Objective:To construct a Nomogram model in predicting recurrence-free survival (RFS) and overall survival (OS) at six months, one year and two years after hepatocellular carcinoma (HCC) resection by using inflammatory markers combined with other routine clinical indicators.Methods:The data of 314 patients with HCC who underwent first time hepatectomy at Beijing Chaoyang Emergency Rescue Center and Air Force Characteristic Medical Center from January 2013 to January 2018 were analyzed. HCC patients who underwent hepatectomy at the First Medical Center of PLA General Hospital from January 2011 to January 2016 ( n=106) were used as the external validation group. Univariate and multivariate Cox proportional risk model was used to analyze independent risk factors of recurrence and death in HCC patients. A Nomogram model was constructed based on independent risk factors. Validation of the efficacy of the Nomogram model was done based on external data. Results:In the experimental group, 174 patients relapsed. The median RFS was 26 months. The 6 months, 1 year and 2 years RFS were 26.8%, 43.9%, and 68.8%, respectively. A total of 142 patients had died. The median survival time was 30 months. The 6 months, 1 year and 2 years OS were 5.9%, 23.6% and 63.1%, respectively. In the external validation group, 63 patients had developed recurrence, with a median RFS time of 28 months. The 6 months, 1 year and 2 years RFS were 26.4%, 45.3%, 54.7%, respectively. The median survival time was 31 months. The 6 months, 1 year and 2 years OS were 7.5%, 25.5%, 46.6%, respectively. Tumor size (>6.0 cm, HR: 1.447), vascular invasion ( HR: 1.408), TBil (>0.94 mg/dl, HR: 1.949), NLR (>2.54, HR: 2.843), AGR (≤0.88, HR: 2.447) were independent risk factors of HCC recurrence ( P<0.05). Tumor size (>6.0 cm, HR: 2.207), vascular invasion ( HR: 1.529), and NLR (>2.54, HR: 2.708) were independent risk factors of death for HCC patients ( P<0.05). The C-indexes of half-year, one-year and two-year RFS were 0.764 (95% CI: 0.677-0.854), 0.710 (95% CI: 0.615-0.824) and 0.673 (95% CI: 0.601-0.786), respectively. The C-indexes of half-year OS, one-year OS and two-year OS were 0.729 (95% CI: 0.648-0.841), 0.708 (95% CI: 0.608-0.813) and 0.664 (95% CI: 0.618-0.771), respectively. Conclusion:In this study, the construction of a Nomogram model in predicting prognosis of HCC patients was helpful to guide clinicians in improving preoperative treatment plans and in providing ideas for individualized treatment of patients.

Objective:To investigate changes in mRNA and protein expression of interleukin-27(IL-27)in glomerular podocyte injury caused by Puromycinonucleoside(PAN), and to explore the mechanism of the protective effect of Tacrolimus(FK506)on glomerular podocyte injury.Methods:Glomerular foot cells from mice were cultured in vitro and divided into 3 groups, which were the control group, PAN group and FK506 group.The morphology of 3 groups of foot cells was observed under a microscope after 8 h, 24 h, and 48 h treatment.The changes in IL-27 concentrations were detected by analyzing the enzyme-linked immunosorbent assay(ELISA)method.The cultured foot cells were then collected.The changes of IL-27 mRNA expression were measured by real-time fluorescence quantitative PCR(qPCR), and the changes of IL-27 protein expression were detected by Western blot. Results:(1)At each time point(8 h, 24 h, 48 h), the cells of the PAN group had smaller volume and different morphology than the cells of the control group, and the cells of the FK506 group was larger and fuller than the cells of the PAN group.(2)The concentrations of IL-27 in the PAN group [(110.00±3.52) ng/L, (302.00±6.23) ng/L, (397.00±8.92) ng/L] were significantly higher than those in the control group [(90.00±5.12) ng/L, (85.00±4.21) ng/L, (88.00±4.20) ng/L] and those in the FK506 group [(96.00±4.17) ng/L, (107.00±4.86) ng/L, (112.00±6.24) ng/L] at 8 h, 24 h and 48 h(all P<0.05). (3)At each time point(8 h, 24 h, 48 h), the IL-27 mRNA expression of the PAN group(1.25±0.11, 1.57±0.08, 1.73±0.13)was significantly higher than that of the control group(1.02±0.02, 1.10±0.04, 0.96±0.02)(all P<0.05). Compared with the control group, the IL-27 mRNA expression of the FK506 group did not significantly increase at 8 h (1.10±0.06), and showed a slight increase at 24 h and 48 h(1.21±0.04, 1.30±0.09). Compared with PAN group, HC506 group were all lower (all P<0.05). (4)At each time point(8 h, 24 h, 48 h), the expression of IL-27 protein in the PAN group(0.94±0.04, 1.56±0.07, 1.63±0.04) was significantly higher than that in the control group(0.83±0.04, 0.85±0.03, 0.83±0.05), there was significant difference(all P<0.05). Compared with the PAN group, the expression of IL-27 protein in the FK506 group(0.84±0.05, 0.89±0.04, 0.91±0.06)was not significantly different at 8 h, but decreased significantly at 24 h and 48 h, there was significant difference ( P<0.05). Conclusions:IL-27 is involved in the pathogenesis of kidney diseases.FK506 can prevent the glomerular podocyte injury by reducing the expression of IL-27.This study provides experimental basis for clinical application of FK506 in the treatment of kidney diseases.

