Acute Disease ; Fatty Liver/diagnosis* ; Female ; Humans ; Liver ; Pregnancy ; Pregnancy Complications/diagnosis*

Objective:To compare the clinical efficacy of transjugular intrahepatic portosystemic shunt (TIPS) with expanded polytetrafluoroethylene (ePTFE)-covered stent and drug combined with gastroscopy as the secondary prevention of esophageal-gastric variceal bleeding in portal hypertension.Methods:Patients with esophageal-gastric variceal bleeding who received TIPS treatment (ePTFE covered stent) or gastroscopy for the first time as the secondary prevention for portal hypertension at Nanfang Hospital of Southern Medical University through March to July 2017 were selected. One year after the operation, liver function changes, ascites remission rates, incidence of hepatic encephalopathy, re-bleeding rate, average hospitalization frequency and expenses, survival time, as well as the TIPS patency conditions were analyzed in the two groups of patients. 2 test, Kaplan-Meier method and Mann-Whitney U test were used to analyze the data.Results:There were 74 and 66 cases in the TIPS and the drug combined gastroscopy group and the follow-up duration (14.57 ± 0.79) was 12-16 months. One year after surgery, the remission rate of ascites in the TIPS group was higher 57.1% (32/56) than that of the drug combined gastroscopy group (0), and the difference was statistically significant (χ 2 = 2 = 36.73, P < 0.01). The cumulative incidence of hepatic encephalopathy at 1, 3, 6, and 12 months after surgery in the TIPS group was 32.4% (24/74), 37.8% (28/74), 40.5% (30/74), and 40.5% (30/74), respectively. The cumulative incidence of hepatic encephalopathy in the drug combined gastroscopy group was 3.0% (2/66), 3.0% (2/66), 3.0% (2/66), and 6.1% (4/66), respectively. Kaplan-Meier analysis showed that the cumulative incidence of hepatic encephalopathy in the TIPS group was higher than that of the drug combined gastroscopy group (χ 2 = 11.29, P < 0.01). The incidence of severe hepatic encephalopathy ( grade III to IV) at 1, 3, 6, and 12 months after surgery in the TIPS group was 2.7% (2/74), 0, 0, and 0, respectively. The incidence of severe hepatic encephalopathy in drug combined gastroscopy group was 0, and there was no statistically significant difference in development of hepatic encephalopathy between the two groups ( P > 0.05). The re-bleeding rates of TIPS group and drug combined gastroscopy group were 0 and 27.3% (18/66), respectively, and the difference was statistically significant (χ 2 = 22.42, P < 0.01). There was no death reported during the follow-up period between both groups. The hospitalization frequency times (1.45 ± 0.80) in TIPS group was lower than that of the drug combined gastroscopy group times (3.24 ± 1.80), and the difference was statistically significant ( U = -4.52, P < 0.01). Conclusion:In the prevention of esophageal-gastric variceal bleeding, TIPS (ePTFE-covered stent) treatment has the advantages of reducing re-bleeding rate, high ascites remission rate and hospitalizations frequency. In addition, patients treated with TIPS have a higher incidence of hepatic encephalopathy than that of drugs combined with gastroscopy. However, TIPS did not exacerbate the incidence of hepatic encephalopathy, and there was no significant difference in the 1-year survival rate after TIPS and drugs combined with gastroscopy treatment.

The epidemic of coronavirus disease 2019 (COVID-19) has become a severe and complicated situation. As of February 23, 2020, there have been more than 77,038 confirmed cases of new coronavirus infection nationwide. COVID-19 is highly infectious and has a long incubation period and a variety of clinical manifestations, which has a great impact on society and economy and also seriously affects the daily operation of hepatobiliary surgery. This article discusses and recommends the medical protection measures required for outpatient, ward, and operation of hepatobiliary surgery, in order to reduce the risk of nosocomial infection in hepatobiliary surgery during the COVID-19 epidemic.

