Objective To evaluate the short-term efficacy and safety of percutaneous liver puncture for local management of portal vein thrombosis(PVT).Methods Variations in thrombus,blood flow,and laboratory examination results were observed before and after percutaneous liver puncture in 197 patients with PVT,and the occurrence of comorbidities was recorded and followed up for one year after treatment.Results After treatment,the thrombus in the main portal vein vessels almostly disappeared in 119 patients(60.41％)with PVT,the thrombus had a significant reduction in 57 patients(28.93％),and the thrombus had a smaller change or an increase in 21 patients(10.66％);146 patients(74.11％)had smooth blood flow in the main portal vein vessels,29 patients(14.72％)showed significant improvement in blood flow,and 22 patients(11.17％)showed no significant improvement or worsening of blockage.The mean portal venous pressure was significantly lower than that before treatment(P＜0.001);thrombin time,activated partial thromboplastin time,and prothrombin time were prolonged compared to those before thrombolysis(P＜0.001),and fibrinogen were reduced compared to those before thrombolysis(P＜0.001).A total of 35 patients(17.77％)occured comorbidities during treatment.One year after treatment,196 patients(99.49％)with PVT survived,of which thrombus essentially disappeared in 141(71.94％),thrombus stabilized(or decreased)in 42(21.43％),and thrombus increased in 13(6.63％).Conclusion percutaneous liver puncture for local management of PVT is effective and reliable in the short-term and requires standardized management of the entire process.

Objective:To investigate the expression of double-stranded RNA-binding protein nuclear factor 45 (NF45) in laryngeal squamous cell carcinoma (LSCC), and the effect of NF45 on the radiation sensitivity of LSCC cells and its mechanism.Methods:NF45 expression in LSCC and adjacent tissues was detected by real-time reverse transcription PCR (qRT-PCR) and immunohistochemical staining. The NF45-ShRNA lentivirus was transfected into Hep-2 cells, and cell transfection efficiency was determined by qRT-PCR and Western blot . Hep-2 cells were randomly divided into the control group, 2 Gy group, sh-NC+2 Gy group and sh-NF45+2 Gy group. Lentivirus infection and 2Gy X-ray irradiation treatment were carried out. Cell proliferation activity was assessed by CCK-8 assay. Apoptosis rate was determined by flow cytometry. Hep-2 cells in each group were treated with mCherry-EGFP-LC3B. The levels of autophagy were detected by immunofluorescence staining. The ratio of autophagy-related protein microtubule-associated protein 1 light chain 3 (LC3)-Ⅱ/LC3-Ⅰ and the expression levels of Beclin-1 and p62 proteins were determined by Western blot.Results:The expression level of NF45 in LSCC tissues was significantly higher than that in adjacent tissues ( P<0.01). The relative expression levels of NF45 mRNA and protein in Hep-2 cells infected with NF45-shRNA were significantly lower than those in the control and sh-NC groups (all P<0.05). Compared with the control group, the cell proliferation activity was decreased, the apoptosis rate was increased, the intracellular autophagy-lysosome were increased, the ratio of LC3-Ⅱ/LC3-Ⅰ was increased, the relative expression levels of Beclin-1 protein were up-regulated, and the relative expression levels of p62 protein were down-regulated in the 2 Gy, sh-NC+2 Gy and sh-NF45+2 Gy groups (all P<0.05). Compared with the 2 Gy group, the cell proliferation activity was decreased, the apoptosis rate was increased, the intracellular autophagy lysosomes were increased, the LC3-Ⅱ/LC3-Ⅰ ratio was increased, the relative expression of Beclin-1 protein was up-regulated, and the relative expression of p62 protein was down-regulated in the sh-NF45+2 Gy group (all P<0.05). Conclusions:The expression of NF45 is up-regulated in LSCC tissues. Targeted down-regulation of NF45 expression can inhibit the proliferation activity of LSCC cells, promote cell apoptosis, and improve the sensitivity of tumor cells to radiation. The mechanism may be related to the regulation of autophagy levels.