Objective: To explore the related factors of subependymal hemorrhage (SEH) and cerebral hemodynamic changes. Methods: From October 2012 to October 2017, 200 cases of children with subependymal hemorrhage diagnosed by ultrasound in our department of pediatrics were selected as the observation group , and a total of 150 children who were admitted to the Department of Pediatrics in the same period due to craniocerebral diseases and other serious diseases were selected as control group. The independent risk factors of the children in the observation group were analyzed, and the difference of the maximum systolic blood flow velocity (SV), the diastolic maximum flow velocity (DV), the systolic and diastolic velocity ratio (S/D), the resistance index (RI), and the pulsatile index (PI) were compared between the two groups. Results: Neonatal asphyxia, preterm birth, acidosis, neonatal respiratory distress syndrome (NRDS), patent ductus arteriosus and coagulation dysfunction were independent risk factors for subependymal hemorrhage. The bleeding side SV and DV of the observation group were higher than those of the control group, with statistically significant difference (P<0.001). In the observation group, the bleeding side SV and DV were higher than those of the healthy side, with statistically significant difference (P<0.001). There was no significant difference in bleeding side SV, DV, S/D, RI and PI in 110 cases of single side ependymal hemorrhage (P>0.05). Conclusions Children with ependymal hemorrhage can observe the hemodynamic indexes of anterior cerebral artery (ACA) dynamically by craniocerebral ultrasound, and judge the therapeutic effect by evaluating the systolic and diastolic blood flow velocity, so as to prevent the further aggravation of subependymal hemorrhage

Objective: To investigate the effects of Tacrolimus(FK506) and Puromycin aminonucleoside(PAN) on apoptosis and expression of α-actinin-4 mRNA and protein in mouse glomerular podocytes in order to explore the protective effect of FK506 on podocytes. Methods: Mouse glomerular podocytes were cultured in vitro, and the control group, PAN group and FK506 group were established.After 8 h, 24 h and 48 h of treatment, the cell morphology was observed and the apoptosis rate was detected.The cells were collected by real-time PCR and Western blot was used to detect the mRNA and protein expression of α-actinin-4. Results: The cell body area of the PAN group was significantly smaller than that of the control group, and the cell area of the FK506 group was larger than that of the PAN group.There was no significant difference in the rate of podocyte apoptosis between those groups at 8 h (all P>0.05). At 24 h and 48 h, the apoptotic rate of podocytes in PAN group[(8.21±0.41)%, (16.32±0.17)%] were significantly higher than those in the control group[(4.28±0.35)%, (6.27±0.28)%], and the differences were significant (all P<0.05). The apoptosis rate of podocytes in FK506 group[(6.26±0.24)%, (13.32±0.24)%] were significantly lower than those in PAN group, and the differences were significant (all P<0.05). At 8 h, there was no significant difference in the expression of α-actinin-4 mRNA and protein(all P>0.05). The expression of mRNA (2.42±0.21, 3.78±0.25) and protein(0.77±0.04, 1.22±0.10) in the PAN group was significantly higher than mRNA(1.50±0.22, 2.15±0.15) and protein(0.44±0.03, 0.83±0.07) in the control group at 24 h and 48 h, and the differences were significant (all P<0.01). The expression of mRNA (1.65±0.24, 1.70±0.32) and protein (0.52±0.05, 0.56±0.07) in FK506 group was significantly lower than that of PAN group, and the differences were significant (all P<0.05). Conclusions FK506 can effectively inhibit the damage of PAN on podocytes and stabilize the expression of α-actinin-4, which provides a basis for the clinical application of FK506 in the treatment of glomerular diseases.

