Objective To observe the clinical efficacy of Ruanjian Sanjie Pills in the treatment of patients with hepatitis B-related cirrhosis in compensatory stage differentiated as blood stasis blocking collaterals syndrome.Methods A total of 80 cases of patients with hepatitis B-related cirrhosis in compensatory stage admitted to Bao'an Hospital of Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from January 2023 to April 2024 were randomly divided into the trial group and the control group,40 cases in each group.The control group was treated with oral administration of Entecavir for hepatitis B virus(HBV),and the trial group was treated with Ruanjian Sanjie Pills on the basis of treatment for the control group,the course of treatment covering one year.Before and after treatment,the two groups were observed in the changes of routine blood test indicators of white blood cell count(WBC)and platelet count(PLT),liver function indicators[albumin(ALB),total bilirubin(TBIL),alanine transaminase(ALT)and aspartate transaminase(AST)],prothrombin time(PT),liver stiffness measurement(LSM),and traditional Chinese medicine(TCM)syndrome scores.After treatment,the clinical efficacy and safety were evaluated.Results(1)There were three cases in the control group and four cases in the trial group fell off,and eventually 37 cases in the control group and 36 cases in the trial group were enrolled in the efficacy statistics.(2)After one year of treatment,the total effective rate of the trial group was 91.67%(33/36)and that of the control group was 67.57%(25/37),and the intergroup comparison(tested by chi-square test)showed that the therapeutic efficacy of the trial group was significantly superior to that of the control group(P<0.05).(3)After treatment,the routine blood test indicators of WBC and PLT in the trial group were increased compared with those before treatment(P<0.05),while the WBC and PLT in the control group did not change significantly(P>0.05).The post-treatment WBC and PLT in the trial group were significantly higher than those of the control group(P<0.05).(4)After treatment,the ALB of patients in the two groups was increased compared with that before treatment(P<0.05),and the PT value of patients in the two groups and the ALT of the trial group were decreased compared with those before treatment(P<0.05),but TBIL and AST of the two groups and ALT of the control group did not differ from those before treatment(P>0.05).The comparison between the two groups showed that the decrease of PT value in the trial group was significantly superior to that of the control group(P>0.05),but no statistically significant differences of ALT,AST,TBIL and ALB were shown between the two groups(P>0.05).(5)After treatment,the LSM of patients in the two groups was decreased compared with that before treatment(P<0.05),and the decrease in the trial group was significantly superior to that in the control group(P<0.05).(6)After treatment,the TCM syndrome scores of the two groups of patients were decreased compared with those before treatment(P<0.05),and the decrease in the trial group was significantly superior to that in the control group(P<0.05).(7)There were no significant adverse reactions or adverse events occurring in the two groups during the treatment.Conclusion Ruanjian Sanjie Pills can improve the clinical symptoms of patients with hepatitis B-related cirrhosis in the compensatory stage,improve the coagulation function,reduce the hardness of the liver,and slow down the process of cirrhosis,with satisfactory efficacy and good safety.

Background::Programmed death 1 (PD-1) blockade plus chemotherapy has become the new first-line standard of care for patients with advanced non-small-cell lung cancer (NSCLC). Yet not all NSCLC patients benefit from this regimen. This study aimed to investigate the predictors of PD-1 blockade plus chemotherapy in untreated advanced NSCLC.Methods::We integrated clinical, genomic, and survival data from 287 patients with untreated advanced NSCLC who were enrolled in one of five registered phase 3 trials and received PD-1 blockade plus chemotherapy or chemotherapy alone. We randomly assigned these patients into a discovery cohort ( n = 125), a validation cohort ( n = 82), and a control cohort ( n = 80). The candidate genes that could predict the response to PD-1 blockade plus chemotherapy were identified using data from the discovery cohort and their predictive values were then evaluated in the three cohorts. Immune deconvolution was conducted using transcriptome data of 1014 NSCLC patients from The Cancer Genome Atlas dataset. Results::A genomic variation signature, in which one or more of the 15 candidate genes were altered, was correlated with significantly inferior response rates and survival outcomes in patients treated with first-line PD-1 blockade plus chemotherapy in both discovery and validation cohorts. Its predictive value held in multivariate analyses when adjusted for baseline parameters, programmed cell death ligand 1 (PD-L1) expression level, and tumor mutation burden. Moreover, applying both the 15-gene panel and PD-L1 expression level produced better performance than either alone in predicting benefit from this treatment combination. Immune landscape analyses revealed that tumors with one or more variation in the 15-gene panel were associated with few immune infiltrates, indicating an immune-desert tumor microenvironment.Conclusion::These findings indicate that a 15-gene panel can serve as a negative prediction biomarker for first-line PD-1 blockade plus chemotherapy in patients with advanced NSCLC.