Objective:To investigate the effect and mechanism of long non-coding RNA (lncRNA) TTN-AS1 on the radiosensitivity of breast cancer cells. Methods:The expression of TTN-AS1 in breast cancer cells was detected by real-time reverse transcription PCR (qRT-PCR). MDA-MB-231 cells were divided into the 0 Gy group, 4 Gy group, negative control (NC) +4 Gy group, si- TTN-AS1+4 Gy group, si- TTN-AS1+ miR-107 inhibitor+4 Gy group, and si- TTN-AS1+ miR-107 inhibitor+si- HMGA1+4 Gy group. CCK-8 assay and flow cytometry were used to detect the proliferation and apoptosis rates in each group. Results:Compared with breast epithelial cells, TTN-AS1 was significantly highly expressed in breast cancer cell lines ( P<0.001). Compared with the NC+4 Gy group, the cell proliferation ability was significantly decreased ( P<0.05) and cell apoptosis was significantly increased ( P<0.001) in the si- TTN-AS1+4 Gy group. Compared with the 0 Gy group, the expression levels of TTN-AS1 and HMGA1 from 8 h to 24 h after radiotherapy were significantly up-regulated (both P<0.01), whereas the expression of miR-107 was significantly down-regulated from 8 h to 24 h after radiotherapy in the 4 Gy group ( P<0.001). The cell proliferation ability in the si- TTN-AS1+ miR-107 inhibitor+4 Gy group was significantly higher than that in the si- TTN-AS1+4 Gy group ( P<0.001), and cell apoptosis was significantly lower than that in the si- TTN-AS1+4 Gy group ( P<0.001). Compared with the si- TTN-AS1+ miR-107 inhibitor+4 Gy group, cell proliferation ability was significantly decreased ( P<0.001), whereas cell apoptosis was significantly increased in the si- TTN-AS1+ miR-107 inhibitor+si- HMGA1+4 Gy group ( P<0.001). Conclusion:TTN-AS1 can promote the radiosensitivity of breast cancer cells by regulating the miR-107/ HMGA1 signaling axis.

Objective:To investigate the effects of CT simulation positioning and three-dimensional conformal radiotherapy combined with regimen of paclitaxel and cisplatin (TP) on serum squamous cell carcinoma antigen (SCC) level and prognosis in patients with advanced esophageal cancer.Methods:A total of 80 cases of advanced esophageal cancer patients in People′s Hospital of Xinjiang Uygur Autonomous Region from June 2016 to October 2017 were selected and randomly divided into treatment group and control group, with 40 cases in each group. The control group was treated with CT simulation positioning three-dimensional combined cisplatin and Docetaxel, and the treatment group was treated with CT simulation positioning three-dimensional combined TP regimen. The clinical efficacy, tumor marker levels [serum SCC, carcinoembryonic antigen (CEA), carbohydrate antigen-199 (CA-199), human cytokeratin 21-1 fragment (CYFRA21-1)], Karnofsky functional status (KPS) score, Quality of Life(QOL) score, progression free survival period and incidence of adverse reactions were compared between the two groups.Results:After treatment, the total effective rate in the treatment group was 70.00%, which was significantly higher than 55.00% in the control group ( P<0.05); the levels of serum SCC, CEA, CA-199 and CYFRA21-1 in the two groups after treatment were significantly lower than those before treatment ( P<0.05), and those in the treatment group were significantly lower than those in the control group ( P<0.05); after treatment, the QOL and KPS scores in the two groups were significantly higher than those before treatment ( P<0.05), and the scores in the treatment group were significantly higher than those in the control group ( P<0.05); The progression free survival time in the treatment group was significantly longer than that in the control group ( P<0.05); The incidence of adverse reactions in the treatment group was 15.00%, which had no significant difference compared with 25.00% in the control group ( P>0.05). Conclusions:CT simulation positioning three-dimensional combined with TP regimen in the treatment of advanced esophageal cancer has obvious effect, can effectively reduce the level of tumor markers, improve the patient′s physical function and quality of life, improve prognosis , and does not increase the survival rate of adverse reactions, which is safe and effective.

