lim﹣ited,particularly in children with the special age and physiological characteristics,which aggravates the clini﹣cal burden. This article reviewed the status of Acinetobacter baumannii infection,especially on different disea﹣ses including pneumonia,bloodstream infections,intracranial infections and antibiotics using.

Acinetobacter baumannii is an important pathogen of clinical infection in critically ill patients.The clinical detection rate of Acinetobacter baumannii is increasing and the drug resistance is becoming more and more serious.The selection of antibiotics to antibiotic-resistant Acinetobacter baumannii is very limited, particularly in children with the special age and physiological characteristics, which aggravates the clinical burden.This article reviewed the status of Acinetobacter baumannii infection, especially on different diseases including pneumonia, bloodstream infections, intracranial infections and antibiotics using.

Exploiting cells as vehicles combined with nanoparticles combined with therapy has attracted increasing attention in the world recently. Red blood cells, leukocytes and stem cells have been used for tumor immunotherapy, tissue regeneration and inflammatory disorders, and it is known that neutrophils can accumulate in brain lesions in many brain diseases including depression. -Acetyl Pro-Gly-Pro (PGP) peptide shows high specific binding affinity to neutrophils through the CXCR2 receptor. In this study, PGP was used to modify baicalein-loaded solid lipid nanoparticles (PGP-SLNs) to facilitate binding to neutrophils . Brain-targeted delivery to the basolateral amygdala (BLA) was demonstrated by enhanced concentration of baicalein in the BLA. An enhanced anti-depressant effect was observed and The mechanism involved inhibition of apoptosis and a decrease in lactate dehydrogenase release. Behavioral evaluation carried out with rats demonstrated that anti-depression outcomes were achieved. The results indicate that PGP-SLNs decrease immobility time, increase swimming time and climbing time and attenuate locomotion in olfactory-bulbectomized (OB) rats. In conclusion, PGP modification is a strategy for targeting the brain with a cell-nanoparticle delivery system for depression therapy.

Objective To investigate the public's perception and attitudes on the development of nuclear power, assess their knowledge about nuclear power and radiation, and to build a database on the public's perception for the purpose of providing better public health service, associate technical support and give suggestions for decision-makers.Methods In total of 1 440 local residents who live within 30 kilometers of a proposed nuclear power were chosen for in-person interviews.Questionnaires comprised of 49 questions designed to assess the public's knowledge of radiation and nuclear power, their attitudes to the development of nuclear power, their evaluation of local government and their informational environment.ANOVA was used to compare the influence of different factors on cognitive level.Multivariate linear regression was used to analyze the main factors affecting the level of public awareness.Comparison among groups (respondents in this survey vs.other comparable surveys) was conducted using x2 test.Results Of the respondents, 29.7％ and 39.5％ of respondents knew about nuclear power and radiation, respectively, 24.2％ supported the construction of a nuclear power plant in their own area, which was lower than the average national support for construction of nuclear power plants (29.0％) (x2 =8.71 ,P ＜ 0.05).When queried about safety cncerns 36.8％ of respondents worried about the safety of nuclear power plant and 78.5％ of respondents were afraid of the damage to their health, while 34.1％ of respondents held the belief that the nuclear power plant could bring harmful effect even under normal operation.Regarding the informational environment, 90.0％ of the respondents could not or barely got access to knowledge on nuclear power plants, 71.1％ hoped to acquire the knowledge on nuclear power plants, 48.4％ hoped to acquire this knowledge by television programs, and 62.4％ mostly trusted information given by experts from universities or institutes.In comparison to other findings acquired in similar surveys on the Tianwan and Qinshan nuclear power plants before the Fukushima accident, the findings indicated that safety assessment of nuclear power plant were lower (x2 =20.49,56.96, P ＜ 0.05).Conclusions The public's knowledge level on nuclear power and radiation directly influenced their attitude on nuclear power.The related agencies should strengthen publicity and education in order to increase the public's knowledge on nuclear power and radiation.The communication platform between the related agencies and the public should be established.Active and continued risk communication should be carried out to increase public acceptance of nuclear power.