Objective To investigate the clinical efficacy and safety of angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) in treatment of children with Alport syndrome (AS).Methods A total of 22 children with AS in Department of Pediatrics,Guangzhou First People's Hospital and Department of Pediatrics,Shenzhen People's Hospital between January 2013 and December 2017 were selected.But four children were not included in this study since they did not take medication regularly,and the other 18 cases were included in this study.All the 18 children were initially treated with ACEI.The observation time was from 1 to 5 years.If the symptoms were not effectively controlled,treatment plan would be changed to ACEI combined with ARB treatment.The observation time was from 1 to 3 years.The clinical data and laboratory examination results [including 24-hour urine protein (mg/24 h),urine red blood cell count,plasma albumin (Alb),urea nitrogen (BUN),serum creatinine (Scr),total cholesterol (TC)] were collected for retrospective analysis.Results Eighteen patients started their treatment with ACEI inhibitors (Fosinopril).Within 2 years of treatment,the urinary protein and urinary red blood cells in the children decreased to 47.7％ and 41.3％,respectively,and the differences were all statistically significant (all P ＜ 0.05),and the renal function was stable within the normal range.Two years later,7 patients had elevation of urinary protein and urinary erythrocyte elevations and decrease of renal function,and they were treated with ACEI and ARB (Losartan).The other children had no significant change in urine protein and urine red blood cells in the 3 rd,4th,and 5th year,and their renal function was stable.After ACEI treatment alone for 5 years,urinary protein was 47.8％ lower than before treatment,and the difference was statistically significant (P ＜ 0.05);urinary red blood cells decreased to 32.0％ compared with before treatment,and the difference was statistically significant (P ＜ 0.05).Seven patients with ACEI alone had poor efficacy,after the treatment with ACEI combined with ARB,the urinary protein and urine red blood cells were lower in the first year and the renal function improved.There was no significant change in urinary protein and urine red blood cells in the 2nd and 3rd year,and renal function was stable.After ACEI combined with ARB treatment for 3 years,urinary protein decreased to 42.3％ before treatment,and the difference was statistically significant (P ＜ 0.05),and urinary red blood cells decreased to 46.9％ compared with before treatment,and the difference was statistically significant(P ＜ 0.05).Conclusions ACEI treatment of children with AS can reduce urine protein and help delay renal failure.For children with poor efficacy of ACEI treatment,ACEI combined with ARB may have a certain effect.ARB can be used as an adjunctive treatment for patients with AS who have a poor response to ACEI alone.