Objective To explore the relationship between gene polymorphisms of triggering receptor expressed on myeloid cells-1 ( TREM-1 ) rs2234237A/T, rs9471535A/G and susceptibility to coronary atherosclerotic heart disease ( coronary heart disease for short , CHD).Methods A case-control study.120 patients with CHD ( CHD group) and 90 healthy people (Normal control group ) were selected from November 2016 to April 2017 in Jingzhou Central Hospital.The single nucleotide polymorphisms (SNPs) of TREM-1gene (rs2234237 and rs9471535)were analyzed using Sanger method in all subjects. Comparing baseline clinical data and the distribution of genotype frequencies in the two groups .Non conditional logistic regression was used to analyze the relationship between TREM -1 gene ( rs2234237 and rs9471535) polymorphisms and susceptibility to CHD .Results The proportion of gender as well as level of age, body mass index, total cholesterol, triglyceride and low density lipoprotein cholesterol were not statistically significant between the two groups ( χ2＝0.575, P＞0.05; t＝-1.670, P＞0.05; t＝-1.719, P＞0.05; t＝1.011, P＞0.05; t＝-1.834, P＞0.05; t＝0.474, P＞0.05, respectively), while the proportion of smoking, hypertension and diabetes as well as level of high density lipoprotein cholesterol and fasting plasma glucose were statistically significant between the two groups (χ2＝4.321, P＜0.05; χ2＝39.213, P＜0.01; χ2＝24.184, P＜0.01; t＝5.476, P＜0.01; t＝-5.106, P＜0.01, respectively).The distribution of rs2234237, rs9471535 genotypes and alleles was statistically significant in the two groups (rs2234237: χ2＝6.893, P＜0.05; χ2＝7.159,P＜0.05, respectively; rs9471535: χ2＝8.284, P＜0.05; χ2＝8.314, P＜0.05, respectively).The genotype frequency of rs2234237(AT+TT)in CHD group was significantly lower than in the control group (38.3% vs 53.3%,χ2＝4.680, P＝0.031), and the genotype frequency of rs9471535 ( AG +GG) in CHD group was significantly lower than in the control group (37.5% vs 53.3%, χ2＝5.225, P＝0.022) .In addition, the T allele frequency of rs2234237 in CHD group was significantly lower than in the control group (21.7%vs 33.3%, χ2＝7.159, P＝0.007) , and the G allele frequency of rs9471535 in CHD group was significantly lower than in the control group(20.8%vs 33.3%, χ2＝8.314, P＝0.004).The CHD risk of people carrying rs2234237 TT was 0.173 times of AA (95% CI: 0.048 -0.629, P＝0.008), and the CHD risk of people carrying rs9471535 GG was 0.108 times of AA(95% CI: 0.026-0.450, P＝0.002).However, carriers with T allele of rs2234237(AT+TT) or with G allele of rs9471535(AG+GG)were not significantly associated with the CHD risk(P＞0.05).Conclusions TREM-1 gene rs2234237 A/T and rs9471535 A/G polymorphisms are significantly associated with susceptibility to CHD .rs2234237 TT genotype and rs9471535 GG genotype might act as protective factors of CHD.

Objective: To survey the conduction and evaluate the effectiveness of extracorporeal membrane oxygenation (ECMO) therapy in pediatric intensive care unit (PICU) in China mainland. Methods: In a questionnaire-based survey, we retrospectively reviewed the application of ECMO in children's hospital and general hospital in China mainland to summarize and analyze the categories of diseases and prognosis of children treated with ECMO therapy. Results: By December 31, 2017, a total of 23 hospitals using ECMO, including 22 tertiary referral hospitals and 1 secondary hospital, among which 16 were children′s hospitals and 7 were general hospitals. Thirty-seven ECMO equipment was available. A total of 518 patients treated with ECMO, within whom 323 (62.4%) successfully weaned from ECMO and 262 (50.6%) survived to discharge. Among 375 pediatric patients, 233 (62.1%) were successfully weaned from ECMO and 186 (49.6%) survived to discharge. Among 143 newborn patients, 90 (62.9%) successfully weaned from ECMO, 76 (53.1%) survived to discharge. ECMO was applied in veno-arterial (VA) mode to 501 (96.7%) patients, veno-venous (VV) mode to 14 (2.7%) patients, and VV-VA conversion mode to 3 (0.6%) patients. Sixty-nine patients required extracorporeal cardiopulmonary resuscitation (ECPR), including 20 newborn patients (29.0%) and 38 pediatric patients (71.0%), who were all with cardiovascular disease. Neonatal respiratory distress syndrome (26/61), persistent pulmonary hypertension of the newborn (PPHN) (12/61), and meconium aspiration syndrome (MAS) (11/61) are the most common pulmonary diseases in newborn patients; among whom, infants with PPHN had highest survival rate (10/12), followed by MAS (9/11). Among newborn patients with cardiovascular diseases, those who admitted were after surgery for congenital cardiac disease were the most common (54/82), while those with septic shock had the highest survival rate (2/3). In pediatric pulmonary diseases, acute respiratory distress syndrome was the most common (42/93), while plastic bronchitis was with the highest survival rate (4/4), followed by viral pneumonia (13/16). Among pediatric cardiovascular diseases, congenital cardiac defect was the most common (124/282), while fulminant myocarditis had the highest survival rate (54/77). Conclusion The application of ECMO as a rescue therapy for children with severe cardiopulmonary failure has dramatically developed in China mainland.