Expanded polytetrafluoroethylene (ePTFE) polymers do not support endothelialization because of nonconductive characteristics towards cellular attachment. Inner surface modification of the grafts can improve endothelialization and increase the long-term patency rate of the ePTFE vascular grafts. Here we reported a method of inner-surface modification of ePTFE vascular graft with extracellular matrix (ECM) and CD34 monoclonal antibodies (CD34 mAb) to stimulate the adhesion and proliferation of circulating endothelial progenitor cells on ePTFE graft to enhance graft endothelialization. The inner surface of ECM-coated ePTFE grafts were linked with CD34 mAb in the presence of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide/N-hydroxysuccinimide (EDC/NHS) solution and the physicochemical properties, surface morphology, biocompatibility, and hemocompatibility of the grafts were studied. The hydrophilicity of CD34 mAb-coated graft inner surface was significantly improved. Fourier transform infrared spectroscopy analysis confirmed ECM and CD34 mAb cross-linking in the ePTFE vascular grafts with our method. Scanning electron microscopy analysis showed protein layer covering uniformly on the inner surface of the modified grafts. The cell-counting kit-8 (CCK-8) assay confirmed that the modified graft has no obvious cytotoxicity. The modified graft showed a low hemolytic rate (0.9%) in the direct contact hemolysis test, suggesting the modification improved hemocompatibility of biopolymers. The modification also decreased adhesion of platelets, while significantly increased the adhesion of endothelial cells on the grafts. We conclude that our method enables ePTFE polymers modification with ECM and CD34 mAb, facilitates endothelialization, and inhibits platelet adhesion on the grafts, thus may increase the long-term patency rate of the prosthetic bypass grafts.
Antibodies* ; Antibodies, Monoclonal ; Biopolymers ; Blood Platelets* ; Endothelial Cells ; Endothelial Progenitor Cells ; Extracellular Matrix* ; Hemolysis ; Hydrophobic and Hydrophilic Interactions ; Methods ; Microscopy, Electron, Scanning ; Polymers ; Polytetrafluoroethylene* ; Spectroscopy, Fourier Transform Infrared ; Surface Properties ; Transplants

Objective To understand the gender specific association between early puberty and behavioral and emotional characteristics in children.Methods The questionnaire survey was conducted among the girls in grade 2-3,boys in grade 3-4 and both girls and boys in grade 7-8 selected through cluster sampling in 2 middle schools and 2 primary schools in Beijing and Shenyang respectively in November 2014.The questionnaire contents included general information,physical activity and video time,pubertal development scale (PDS) and strength and difficulties questionnaire (SDQ).Descriptive statistics were used to describe the prevalence of early puberty and the detection rate of abnormal behavioral problems.The effects of early puberty on behavioral and emotional problems were estimated with univariate and multivariate logistic regression analyses.The odds ratios and their 95％ confidence intervals were calculated.Results A total of 3 253 complete questionnaires were collected,the prevalence of early puberty was 15.9％ (518).The detection rate (number) of abnormal emotional symptoms,conduct problems,hyperactivity/inattention,peer relationship problems,pro-social behaviors and total difficulties were 8.3％ (269),9.1％ (297),6.5％ (211),16.4％ (534),9.2％ (299) and 13.8％(448) respectively.Multivariate logistic regression analysis showed that early puberty was the risk factor for conduct problems (OR=2.260,95％CI:1.322-3.863) and hyperactivity/inattention (OR=1.980,95％ CI:1.111-3.527) in the girls,and early puberty was risk factor for total difficulties in boys (95％CI:1.018-2.063).Conclusions Early puberty might increase the risk of conduct problems and hyperactivity/inattention in girls and increase the risk of total difficulties in boys.It is important to conduct gender specific psychological intervention among adolescents for improving their physical and mental health.

OBJECTIVETo summarize the experience of endovascular repairing aortic arch disease hybrid with supra-arch debranching procedures.

METHODSIt was a retrospective study. From January 2002 to December 2014, 42 high risk patients with aortic arch disease were treated by supra-arch debranching hybrid with subsequent endovascular repair in the First Affiliated Hospital of Sun Yat-sen University. There were 39 male and 3 female patients with a mean age of (53±13) years (ranging from 34 to 80 years). Of the 42 patients, 7 were thoracic aortic aneurysm, 20 were Stanford type B aortic dissection and 15 were Stanford type A aortic dissection. After the supra-aortic debranching technique, simultaneous (n=16) or staged (n=26, mean interval (7±3) days) endovascular repair were performed. Fisher exact test was used to compare the in-hospital mortality of ascending aorta based debranching and non-ascending aorta based debranching.