Objective To study the curative efficacy and safety of single-unit umbilical cord blood transplantation (sUCBT) for malignant hematologic diseases,which is provided by China's public cord blood bank.Methods We retrospectively analyzed 409 cases of malignant hematologic diseases who accepted myeloablative single-unit unrelated donor UCBT without ATG at our center between May 2008 and December 2016.A comparative analysis was made on the total nuclear cells (TNC) of the umbilical cord blood before freezing and after thawing,the cells of CD34+,the recovery rate of cells and the clinical effect of UCBT.Result 409 units of umbilical cord blood used in UCBT respectively came from eight China's public cord blood banks.The average TNC of 409 units of umbilical cord blood before freezing and after the tubular recovery were respectively 18.5 × 108 and 16.34 × 108 (p =0.000).The average recovery rate of the tubular recovery was 88.5％,and there was significant difference among cord blood banks (P =0.000).The average TNC of umbilical cord blood before freezing and transfusion were respectively 18.5 × 108 and 15.86 × 108 (p =0.000).The average recovery rate of umbilical cord blood transfusion was 85.9％,with the difference being significant among cord blood banks (P =0.000).The average number of CD34+ cells before freezing and after the tubular recovery was 11.18 × 106and 8.68 × 106 (p =0.000).The average recovery rate of CD34+ cells after the tubular recovery was 80.75 ％,with the difference being significant among the cord blood banks (P =0.000).At 42nd day after UCBT,the cumulative incidence of neutrophil engraftment was 95.4％,and the median time of the engraftment was 17 days (11-38 days).The cumulative incidence of platelet engraftment at 120th day was 84.6％,and the median time of the engraftment was 36 days (14-93 days).The cumulative incidence of erythrocyte engraftment at 60th day was 92％,and the median time of engraftment was 22 days (9d-60 days).After the umbilical cord blood provided by each bank was used in UCBT,it got the difference in cumulative incidence of engraftment.The P values for cumulative incidence of neutrophil,platelet and erythrocyte engraftment were respectively 0.004,0.01 and 0.000 2,with the differences being statistically significant.At 100th day after UCBT,the cumulative incidence of Ⅱ-Ⅳ and Ⅲ-Ⅳ degrees of acute graft-versus-host disease (aGVHD) was respectively 28.63％ and 15.7％.After umbilical cord blood provided by each bank was used in UCBT,it got the difference in cumulative incidence of aGVHD.There was no significant difference between Ⅱ-Ⅳ and Ⅲ-Ⅳ degrees (P =0.809 and 0.68 respectively).At 3rd year after UCBT,the cumulative incidence of relapse was 15.89％.After umbilical cord blood provided by each bank was used in UCBT,there was no significant difference in the cumulative incidence of relapse (P =0.898).At 3rd year after UCBT,the overall survival (OS) rate and disease free survival (DFS) rate were respectively 66.7％ and 59％.After umbilical cord blood provided by each bank was used in UCBT,it got the difference in OS and DFS.There was no significant difference in OS and DFS (P =0.566 and 0.703 respectively).At 3rd year after sUCBT,the rate of graft-versus-host diseases/relapse-free survival (GRFS) was 54.3％.After umbilical cord blood provided by each bank was used in UCBT,there was no significant difference in the rate of GRFS (P =0.449).Conclusion The umbilical cord blood provided by China's public cord blood bank was used in UCBT.It has a high safety and good efficacy in treating malignant hematologic diseases.But it needs to set up the standardized and normalized quality-control system of umbilical cord blood for China's public cord blood bank.

Objective To evaluate effects of interleukin-36α (IL-36α) on psoriasiform skin lesions and C-C motif chemokine ligand 20 (CCL20) expression in mice.Methods Totally,30 BALB/c female mice were randomly and equally divided into 3 groups:control group treated with topical vaseline cream on the shaved back and intracutaneous injection with phosphate buffer saline (PBS),model group treated with topical imiquimod cream on the shaved back and intracutaneous injection with PBS,experimental group treated with topical imiquimod cream on the shaved back and intracutaneous injection with IL-36α solution.Psoriasis area severity index (PASI) was used to evaluate changes of psoriasiform skin lesions in mice,and light microscopy to observe morphological changes of skin lesions and to measure the thickness of the epidermis.Real-time fluorescence-based quantitative PCR (qRT-PCR) and Western blot analysis were performed to determine the expression of IL-36α in skin lesions in the control group and model group,and qRT-PCR,Western blot analysis and immunohistochemical study to evaluate changes of CCL20 levels in skin lesions.Results The model group showed significantly increased mRNA (△ Ct value:0.0195 ± 0.0059) and protein expression (3.922 ± 0.248) of IL-36α compared with the control group (mRNA:0.0012 ± 0.0004,P ＜ 0.05;protein:0.690 ± 0.025,P ＜ 0.05).The mRNA and protein expression of CCL20 were significantly higher in the experimental group than those in the model group (mRNA:2.152 ± 0.793 vs.0.999 ± 0.178;protein:0.397 ± 0.033 vs.0.145 ± 0.030;both P ＜ 0.05),and higher in the model group than those in the control group (mRNA:0.378 ± 0.075;protein:0.025 ± 0.009;both P ＜ 0.05).Immunohistochemical study showed that the expression intensity of CCL20 in skin lesions significantly increased in the experimental group compared with that in the model group (Z =2.294,P ＜ 0.05).Conclusion IL-36α may aggravate psoriasiform skin inflammation in mice by promoting CCL20 expression.

