Objective:To explore the experience to reconstruct large nasal defects with combined local flaps after cutaneous tumor excision based on the aesthetic subunit principle.Methods:From May 2007 to May 2019, based on the nasal aesthetic subunit principle, combined local flaps were used to cover the large nasal defects in 21 cases of nasal tumors that were removed. Among 21 cases, there were 11 cases of basal cell carcinoma, 7 cases of squamous cell carcinoma, and 3 cases of pigmented naevus. The locations were dorsum of nose in 8 cases, nasal side in 7 cases, nasal ala in 5 cases, nasal tip in 1 case, and across two nasal subunits in 17 cases. The area of the defect ranged between 1.3 cm × 0.9 cm and 3.6 cm × 3.1 cm. A local combined skin flap was used to repair the skin defect. The secondary defect of donor site was directly sutured.Results:Among 21 cases, 20 cases acquired complete recovery; 1 case had epiderm necrosis over the far end of the flap achieved healing by the first intention. The nasal defect was successfully repaired in all patients, and the all flaps survived. A total of 21 patients were available for follow-up of 1 to 48 months, no tumor recurrence occurred, and the repaired tissues were well matched to the surrounding tissue, good nasal contour was obtained, and the cosmetic results were satisfactory.Conclusions:Based on the nasal aesthetic subunit principle, the combined local flaps can be used to reconstruct the large nasal defects, and the cosmetic results are satisfactory.

Objective:To investigate the infection rate and intra-type lineage distribution of human papillomavirus type 30 (HPV30) in Chinese women.Methods:Cervical exfoliated cells were collected within 30 days of cytological tests for patients from the People’s Liberation Army General Hospital. After DNA extraction and screening of HPV30 type specific polymerase chain reaction (PCR), full-length genomes were amplified for HPV30 positive samples.Results:A total of 1 600 cervical samples were collected. The infection rate of HPV30 was 0.56% (9/1 600). All the nine HPV30 strains belonged to lineage A. A1 accounted for 66.7%(6/9), A4 accounted for 22.2%(2/9), A5 accounted for 11.1%(1/9).Conclusion:HPV30 infection exists among Chinese women. Lineage A was the only prevalent lineage across all the HPV30 isolates.

Objective:To use metagenomic sequencing to compare the differences in intestinal microbiota species and metabolic pathways in patients with hepatitis B cirrhosis with or without ascites and further explore the correlation between the differential microbiota and clinical indicators and metabolic pathways.Methods:20 hepatitis B cirrhosis cases [10 without ascites (HBLC-WOA), 10 with ascites (HBLC-WA), and 5 healthy controls (HC)] were selected from the previously studied 16S rRNA samples. Metagenome sequencing was performed on the intestinal microbiota samples. The Kruskal-Wallis rank sum test and Spearman test were used to identify and analyse differential intestinal microbiota populations, metabolic pathways, and their correlations.Results:(1) The overall structure of the intestinal microbiota differed significantly among the three groups ( R = 0.19, P = 0.018). The HC group had the largest abundance of Firmicutes and the lowest abundance of Proteobacteria at the genus level. Firmicutes abundance was significantly decreased ( Pfdr < 0.01), while Proteobacteria abundance was significantly increased ( Pfdr < 0.01) in patients with cirrhosis accompanied by ascites; (2) LEfSe analysis revealed that 29 intestinal microbiota (18 in the HBLC-WA group and 11 in the HBLC-WOA group) played a significant role in the disease group. The unclassified Enterobacteriaceae and Klebsiella species in the HBLC-WA group and Enterobacteriaceae in the HBLC-WOA group were positively correlated with the Child-Turcotte-Pugh (CTP) score, prothrombin time, and international normalized ratio score and negatively correlated with albumin and hemoglobin levels ( P < 0.05). Escherichia and Shigella in the HBLC-WA group were positively correlated with CTP scores ( P < 0.05); (3) The correlation analysis results between the KEGG pathway and 29 specific intestinal microbiota revealed that Enterobacteriaceae and arachidonic acid, α-linolenic acid, glycerolipid metabolism, and fatty acid degradation were positively correlated in the lipid metabolism pathway, while most Enterobacteriaceae were positively correlated with branched-chain amino acid degradation and negatively correlated with aromatic amino acid biosynthesis in the amino acid metabolic pathway. Conclusion:A significant increment of Enterobacteriaceae in the intestines of HBLC-WA patients influenced hepatic reserve function and was associated with amino acid and lipid metabolic pathways. Therefore, attention should be paid to controlling the intestinal microbiota to prevent complications and improve the prognosis in patients with hepatitis B cirrhosis, especially in those with ascites.

