Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.

Objective:To observe the maximum tongue pressure and study the oropharyngeal activity during swallowing of patients with nasopharyngeal carcinoma (NPC) after radiotherapy so as to correlate the maximum tongue pressure with swallowing function.Methods:The mean maximum tongue pressure of nineteen NPC patients with dysphagia was measured at the anterior (TA), middle (TM) and posterior (TP) positions, followed by video fluoroscopy. Oral transit time (OTT), upper esophageal sphincter(UES)opening time (UOT) and UES opening range (UOR) were correlated with the mean maximum tongue pressures.Results:The maximum pressure at the TM and TP positions was significantly negatively correlated with OTT, but there was no significant correlation with the anterior readings. The maximum pressures at all three tongue positions were, however, positively correlated with UOT and UOR.Conclusion:The maximum pressure at the TA, TM and TP positions is strongly correlated with the swallowing function of NPC patients.

Objective: To identify the pathophysiological characteristics of cortical stroke survivors′ swallowing. Methods: Sixty cortical stroke survivors with dysphagia and cognitive impairment were enrolled into the observation group, while another 16 with dysphagia but without cognitive impairment formed the unimpaired control group and 16 healthy counterparts were selected for a normal control group. Each subject was recorded videofluoroscopically while swallowing 5ml of a liquid of medium consistency. The occurrence of refusing to eat, mouth opening difficulty, incomplete oral closure, residue in the oral cavity, residue in the pharyngeal cavity, leakage and aspiration were observed. Each subject′s swallowing time and kinematic parameters were analyzed from the fluoroscopic videos. Results: The incidence of refusing to eat (37.5%) and/or incomplete mouth closure (68.75%) were significantly higher in the observation group than in the other two groups. The incidence of difficulty in opening the mouth (37.5%), residue in the oral cavity (81.25%), residue in the pharyngeal cavity (56.25%), leakage (56.25%) and aspiration (50%) of the observation group were significantly higher in the observation group than among the normal controls, but were not significantly different from those incidences among the group without cognitive impairment. The average oral transit time and soft palate elevation time of the observation group were significantly longer than those of the other two groups. The observation group′s average hyoid movement time was significantly longer than that of the normal control group, but not significantly different from that of the group without cognitive impairment. There were no significant differences among the groups in average upper esophageal sphincter opening time, larynx closure time or the kinematic parameters. Conclusions Stroke survivors with dysphagia and cognitive impairment present dysphagia characteristic of oral phase swallowing difficulties.

Objective To investigate the protective effect and underlying mechanism of the superoxide dismutase mimic, manganese (Ⅲ) tetrakis (1-methyl-4-pyridyl) porphyrin pentachloride (MnTMPyP), on paraquat (PQ) -induced lung epithelial-like cell injury. Methods Alveolar epithelial-like cells (A549) were pretreated with 10 μmol/L of MnTMPyP for 1.5 h and then cultured with or without PQ (750 μmol/L) for 24 h. Cell survival was determined using the MTT assay. Reactive oxygen species (ROS) production and Ca2+ levels were measured using flow cytometry. Glutathione reductase (GR) activity was determined using spectrophotometry. Expressions of the endoplasmic reticulum (ER) stress proteins, glucose regulatory protein 78 (Grp78) and C/EBP homologous protein (CHOP), were measured using Western blotting. Results Cell viability and GR activity were decreased, but ROS production, cytoplasmic Ca2+ levels, and expressions of Grp78 and CHOP were all increased in the PQ group compared to those in the control group. There were no statistically significant changes in the MnTMPyP group. Cell viability and GR activity were increased, while ROS production, cytoplasmic Ca2+ levels, and expressions of Grp78 and CHOP were all significantly reduced in the MnTMPyP group compared to those in the PQ group. Conclusion MnTMPyP effectively reduced PQ-induced lung epithelial-like cell injury, and the underlying mechanism is related to antagonism of PQ-induced ER stress and oxidative stress.

Objective: To compare a new agar thickener with xanthan gum as a thickener in treating dysphagia patients with nasopharyngeal carcinoma after radiotherapy. Methods: Twenty nasopharyngeal carcinoma patients with dysphagia after radiotherapy were asked to swallow moderately and extremely thick liquids thickened with the agar and xanthan gum, and their swallowing was recorded with a videofluoroscope. Results: The average pharyngeal constriction ratio when swallowing agar thickener was significantly lower than when swallowing the traditional thickener. The average oral transit time, the initiation of pharyngeal swallowing were both significantly quicker. There was no significant difference in the average penetration aspiration scale scores between the two thickeners. In the subjective evaluation, the agar thickener was adjudged smoother and with better residual mouthfeel than the xanthan gum, but the scent of the xanthan gum was preferred. Conclusion The new agar thickener is smooth and not sticky. It produces faster transport with less oropharyngeal residue. It can be widely used among nasopharyngeal carcinoma patients with dysphagia after radiotherapy.