Objective    To explore the value of extracorporeal membrane oxygenation(ECMO) combined with hypothermia therapy for children patients with refractory cardiac arrest after congenital heart disease surgery. Methods    From January 2013 to June 2016, we conducted a prospective study of 23 children (18 males, 5 females at age of 7±11 months) who underwent ECMO for refractory cardiac arrest after congenital heart disease surgery. All patients were randomly divided into two groups: a standard group (11 patients) and a hypothermia group (12 patients). The patients of the standard group received standard therapy (the core body temperature maintaining at 37.0℃) and the hypothermia group received hypothermia therapy (the core body temperature maintaining at 33.0℃). The hospital discharge rate, the rate of weaning from ECMO and the morbidity were compared between the two groups. Results     Eleven of 23 patients (47.8%) were weaned from ECMO successfully and 7 of 23 patients (30.4%) discharged from hospital. The hospital discharge rate between the hypothermia group (n=6, 50.0%) and the standard group (n=1, 9.1%) had no statistical difference (χ2=4.537, P=0.069). The rate of weaning from ECMO of the hypothermia group (n=9, 75.0%) was higher than that of the standard group (n=2, 18.2%, χ2=7.425, P=0.006). The morbidity between the two groups had no statistical difference. Conclusion    Extracorporeal cardiopulmonary resuscitation can improve the survival rate of the children who suffered from refractory cardiac arrest after congenital heart disease surgery. There is no evidence that ECMO combined  with hyperthermia therapy is better than the only ECMO in improving the discharge rate. But ECMO combined with hypothermia therapy has higher rate of weaning from ECMO than that of the only ECMO.

Objective To summarize the clinical experience of surgical intervention for cardiac neoplasm in a fetus . Methods A 32-year-old pregnant woman was admitted to our hospital for complaint of fetal cardiac neoplasm .A separated het-erogenic cardiac occupying lesion was identigied at right atrium of the fetus by echocardiography , whose size is 2.85 cm ×2.25 cm, but the pathogenic origin still remained uncertain, maybe originate from ether pericardium or atrium.The annulus of tri-cuspid valve was compressed nearly 50% with the presence of amount of pericardial effusion.The fetal heart rate decreased at some fetal position resulting in the compression to the heart.So an Ex-utero Intrapartum Therapy(EXIT) procedure was per-formed under the supply of placenta at the 32 weeks of pregnancy.Cesarean section was performed with intact umbilicus and fe-tal circulation by obstetricians.Consequently, the median sternotomy of this fetus and pericardiotomy were performed , with 30 ml clear pericardial effusion drained .The tumor was confirmed to be giant right atrial neoplasm after the intraoperative explora-tion.Considering on the high risk of the cardiopulmonary bypass and limited time for EXIT , the giant atrial neoplasm was left alone with delayed sternum closure after the effectively decompression of the heart .The omphalotomy was successfully per-formed after the EXIT surgery.The neoplasm resection and the repair for its defect on right atrium were performed with cardiop-ulmonary bypass 2 days later.Results Convalesce of this mother was quite good after cesarean resetion .Hemodynamics of the premature baby was satisfatory after the resection of right atrial neoplasm which pathological report was benign hemangioma . Conclusion Via multiple disciplines collaboration , EXIT intervention for fetus is feasible and safe under adequate prepara-tion.