Objective To explore the effects of smoking on medications and provide an accurate and reliable evidence for smoking patients. Methods The drug instructions were surveyed from Datong medical drug counselling software database, and then the effects of smoking on drugs were analyzed by the drug instructions combined with the literature reports. Results There were 48 drugs varieties which might interact with smoking in Chinese drug instructions filtered from Datong medical drug counselling software database,which was much less than the report surveyed based on the FDA drug instructions(188 drugs varieties),there were another 37 varieties that off the instructions,reported by literatures interacted with smoking.Analysis revealed that smoking effects on drugs mainly by means of changing the pharmacokinetics and reducing the efficacy through inducing the CYP1A2,increasing the morbidity of some diseases such as cardiovascular disease,and increasing the adverse drug reactions.It was found that dosages of 8 drugs varieties need to be adjusted in smokers which were mainly or partly metabolized by CYP1A2.They are hydrochloride erlotinib,theophylline,riociguat,insulin,warfarin,clozapine,olanzapine and chlorpromazine. Dosage of 9 drugs varieties may need to be increased in smokers. Conclusion For the purpose of rational drug use,dosage of a variety of drugs should be adjusted in smokers.

Objective To explore the feasibility of MR lymphography (MR-LG) in detecting internal mammary sentinel lymph node (SLN) for rabbit models of VX2 breast cancer.Methods Totally 75 New Zealand white rabbits were randomly divided into 2 groups to establish VX2 breast cancer (tumor group) and inflammation models (inflammation group),respectively.MR-LG examinations and lymph node dissection were performed in all the rabbits.The results of internal mammary SLN and lymphatic vessels mapping were recorded,and the influence factors were analyzed.Results The success rate of model establishment was 97.33％ (73/75).The detection rate of internal mammary SLN and lymphatic vessels was 15.94％ (11/69) and 75.36％ (52/69),respectively,there was no statistical difference between the two groups (both P＞0.05).The rabbit's weight,time of tumor growth,tumor size,number,size and status of axillary SLN,as well as presence or not of internal mammary lymph vessels detection showed no statistical difference between detection and non-detection of internal mammary SLN (all P＞0.05),while the tumor size and axillary lymph node number showed statistically significant differences between detection and not detection of internal lymphatic vessels (both P＜0.05).The accuracy,sensitivity,specificity,false negative and false positive rate of internal mammary SLN detection with MR-LG was 76.81％ (53/69),39.13％(9/23),95.65％(44/46),60.86％(14/23) and 4.35％(2/46),respectively.Conclusion MR-LG can effectively detect internal mammary SLN and lymphatic vessels for rabbit models of VX2 breast cancer.

Objective To compare the bispectral index ( BIS) values at loss of consciousness in-duced by etomidate and propofol given by target-controlled infusion (TCI). Methods A total of 120 Amer-ican Society of Anesthesiologists physical statusⅠ-Ⅲ patients, aged 18-64 yr, scheduled for elective ca-rotid endartrectomy under total intravenous anesthesia, were divided into R0e, R1e, R2e, R0p, R1p and R2p groups (n＝20 each) using a random number table method. R1e and R1p groups received remifentanil at an target effect-site concentration (Ce) of 1 ng∕ml, and R2e and R2p groups received remifentanil at an target Ce of 2 ng∕ml. At the beginning of anesthesia induction, remifentanil was given by TCI until the pre-set effect-site concentration was achieved, and etomidate was given by TCI at an initial target plasma con-centration of 0. 6 μg∕ml followed by an increase by 0. 1 μg∕ml every minute until loss of consciousness in R0e, R1e and R2e groups, and propofol was given by TCI at an initial target plasma concentration of 2 μg∕ml followed by an increase by 0. 1 μg∕ml every minute until loss of consciousness in R0p, R1p and R2p groups. BIS values were recorded immediately after pasting the BIS electrode, when the preset Ce of remifentanil was achieved and at loss of consciousness. Results Compared with group R0p, BIS values were significantly decreased at loss of consciousness in group R0e ( P＜0. 05) . Compared with group R1p, BIS values were significantly decreased at loss of consciousness in group R1e ( P＜0. 05) . BIS values were significantly lower at loss of consciousness in group R2e than in group R2p ( P＜0. 05) . Conclusion BIS values are significantly lower at loss of consciousness induced by TCI of etomidate than propofol.