Objective To investigate the apoptosis mechanism induced by paraquat (PQ) in human type Ⅱ alveolar epithelial-like A549 cells.Methods A549 cells were cultured in vitro.The cells in the experimental group were exposed to various concentrations of PQ (50,100,150,and 200 μmol/L),while those in the control group were cultured in RPMI1640 medium.After treatment for 24 and 48 h,the cell survival rate was assessed by MTT assay.Morphological changes in the nuclei were observed by Hoechst 33258 fluorescence staining.Cellular apoptosis and mitochondrial transmembrane potential were assayed by flow cytometry.The activities of caspase-3 and caspase-9 were assayed by spectrophotometry.Western blotting was used to analyze the expression of proteins in the Bcl-2 family,such as Bcl-2,Bcl-xL,Bax,and Bak.Results PQ exhibited significant anti-proliferative activity in A549 cells.PQ-treated A549 cells were subjected to Hoechst 33258 staining.The hallmarks of apoptosis were detected,and the degree of apoptosis increased.Mitochondrial membrane potential was decreased,the levels of active caspase-3 and caspase-9 increased,the expression of Bcl-2 and Bcl-xL was decreased,and the expression of Bax and Bak was increased.These effects occurred in concentration-and time-dependent manners.Conclusion PQ efficiently induced intracellular apoptosis through the mitochondrial pathway in A549 cells.

Based on analyzing the classification catalog of medical device for rehabilitation, combined with the example,this paper discusses the principle of judgment of the classification of medical device for rehabilitation, and the naming and technical standards related to classification, puts forward the suggestions of classification management,attributes definition, and the naming, in order to provide support for promoting the reform of medical device classification management, and improving the level of scientific supervision.

The related curriculum knowledge system was constructed according to the orientation and goal of the three oriented medical personnel training. In order to provide important foundation for further formulating curriculum standards, revising basic requirements of curriculum, compiling relevant teaching materials and innovation of curriculum reform. This study constructs three oriented curriculum system mainly from the following six aspects: medicine and humanity, patient and doctor, innovation and practice, medical foundation and clinical application, teachers and learning promotion, quality control and teaching evaluation. The reference to teaching innovation of integrated curriculum will be provided.

Objective To investigate the distribution of human papillomavirus ( HPV ) in the diseased areas cut from HPV?positive cervical adenocarcinoma ( ADC ) detected by laser capture microdissection ( LCM ) . Methods Paraffin?embedded specimens diagnosed as ADC between 2005 and 2010 were collected from 9 hospitals in 7 regions across China. HPV genotyping was conducted on paraffin sections using sandwich technique and LCM in order to identify HPV infection in the tumor tissues. HE and p16 immunohistochemistry staining were performed to make histological diagnosis. Results A total of 169 cervical adenocarcinoma cases were recruited, including 94 cases of mucinous adenocarcinoma ( ADC?CX) , 9 cases of adenosquamous carcinoma ( ASC) , 19 cases of minimal deviation adenocarcinoma ( ADC?MIN) , 14 cases of clear cell adenocarcinoma ( ADC?CC) , 8 cases of endometrioid adenocarcinoma ( ADC?ENDO) , 9 cases of serous adenocarcinoma ( ADC?SER ) and 16 cases of adenocarcinoma not otherwise specified (ADC?NOS). Fourteen types of high risk HPV were detected in the whole tissue section (WTS). HPV16 was the most common type, and the second was HPV18 and HPV52, respectively. Compared with WTS, the HPV?positive rate detected by LCM was lower. The HPV positive rates were significantly different among different subtypes of cervical adenocarcinoma ( P<0.001) . After LCM, the HPV positive rate was 50.8% and 66.7% in the single infection and multiple, infection groups respectively (P=0.14). The positive rates of p16 was significantly different among different subtypes of cervical adenocarcinoma ( P<0.001) . p16?positive rate was 73. 9% in the HPV?positive samples after LCM, significantly higher than the 38. 5% of negative samples ( P<0.001) . Conclusions Laser capture dissection technique can more precisely reflect the HPV distribution in cervical adenocarcinomas. The etiological association between HPV infection and cervical adenocarcinoma occurrence is not as close as that reported in the literature.