RESULTSTechnical success rate was 81.0% (34/42). The overall 30-day complication rate was 31.0% (13/42), including 3 cerebral stroke (7.1%), 8 endoleak (19.0%, including 6 type I endoleak and 2 type II endoleak), 1 circulatory failure, 1 aorto-tracheal fistula. The 30-day mortality was 9.5% (4/42), 2 died of cerebral stroke, 1 died of circulatory failure, 1 died of aorto-tracheal fistula. The in-hospital mortality of ascending aorta based debranching group was obviously higher than that of the non-ascending aorta based debranching group (4/16 vs. 0, P=0.02). The median time of follow-up was 64.8 (2 to 156.9) months. CT scanning was performed at 1, 3 months after surgery and annually thereafter. The overall survival rate was 76.6%. During the follow-up period, there was 4 deaths, and 2 of them were aortic artery related (5.3%). There were 4 de novo complications during the follow-up period, 1 stroke attributed to bypass occlusion was cured by medical treatment, 2 pseudoaneurysm was successfully treated with open surgery, 1 stent-graft induced new distal entry tear was successfully treated with a tapered stent-graft, there was no new endoleak during follow up period, 3 type I endoleak disappeared spontaneously, and 1 type II endoleak disappeared after secondary intervention.

CONCLUSIONSEndovascular repair of aortic arch disease hybrid with supra-arch debranching procedure is low invasive with favorable long-term outcomes. It is suitable for high risk patients of poor general condition with little tolerance to aortic arch replacement. The in-hospital mortality is higher in the ascending aorta based debranching group than in the non-ascending aorta based debranching group. Stroke is a critical fatal complication and should be attached attention.

Adult ; Aged ; Aged, 80 and over ; Aneurysm, Dissecting ; surgery ; Aorta ; pathology ; surgery ; Aortic Aneurysm, Thoracic ; surgery ; Aortic Diseases ; surgery ; Blood Vessel Prosthesis Implantation ; Endoleak ; complications ; Endovascular Procedures ; Female ; Hospital Mortality ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Stroke ; complications ; Survival Rate ; Tomography, X-Ray Computed

OBJECTIVETo summarize the experience of treating aortic arch disease with ascending aorta to carotid artery revascularization and subsequent endovascular repair.

METHODSFrom January 2002 to June 2013, 10 high risk patients with aortic arch disease were treated with ascending aorta to carotid artery revascularization with subsequent endovascular repair in the First Affiliated Hospital, Sun Yat-sen University. There were 9 male and 1 female patients with a mean age of (54 ± 14) years (ranging from 34 to 71 years). Of the 10 patients, 8 were aortic dissection and 2 were thoracic aortic aneurysm. All aortic arch debranching was performed with mid-sternotomy, including 7 ascending aorta to innominate artery and left common carotid artery bypass, and 3 ascending aorta to left common carotid artery and left subclavian artery bypass.Subsequently, simultaneous (n = 5) and staged (n = 5, mean interval (7 ± 4) days) endovascular repair were performed via femoral artery.

RESULTSTechnical success rate was 10/10. The 30 day-mortality was 3/10, including 1 brain stem infarction, 1 circulatory failure and 1 aorto-tracheal fistula. Complication included 1 type II endoleak. The median time of follow-up was 24 (14) months. CT scanning was performed at 1, 3 months and annually thereafter. There was no death and no occlusion of bypass during follow-up.No complication occurred except 1 existing type II endoleak.

CONCLUSIONAscending aorta to carotid artery revascularization with subsequent endovascular repair is suitable for high risk aortic arch pathology patients in poor general condition with little tolerance to aortic arch replacement.

Adult ; Aged ; Aneurysm, Dissecting ; Aorta ; Aortic Aneurysm ; Aortic Aneurysm, Thoracic ; Aortic Diseases ; surgery ; Blood Vessel Prosthesis Implantation ; Brachiocephalic Trunk ; Carotid Artery, Common ; Endoleak ; Endovascular Procedures ; Female ; Femoral Artery ; Humans ; Male ; Middle Aged ; Sternotomy ; Subclavian Artery ; Tomography, X-Ray Computed ; Vascular Surgical Procedures ; Wound Healing

OBJECTIVETo investigate the clinicopathological features and prognosis of 22 cases of central neurocytoma (CNC), representing 0.48% of a series of 4 528 patients undergoing biopsy for central nervous system tumors.

METHODSThe histopathological, ultrastructral, immunohistochemical and clinical features of CNC were studied by electron microscopic examination and immunohistochemical stain for Synaptophysin (Syn), neuron special enolase (NSE), Leu-7, glial fibrillary acid protein (GFAP), MBP and proliferating cell nuclear antigen (PCNA).

