Despite therapy with potent antiviral agents, chronic hepatitis B (CHB) patients remain at high risk of hepatocellular carcinoma (HCC). While metabolites have been rediscovered as active drivers of biological processes including carcinogenesis, the specific metabolites modulating HCC risk in CHB patients are largely unknown. Here, we demonstrate that baseline plasma from CHB patients who later developed HCC during follow-up exhibits growth-promoting properties in a case-control design nested within a large-scale, prospective cohort. Metabolomics analysis reveals a reduction in long-chain acylcarnitines (LCACs) in the baseline plasma of patients with HCC development. LCACs preferentially inhibit the proliferation of HCC cells in vitro at a physiological concentration and prevent the occurrence of HCC in vivo without hepatorenal toxicity. Uptake and metabolism of circulating LCACs increase the intracellular level of acetyl coenzyme A, which upregulates histone H3 Lys14 acetylation at the promoter region of KLF6 gene and thereby activates KLF6/p21 pathway. Indeed, blocking LCAC metabolism attenuates the difference in KLF6/p21 expression induced by baseline plasma of HCC/non-HCC patients. The deficiency of circulating LCACs represents a driver of HCC in CHB patients with viral control. These insights provide a promising direction for developing therapeutic strategies to reduce HCC risk further in the antiviral era.

Objective To investigate the effect of nutritional deficiency on autophagic flux in human hepatoblastoma HepG2 cells and the autophagy-dependent molecular pathway mediated by ATG5 against nutritional stress.Methods Lentiviral siRNA knockdown of ATG5 was performed to knock down the expression in HepG2 cells,and the transfection was verified by Western blotting and qRT-PCR.HBSS was used to treat HepG2 cells for 0,1,2,3,4,5,6 and 7 h for starvation-induced autophagy.Monodansylcadaverine(MDC)fluorescence staining was employed to detect the formation of intracellular autophagic vesicles.Western blotting was performed to measure the expression changes in microtubule-associated protein 1A/1B-light chain 3(LC3),autophagy receptor protein(sequestosome 1,P62),autophagy-related gene 5(ATG5)and nutrient stress pathway(AMPK/mTOR pathway)related proteins.CCK-8 assay was utilized to test cell proliferation.Results Compared with the HepG2 cells under conventional culture medium,starvation induction resulted in more autophagic vacuoles(accumulation of autofluorescent marker,MDC),which peaked at 6 h of starvation(P<0.000 1),up-regulated protein levels of LC3B-Ⅱ and ATG5(P<0.05),decreased protein expression of P62(P<0.05),gradual activation of the AMPK/mTOR pathway with elapse of starvation time,and increase in the intensity of autophagic flux.However,in the HepG2 cells with ATG5 knockdown,starvation treatment led to decreased ATG5 expression,no significant difference in LC3B-II and P62 changes,inhibited autophagic flux,and suppressed cell proliferation(P<0.000 1).Conclusion Human hepatoblastoma HepG2 cells can regulate autophagic flux to against nutritional stress by inducing ATG5 expression.

Objective:To explore the characteristics and therapeutic strategies of Pott's puffy tumor（PPT）. Methods:The clinical data of two patients with PPT were retrospectively analyzed and combined with the literature, focusing on the comprehensive analysis of perioperative diagnosis and treatment strategies. Both patients underwent muti-disciplinary treatment, including timely administration of sufficient antibiotics capable of penetrating the blood-brain barrier. Early removal of PPT lesions was performed using a combined internal and external approach under nasal endoscopic guidance. Results:After standardized perioperative management, the symptoms of the two patients were completely relieved, with no recurrence after one=year follow=up. Postoperative complications such as frontal pain, numbness, local depression, or scar hyperplasiawere not present. Conclusion:PPT, being relatively rare and severe, requires careful attention. Key strategies for standardized perioperative management include multi-disciplinary consultation, timely and adequate antibiotic administration, and surgical intervention using a combined intranasal and extranasal endoscopic approach for lesion removal.
Humans ; Pott Puffy Tumor/complications* ; Retrospective Studies ; Tomography, X-Ray Computed ; Endoscopy/adverse effects* ; Postoperative Complications ; Anti-Bacterial Agents/therapeutic use* ; Frontal Sinusitis/complications*