Objective To investigate the therapeutic effect of traditional Chinese medicine (TCM) on portal vein thrombosis (PVT) in patients with liver cirrhosis and its medication characteristics. Methods A retrospective analysis was performed for 89 patients with liver cirrhosis and PVT who were hospitalized and treated in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, and according to whether TCM treatment was applied in combination, they were divided into TCM group with 59 patients and control group with 30 patients. Related data were collected for the two groups, including demographic data, laboratory examination, radiological examination, gastroscopy, history of surgery, portal hypertension-related complications, medication, and follow-up data. The independent samples t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. An ordinal polytomous Logistic regression analysis was used for multivariate analysis. TCM Inheritance Computing Platform (V3.0) was used to perform a drug effect cluster analysis of TCM prescriptions. Results The multivariate logistic regression analysis showed that esophageal and gastric varices (odds ratio [ OR ]=3.144, 95% confidence interval [ CI ]: 1.221-8.094), PVT involving the portal vein (PV) and the superior mesenteric vein (SMV) ( OR =51.667, 95% CI : 3.536-754.859), PVT involving PV+spleen vein (SV)+SMV ( OR =13.271, 95% CI : 2.290-76.928), cavernous transformation of the portal vein ( OR =11.896, 95% CI : 1.172-120.696), and TCM intervention ( OR =0.348, 95% CI : 0.129-0.938) were influencing factors for the outcome of PVT in liver cirrhosis. Follow-up results showed that compared with the control group, the TCM group had a significantly lower progression rate (16.95% vs 56.67%, P < 0.001) and a significantly lower incidence rate of variceal rupture and bleeding (8.47% vs 33.33%, P < 0.001). Effective TCM drugs with a relatively high frequency of use included deficiency-tonifying drugs (359 times, 34.6%), blood-activating and stasis-resolving drugs (202 times, 19.5%), and diuresis-inducing and dampness-draining drugs (180 times, 17.3%); the TCM drugs with a relatively high frequency of use included Astragalus membranaceus (57 times, 8.7%), Angelica sinensis (50 times, 7.6%), and leech (48 times, 7.3%); TCM drug combinations with a relatively high frequency of use included Astragalus membranaceus+Angelica sinensis, Astragalus membranaceus+leech, Angelica sinensis+leech, and Astragalus membranaceus+Angelica sinensis+leech. Conclusion Qi-tonifying, blood-activating, and stasis-breaking drugs, such as Astragalus membranaceus, Angelica sinensis, and leech, can promote the stabilization or recanalization of PVT in liver cirrhosis and reduce the incidence rate of bleeding events due to portal hypertension.

In animal experiments, ischemic stroke is usually induced through middle cerebral artery occlusion (MCAO), and quality assessment of this procedure is crucial. However, an accurate assessment method based on 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is still lacking. The difficulty lies in the inconsistent preprocessing pipeline, biased intensity normalization, or unclear spatiotemporal uptake of FDG. Here, we propose an image feature-based protocol to assess the quality of the procedure using a 3D scale-invariant feature transform and support vector machine. This feature-based protocol provides a convenient, accurate, and reliable tool to assess the quality of the MCAO procedure in FDG PET studies. Compared with existing approaches, the proposed protocol is fully quantitative, objective, automatic, and bypasses the intensity normalization step. An online interface was constructed to check images and obtain assessment results.
Animals ; Fluorodeoxyglucose F18 ; Infarction, Middle Cerebral Artery/diagnostic imaging* ; Positron-Emission Tomography/methods*