Objective To investigate the distribution and drug resistance of Pseudomonas aeruginosa(PAE) in the hospital ,so as to provide the reference for the rational drug use and the infection control in clinical .Methods The infection distribution and drug resistance of 822 isolates of PAE were analyzed .The drug sensitivity test was proceeded by dilution method ,and the results were judged according to the relevant documents of the CLSI .The data was analyzed by WHONET 5 .6 software .Results 822 isolates of PAE were mainly distributed in intensive care unit ward ,general surgical department and respiration department .The sample was 82 .1% from sputum .The infection rate was the highest in autumn(30 .0% ) .The drug resistance rate of PAE to cefperazone/sul-bactam was the lowest(7 .6% ) ,and which to amikacin was 19 .1% .The resistance rates of PAE to other drugs were all higher than 20 .0% .Conclusion PAE is a common pathogen of respiratory tract infection ,which has a high resistance rate to the current clini-cal antibacterial agents ,and doctors should pay attention to the infection caused by PAE .

Objective To determine the antigen-specific CTL in PBMC induced by a fusional family-gene vaccine of the immunoglobulin heavy chain variable gene framework region combined with the sequence of cytokine CM-CSF in vitro with MHC pentamer. Methods Peripheral blood samples were collected from two healthy donors and two patients. One was follicular lymphoma and another was hair cell leukemia. PBMC were isolated by density gradient centrifugalization with Ficoll and then subsequently differentiated into immature DCs (imDCs) induced by recombinant human GM-CSF and recombinant human IL-4. Gene gun was used to deliver the plasmids of the gene vaccine or the control plasmids into the imDCs. RT-PCR and ELISA assay were used to detect IgHVl-GM-CSF mRNA and GM-CSF in order to validate the transfection of the vaccine. After adding the cytokine cocktail, the imDCs became mature DCs. Then the mature DCs were co-cultured with lymphocytes from the blood samples for the induction of the antigen-specific CTL. The cultured cells were classified into vaccine group and control group and harvested at different time points of 0 d,7d, 17 d and 24 d after transfection. The subset of CD3+CD8+ T cells was analyzed by FCM assay. Finally, the CTL levels were detected with fluorescently labeled MHC pentamer antibody targeting vaccine epitopes. Results With the induction of cytokines, the imDCs with typical morphology were generated in PBMC. After delivering, the efficient expressions of the vaccine in the imDCs were determined by RT-PCR. And ELISA results also confirmed that GM-CSF was produced at a level of (28 ±6) ng/106 cells of the imDCs loaded with the vaccine, which was significantly different from that of control group (10 ± 3) ng/106 cells (t = 5. 191, P <0.01). FCM assay result showed that the CD3+ CD8+ T cells increased in a stepwise pattern during the culture. For control group, the levels at 0 d,7d, 17d and 24 d were ( 34. 24 ± 2. 72 )% , (46.06 ± 3.08)%, ( 65. 34 ± 4. 26 )% and (73.86 ±4.85 )% , respectively. For vaccine group, the results were (32. 28 ± 2. 08 ) % , (45. 32 ± 3. 81)% , ( 63. 37 ± 4. 21)% and (75. 01 ±3. 20)%. The differences between each time point had statistical significance (F = 176. 966 ,P <0.01) ,but there was no statistical differences between vaccine group and control group ( F = 0.657,P>0.05). The MHC pentamer analysis showed that the DCs loaded with IgHV1-GM-CSF fusional vaccine could efficiently induce the antigen-specific CTL response and the CTL levels increased gradually with the culture time, with the highest level of 4. 36% in the lymphoma blood and 3. 89% in the hair cell leukemia blood. Conclusions MHC pentamer assay could efficiently determine the antigen-specific CTLs response induced by the gene vaccine of family IgHV frame region in vitro. It could be a useful method for monitoring of anti-tumor cell immunity and evaluating of diagnosis and prognosis of the tumors in clinical application.