Objective To study the value of CT lymphography (CT-LG) in evaluating axillary sentinel lymph nodes (SLN) of rabbit with breast cancer using 3D and curved planar reformation (CPR).Methods CT-LG examinations were completed on the VX2 rabbit models bearing breast cancer established by tumor tissue mass suspension injection.All raw data were transferred to a postprocessing workstation, then the 3D and CPR were used to show lymphatic vessel and lymph nodes.On the CT-LG images, one or several lymph nodes displayed firstly in the lymphatic drainage pathway was defined as the SLN which was then confirmed by the biopsy.Results (1) 20 rabbits bearing tumor underwnet CT-LG examinations, and both SLNs and draining lymphatic vessels were detected using 3D and CPR techniques.70% (14/20) of experimental rabbits had fine images, and 16 SLNs and 7 non-SLNs were demonstrated on 14 rabbits on CT-LG images with good quality.(2) 8 continuous lymphatic vessels displayed well, exhibiting a homogeneous and continuous tube with uniform contrast-medium filling on CPR images.Most lymphatic vessels demonstrated well, and the 14 vessels with local interrupt or fuzzy on 3D images showed continuous tubular contrast-filling with heterogeneous high-density on the CPR images from the injection sites to axillary SLN.Among 6 rabbits with poor images, 3 rabbits showed the SLN but without lymphatic vessels on 3D images, 2 showed only initial segment of lymphatic vessel,and 1 had no lymphatic vessel and SLN.(3) A total 24 SLNs were obtained by SLNB,including 18 metastatic SLNs and 6 negative ones.On CT-LG images, there were statistical differences between the metastatic and negative SLNs in the maximum diameter and filling defect (P=0.041 and P=0.001, respectively).However, the short diameter, shape and margin of SLNs had no statistical differences between the two groups (all P>0.05).Conclusion On CT-LG examinations, 3D and CPR images may show axillary SLNs and lymphatic vessels effectively,and CPR can demonstrate more details than 3D.The maximum diameter and fillingdefect of SLN are helpful for distinguishing metastatic and negative SLNs.

Objective To understand the characteristics and trends of clinical epidemiology of colorectal cancer in recent years.Methods The data of 849 patients with colorectal cancer confirmed by pathology in Hongqi Hospital of Mudanjiang Medical College and Cancer Hospital of Mudanjiang City from January 2010 to December 2015 were collected and analyzed by chi square test and variance analysis.Results In recent years,the patients with colorectal cancer were aging (F~ =2.471,P ＜ 0.05).Though the elderly (＞ 60 years old) people were the main population (65.6 ％,557/849),the young (＜ 40 years old) patients with colorectal cancer still accounted for 3.5 ％ (30/849).The rectum was the most common site where the carcinoma arose (56.54 ％,480/849).There was a significant difference between male and female patients in the location and pathological type of tumor (x2 =10.294,P =0.006;x2 =10.468,P =0.015).The incidence of left and right colon was increased [20.02 ％ (170/849) and 23.44 ％ (199/849),x2 =29.023,P =0.004],and the proportion of adenocarcinoma was increased (x2 =40.203,P =0.001).Conclusion The number of elderly patients with colorectal cancer in Mudanjiang region of China is increased significantly in recent years.The adenocarcinoma is the most common pathological type,and its incidence is increasing in recent 5 years.Thus healthy education and colorectal cancer prevention should be strengthened.

AIM: To investigate the effect of microRNA (miR)-30c on the viability and migratory ability of human umbilical vein endothelial cells (HUVECs) by targeting plasminogen activator inhibitor-1 (PAI-1).METHODS:The HUVECs were transfected with miR-30c mimic and inhibitor or negative control (NC), and then the expression levels of miR-30c, PAI-1 mRNA and protein were detected by RT-qPCR and Western blot.The viability and migratory ability of HUVECs were measured by CCK-8 assay and wound healing test .After bioinformatic analysis, the assessment of miR-30c binding to PAI-1 3’-UTR was carried out using a luciferase reporter gene assay .RESULTS:miR-30c directly down-regu-lated PAI-1 levels by binding to the 3’ UTR seed sequence of PAI-1 mRNA.Furthermore, transfection of a miR-30c mimic down-regulated the expression of PAI-1 at mRNA and protein levels, leading to enhanced migratory ability and viability of the HUVECs.However, transfection of a miR-30c inhibitor up-regulated the expression of PAI-1 at mRNA and protein le-vels, leading to decreased migratory ability and viability .CONCLUSION:Regulation of miR-30c level changes the migra-tory ability and viability of HUVECs by affecting the PAI-1 expression, indicating the involvement of miR-30c in modulating endothelial function .