Objective To investigate the mechanism of action of integrin α4 (ITGA4) in liver fibrosis based on the anti-liver fibrosis effect of sticky sugar amino acid (SSAA) in rats. Methods A rat model of liver fibrosis was induced by intraperitoneal injection of CCl 4 , and then colchicine and low-, middle-, and high-dose SSAA were used for intervention, with blank control group and SSAA group as control. After 12 weeks of experimental intervention, serum and liver samples were collected to measure the serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and HE staining and Sirius Red staining were used to observe the pathological conditions of liver tissue; quantitative real-time PCR was used to measure the transcriptional level of ITGA4, integrin β1 (ITGB1), transforming growth factor-β1 (TGFβ1), alpha-smooth muscle actin (α-SMA), and TIMP2 in liver tissue; Western blot was used to measure the relative protein expression levels of ITGA4, ITGB1, TGFβ1, α-SMA, MMP2, TIMP1, and TIMP2; immunohistochemistry was used to observe the protein expression of TGFβ1 and α-SMA. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t -test was used for comparison between two groups. Results There were significant increases in AST and ALT in the CCl 4 model group, and intervention with colchicine or low-, middle-, and high-dose SSAA reduced the levels of AST and ALT, with a significant difference between the CCl 4 model group and the other groups (all P < 0.05). HE staining and Sirius Red staining showed disordered structure of hepatic lobules and an increase in collagen fibers in the CCl 4 model group, and the structure of hepatic lobules was improved after intervention with colchicine or low-, middle-, and high-dose SSAA. The CCl 4 model group had significantly higher transcriptional levels of ITGA4, TGFβ1, α-SMA, and TIMP2 than the other groups, and there were significant reductions in the transcriptional levels of each factor after intervention with colchicine or SSAA, with a significant difference between the CCl 4 model group and the other groups (all P < 0.05). The CCl 4 model group had significantly higher protein expression levels of ITGA4, TGFβ1, α-SMA, TIMP2, and TIMP1 and a significantly lower protein expression level of MMP2 than the other groups, and intervention with colchicine or SSAA inhibited the expression of ITGA4, TGFβ1, α-SMA, TIMP2, and TIMP1 and promoted the expression of MMP2. Immunohistochemistry showed that the CCl 4 model group had significantly higher expression levels of TGFβ1 and α-SMA than the other groups, which was inhibited by intervention with colchicine or SSAA. The high-dose SSAA group had the most significant effect in reducing aminotransferases, improving lobular structure, and inhibiting the protein expression of liver fibrosis factors. Conclusion The high expression of ITGA4 in the liver is associated with the development of liver fibrosis, which is consistent with the increases in the expression of TGFβ1 and α-SMA. Inhibiting the expression of ITGA4 can provide more therapeutic targets for liver fibrosis and expand the anti-liver fibrosis mechanism of SSAA.

Objective:To establish and optimize the isolation scheme of exosomes from herpes simplex virus type 1 (HSV-1) infected HEp-2 cells.Methods:The supernatant of HSV-1 infected HEp-2 cells were collected and pretreated with differential centrifugation and filtration, then purified by total exosome isolation (TEI) in combination with size-exclusion chromatography (SEC); and enriched the exosome with ultrafiltration. Western blotting, transmission electron microscopy (TEM) and nanoparticle tracking analysis (NTA) were performed to characterize the purified exosomes.Results:The purified exosomes from HEp-2 cells with or without HSV-1 infection showed positive signals of exosome-specific markers (TSG101 and CD9), and the expression of virus protein gB, VP16 and ICP5 were detected in exosomes derived from HSV-1 infected cells. The purified exosomes from HEp-2 cells with or without HSV-1 infection showed a typical round-shaped morphology under TEM, with a mean diameter of 50~150 nm; meanwhile, no typical HSV-1 virus particles were detectable. The peak diameter of purified exosomes was 112.2 nm, furthermore, the peak concentration of exosomes from HEp-2 control cells was 3.4×10 9 particles/ml, while the peak concentration of exosomes from HSV-1 infected cells was 4.1×10 9 particles/ml. Conclusions:We accomplished an efficient and optimized approach for the isolation and purification of exosomes from HSV-1 infected cells.