RESULTSThe age of the cases ranged from 4 to 44 (average 27.9 years) with all tumors localized in the ventricles. In the 18 patients followed up, 14 were alive for 8 months to 14 years and 11 months after the operation, and 4 died. The average survival period was 70.7 months. Histologically, the tumor in all 22 cases had the oligodendroglioma-like pattern with honeycomb appearance and cell-free islands of eosinophilic matrix. Cellular anaplasia, mitosis and necrotic areas were rarely seen in the tumors. Immunohistochemical study demonstrated strong positivity for Syn, NSE and Leu-7, and negative for GFAP and MBP. Ultrastructural features showed presence of round tumor cells with abundant cell processes containing microtubules, neurosecretory granules, clear vesicles and lysosome-like structures.

CONCLUSIONSThe differential diagnosis between CNC and oligodendroglioma could not be established by routine light microscopy. The importance of immunohistochemical and electron microscopic studies for making a correct diagnosis is emphasized. The prognosis of patients is usually favorable, even if the tumor was resected subtotally. The relationship between the presence of anaplastic histological features in CNC and patient outcome remains unclear.

Adolescent ; Adult ; Biomarkers, Tumor ; Brain Neoplasms ; metabolism ; pathology ; physiopathology ; CD57 Antigens ; metabolism ; Child ; Child, Preschool ; Female ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Male ; Microscopy, Electron ; methods ; Neurocytoma ; metabolism ; pathology ; physiopathology ; Phosphopyruvate Hydratase ; metabolism ; Prognosis ; Proliferating Cell Nuclear Antigen ; Synaptophysin ; metabolism

OBJECTIVETo screen the genes related to the occurrence and development of varicosis of the great saphenous vein in the patients with primary deep vein valve insufficiency.

METHODSUsing mRNA fluorescent differential display reverse transcriptive polymerase chain reaction (FDD-RTPCR), different genes expressed in the varicose great saphenous veins in patients with primary deep vein valve insufficiency and corresponding normal human tissues were compared. Differentially expressed cDNA fragments confirmed by Northern blot were compared and then cloned into the pGEM-Teasy vector. Positive clones were selected and sequenced. All the sequences were put into GenBank and analyzed by BLASTN software to search for their genetic origins.

RESULTSAltogether 37 different cDNA fragments were obtained and 30 of which were confirmed by Northern blot. Analysis of the sequences by BLASTN software showed that C(610) fragment (NO. 18 cDNA clone) shared 96% homology with the mRNA sequence of the human Mckusick-Kaufman syndrome gene (MKKS gene).

CONCLUSIONC(610) fragment is highly homologous with the mRNA sequence of the human MKKS gene and is closely related to the development of varicosis of the great saphenous vein in patients with primary deep vein valve insufficiency.

Base Sequence ; Blotting, Northern ; Cloning, Molecular ; Group II Chaperonins ; Humans ; Lower Extremity ; blood supply ; Molecular Chaperones ; genetics ; Molecular Sequence Data ; RNA, Messenger ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Saphenous Vein ; Sequence Homology, Nucleic Acid ; Varicose Veins ; etiology ; genetics ; Venous Insufficiency ; complications ; genetics

Objectives:To study the clinicopathological features of extraovarian peritoneal serous papillary carcinoma.Methods:The clinical pictures and pathological characteristics of 6 cases extraovarian peritoneal serous papillary carcinoma admitted to our hospital from 1992 to 1999 were studies retrospectively.H & E staining,histochemical staining and immunohistochemical staining were used.Results:The ages of the 6 patients were between 32～62(43.7) years old.The bilateral ovaries and fallopian tubes were almost normal.Tumors were examined histomorphologically by microscope and electron microscope,periodic acid-Schiff (PAS) stain was used in the histochemical study and carcinoembryonic antigen (CEA),CA125,p53,AE1 and AE3 monoclonal antibody assays were detected immunohistochemically.The results revealed no difference between extraovarian peritoneal serous papillary carcinoma and ovarian serous papillary carcinoma.Conclusions:Extraovarian peritoneal serous papillary carcinoma is considered arising from the secondary Müllerian system.Histologically,extraovarian peritoneal serous papillary carcinoma was identical to that of the similar epithelial carcinomas arising from the ovaries.The diagnosis was made only when the ovaries were not involved and without any evidence of similar epithelial carcinoma obtained in the ovaries.Histochemical staining and immunohistochemical staining are helpful as accessory criteria for the differential diagnosis between primary carcinoma of the peritoneum and malignant mesothelioma.The prognosis is poor.