Objective To gain an in-depth understanding of the authentic experiences of impaired dignity among patients in the recovery phase of severe bums,thereby informing the development of targeted dignity intervention plans by clinical medical staff.Methods By purposive sampling,the study included 16 patients in the recovery phase of severe burns,admitted to the Burn and Plastic Surgery Rehabilitation Department of a tertiary hospital in Guangzhou between December 2023 and January 2024.Face-to-face,semi-structured in-depth interviews were conducted,and the themes were analyzed,summarized,and distilled by the Colaizzi 7-step analysis method.Results 3 themes were identified,including impairment of physical dignity(physical disfigurement,change in appearance,and limitations in autonomous activities),psychological dignity conflicts(negative emotional disturbances and positive adjustment for adaptation)and the aspiration for social dignity(desire for family understanding,social support,and the hope to return to a normal life).Conclusion Clinical nurses should value the dignity experience of patients in the recovery phase of severe burns and establish patient-dignity-centered intervention plans to facilitate their dignified and high-quality recovery to a normal life.

Objective To analyze the effects of valproic acid(VPA),a histone deacetylase(HDAC)inhibitor,on macrophage polarization in?duced by paraquat(PQ)or lipopolysaccharide(LPS). Methods Mouse RAW264.7 cells were cultured at 37℃with 5%CO2,passaged,and then given one of the following treatments:(1)PQ;(2)PQ+VPA(classⅠandⅡa HDAC inhibitor);(3)PQ+apicidin(classⅠHDAC inhibitor);(4)PQ+MC1568(classⅡa HDAC inhibitor);(5)LPS;(6)LPS+VPA;(7)LPS+apicidin;(8)LPS+MC1568. The cells and culture supernatants were harvested after 8 h of treatment. RT?PCR,ELISA,and flow cytometry were conducted to assess the expression levels of macrophage phenotyp?ic markers. Results Both PQ and LPS skewed the macrophage functional polarity toward proinflammatory phenotype. VPA,apicidin,and MC1568 all inhibited PQ?and LPS?induced macrophages polarizing toward pro?inflammatory phenotype ,but the inhibitory effects were different in some ways. Conclusion VPA inhibits the proinflammatory function of macrophages induced by PQ and LPS ,but the effect of VPA on PQ?and LPS?induced macrophages has its own characteristics.

Objective]In order to study the impact of adenoid hypertrophy(AH)with allergic rhinitis(AR)in the otitis media with effusion(OME)in children,as well as to discuss the risk factors on the inducement of OME in patients with AH.[Methods]The clinical materials were collected and analyzed from 205 children with AH who admitted for surgical treatment between 2013 and 2015, including medical history and signs,acoustic immittance measurement,allergy screen as well as blood routine,and to evaluate the situation of OME and AR in patients with AH. All the data were analyzed by SPSS 20.0.[Results]Among the 205 AH children,66 cases(32.20%)were accompanying with OME. The AH patients aged 3-5 years had the highest incidence of OME,which decreased with age(P=0.018). It is significant on the prevalence of the OME in patients with AH between the two groups with and without AR (P = 0.010). In the logistic model investigating the risk factors of inducing OME among patients with AH,the third-degree AH, Type-three and the accompanying with AR were significant. The third-degree and third-type AH children were 2.729 and 6.390-folds higher than others respectively (P = 0.047,P = 0.001). The incidence of OME appeared to be 1.212-folds higher among patients with AR(P = 0.010).[Conclusion]Mechanical obstruction and AR played a superimposed role in the inducement of OME among patients with AH,which was effected by multiple factors. We should pay attention to the“lateral respiratory”allergic diseases on eustachian tube and middle ear.

OBJECTIVE To compare the costeffectiveness of two surgical approaches:endoscopic silicone tube intubation(ESTI) and conventional blind silicone tube intubation(CBSTI),in the management of chronic dacryocystitis(CDC).METHODS There were 46 cases of CDC from the Third Affiliated Hospital of Sun Yat-sen University from 2014 to 2015.Randomly,22 CDC patients were included in ESTI,24 patients were performed CBSTI.We analyzed both the final success rate,operating time,intraoperative visual analogue scale(VAS) and the rate of post-operative complications,as well as the final therapeutic effect.RESULTS In ESTI group,17 cases were cured,5 cases were improved and 3 cases were invalid.The success rate was 88.00％.Correspondingly for CBSTI group,14 cases were cured,6 eases were improved and 5 cases were invalid,and the success rate was 80.00％.ESTI was better,but there was no significant in success rate between the two groups (x2=0.881,P=0.644).Besides,the operating time and intraoperative VAS score in ESTI group was (10.32±2.30)min and 2.02±0.86,and they were(25.32 ± 4.87)min and 4.11 ± 1.44 in CBSTI group.So ESTI was better than CBSTI(t=-13.918,P=0.000;t=-6.012,P=0.000).ESTI had fewer complications(x2=4.878,P=0.027).CONCLUSION Compared to CBSTI,ESTI is a minimally invasive and highly effective technique for the treatment of CDC.The visualization of nasal endoscopy is the optimization of CBSTI,and this method need to be popularization and application.