Objective To compare the performance of three nucleic acid detection methods for hepatitis E virus.Methods The open reading frame (ORF) 2 gene sequence of HEV genotype 4 representative strain was cloned into pUC57 vector.Plasmid DNA was detected by two real-time quantitative method A and B,and the detection limits were compared.Other samples were used for specificity detection.Serum specimens of acute hepatitis E patients were detected by three method,and the results were compared.Results The lowest detection limit of plasmid DNA by A and B method can both reach 35 copies/reaction,with specificity of 100％.The HEV RNA positive rate of serum samples from acute hepatitis E patients by A,B and C method was 47.8％ (43/90),43.3％ (39/90) and 41.1％ (37/90),with the concordance rate of 88.9％ (80/90).There was no statistically significant difference among the three method (x2=0.8414,P=0.6566).Serum specimens with Ct values below 34.6 detected by method A,or below 35.6 detected by method B,the success rate of amplification by method C was 100％.Conclusions Method A has both higher sensitivity and specificity,and method C is a sensitive gene detection method.

Objective:To compare the diagnostic performance of four IgM antibody diagnostic kits for hepatitis E virus (HEV) in an outbreak.Methods:Four reagent kits were used to detect the IgM antibody to HEV in serum samples of the subjects in an outbreak of hepatitis E, and the HEV RNA was detected; statistical analysis was carried out.Results:The detection rates of HEV IgM antibody with MP, Kehua, Wantai and Beier′s reagent kits were 40.00% (108/270), 29.26% (79/270), 28.52% (77/270) and 20.37% (55 /270), respectively, with a consistency rate of 78.52% (212/270). For HEV RNA positive samples, the sensitivity of MP, Kehua and Wantai’s reagents was 66.67% (32/48) and that of Beier’s reagent was 58.33% (28/48). The sensitivity of MP, Kehua and Wantai’s reagents was 69.81% (37/53) and that of Beier’s reagent was 60.38% (32/53) for sera from patients with acute hepatitis E. The detection rates of HEV IgM antibody in serum samples of RNA positive or acute hepatitis E clinical diagnosis cases of Beier-Kehua and Beier-Wantai were significantly different (McNemar’s test: P<0.05), but there was no significant difference between the detection rates of other reagents (McNemar’s test: P>0.05); for serum samples of HEV RNA negative or clinically excluded cases of acute hepatitis E, the detection rates of HEV IgM antibody of Kehua and Wantai’s reagents were the most similar (McNemar’s test: P>0.05), but the detection result of other reagents were significantly different (McNemar’s test: P<0.05). Conclusions:The diagnostic kits of MP, Kehua and Wantai for HEV IgM antibody have high sensitivity and are suitable for the early serological screening of acute hepatitis E. In the outbreak of hepatitis E, comprehensive diagnosis should be made by combining the detection result of HEV IgM antibody and HEV RNA.

Objective:To recognize the development pattern of COVID-19 epidemic, and to predict the development trend of the epidemic in three categories: the country, Hubei province, and areas outside Hubei province.Methods:The BloComp model was used to fit existing data. With the estimated parameters, we simulated future epidemic development.Results:The pattern of virus transfer among different populations in Hubei province was significantly different from that outside Hubei province. It is predicted by the BloComp model that the time when the number of confirmed cases fell to zero in Hubei province and areas outside Hubei will be May 2020 and April 2020, respectively.Conclusions:The epidemic situation will end at the end of May 2020. Adequate medical resources investment and more comprehensive and accurate investigation of suspected people play important roles in controlling the epidemic situation.