OBJECTIVE To obtain and compare the clinical characteristics in patients with allergic rhinitis(AR) and nonallergic rhinitis(NAR) and investigate the trends in the proportion of AR and NAR in recent 10 years in Guangzhou. METHODS 5486 patients with nasal hyper-reactivity symptoms were divided into the AR group and NAR group. Clinical data including gender, age distribution and seasonality were analyzed. RESULTS The trends in the proportion of AR and NAR during the past decade did not change significantly. Male made up the majority of AR patients and NAR patients and AR patients were significantly younger than NAR patients. Male AR patients were significantly younger than females, while there were no significant difference in the age distribution among the male NAR patients and female ones. As the age increasing, the proportion of AR and NAR patients in overall study population present opposite tendency. The main onset season in AR was summer and in NAR was winter in Guangzhou city. CONCLUSION There were significant differences between AR and NAR in age, gender and seasonality. However, the trends in the proportion of AR and NAR in recent 10 years did not change significantly in Guangzhou.

OBJECTIVE To drew the map of distribution of concealed sites in epistaxis and optimize the mode of diagnosis and treatment. METHODS We have searched 117 references on intractable/refractory/latent epistaxis treated under nasal endoscopy in the last decade, including 11 708 cases with epistaxis. There were total 11 860 cases in this study plus 152 cases in our hospital. We summed up the experiences of the optimized treatment mode performed on concealed epistaxis, which was searching the accurate bleeding areas by nasal endoscopy and performing minimally invasive radiofrequency treatment without nasal packing. RESULTS We had found that the offending arteries about epistaxis are mainly sphenopalatine artery and anterior or posterior ethmoid artery. The frequency of bleeding areas came as follows: the vault of inferior nasal meatus in 3783 cases(31.90%), the olfactory sulcus of middle turbinate in 3522 cases(29.70%), the posterior regions of middle meatus in 1349 cases(11.37%), the regions of deviation of nasal septum in 1065 cases(8.98%), the foremost regions of nasal cavity in 738 cases(6.22%), and the others or uncertain in 1403 cases(11.83%). Finally, we drew a concise map of distribution about epistaxis on the basis of the concealed bleeding areas and offending vessels. 151 of 152 patients(99.34%) could find out the bleeding sites accurately and stop the bleeding through minimally invasive radiofrequency ablation. CONCLUSION We drew a map of distribution about epistaxis in concealed areas so that it is convenient for us to seek out the bleeding sites. Rational use of nasal endoscopy to explore the sites of intractable epistaxis and minimally invasive radiofrequency are optimized mode of treatment.

Objective To analyze the skeletal characteristics of temporomandibular joint in patients with unilateral posterior scis-sors bite by using the cone-beam computed tomography(CBCT) .Methods Thirty-five patients of Angle class Ⅰ were scanned by CBCT (19 cases with unilateral scissors bite as the experimental group and 16 cases without scissors bite as the control group ) The CT images were reconstructed into 3D computer models by using the Dental Volume Reformat Function of the Ondemand 3D pack-age .9 anatomical landmarks were located and all data of 11 measured value were statistically analyzed .Results There were statisti-cal differences in the skeletal characteristics of temporomandibular joint in the scissors-bite side of the experimental group compared with those in the non-scissors-bite side (P<0 .01) .The side-to-side differences of the skeletal characteristics of temporomandibular in the controlled group were not statistically significant (P>0 .05) .There were statistical significances in the skeletal characteris-tics of temporomandibular joint of the controlled group compared with those in the scissors-bite side of the experimental group ,and the same with those in the non-scissors-bite side (P<0 .01) .Conclusion The CBCT is an effective tool to analyze the skeletal char-acteristics of temporomandibular joint characteristics .There were differences in the morphology of the condyle and the glenoid fossa of patients with unilateral posterior scissors bite .