Objective To evaluate the value of multislice spiral computed tomography angiography (MSCTA) in differential diagnosis between epithelial ovarian carcinoma (EOC) and borderline epithelial ovarian tumor (BOT).Methods The MSCTA images of 39 EOC patients and 23 BOT patients confirmed by surgical pathology were reviewed retrospectively.Main characteristics of tumor vessels were analyzed: the number of feeding arteries, the existence of dilated draining veins, whether the tumor vessels were tortuous, whether the distribution of tumor vessels were disturbed, and whether there were accompanying microaneurysms or arteriovenous malformations (AVMs).Results Two or more feeding arteries of the EOCs and BOTs were 89.7% (35/39) and 8.7% (2/23), respectively.Dilated draining veins were observed in 87.2% (34/39) of the EOCs and 4.3% (1/23) of the BOTs.The tortuosity of tumor vessels was observed in 97.4% (38/39) of the EOCs and 13.0% (3/23) of the BOTs.79.5% (31/39) of the EOCs and 8.7% (2/23) of the BOTs were complicated by microaneurysms, and 74.4% (29/39) of the EOCs and 4.3% (1/23) of the BOTs were complicated by AVMs.The characteristics of tumor vessels were significantly different between the two groups (P<0.01), with relatively high sensitivity and specificity.Conclusion MSCTA can better show the distribution, number and pattern of tumor vessels and is of great value in differential diagnosis between EOC and BOT.

Objective To assess the enhancement feature of intracranial atherosclerotic plaque in the vessel supplying the territory of infarction by using high-resolution MR imaging.To analyze the correlation between the degree of plaque enhancement , time elapsed and the concentration of hypersensitive C-reactive protein ( hs-CRP ).Methods The characteristics of vessel walls and intracranial vascular stenoses were retrospectively analyzed in 81 patients with ischemic strokes.All subjects were imaged with a traditional stroke MR protocol and HR-MRI scanning for plaque on a 3.0 T MRI scanner.According to the elapsed time between infarct and MR examination , all cases were classified into early stage (<4 weeks from acute stroke, n=58), middle stage (4-12 weeks, n=13) and late stage ( >12 weeks, n=10).The characteristics of vessel walls and degrees of enhancement of atherosclerotic plaques were assessed and the concentrations of hs-CRP in all patients were determined.The Kruskal-Wallis H test was used to compare the degree of enhancement and hs-CRP concentration among the early , middle and late stage.The concentration of hs-CRP was presented as median ( interquartile range ).The Spearman correlation was used to analyze the correlation between elapsed time , hs-CRP concentration and degree of enhancement.Results Fifty-five (55/81) plaques were located at the M1 segments, and the other 26 (26/81) plaques were at the basilar artery.The degree and presence of enhancement from strong to none were 29, 25 and 4 in the early stage;4, 6 and 3 in the middle stage and 0, 4, 6 in the late stage, respectively.The degree and presence of enhancement were significantly different among them (H=16.934,P<0.01).There was a remarkable trend of decreasing degree and presence of enhancement of the atherosclerotic plaque relative to increasing time after the ischemic event(r=-0.792,P<0.01).The serum hs-CRP concentration for early, middle and late stage were 7.0(3.0, 13.0), 2.27(1.0, 3.03) and 1.88(0.50, 4.0)mg/L (H=14.345,P<0.01) , respectively.There was a trend of decreasing hs-CRP concentration relative to the time elapsed ( r =-0.357,P<0.01).The degrees of enhancement of the plaques were parallel to the levels of hs -CRP( r=0.526,P<0.01).Conclusions Enhanced HR-MRI scanning may clearly demonstrate the enhancement characteristics of intracranial atherosclerotic plaques as an indicator of inflammation.It might play an important role to detect risk factors for intracranial plaque rupture and subsequent acute ischemic stroke .

Objective To observe the effect of modified Qinghao Biejia Decoction ( QBD) on Th17 cells and renal pathology of MRL/lpr mice with spontaneous systemic lupus erythematosus. Methods Thirty-two female MRL/lpr mice aged 8 to 10 weeks were divided into 4 groups: model group, Chinese medicine group, prednisone group, and combination group, 8 mice in each group. Eight female C57BL/6 mice aged 8 to 10 weeks served as normal control. Mice in Chinese medicine group were given concentrated solution of modified QBD (19.25 g·kg-1·d-1), mice in the prednisone group were given water solution of prednisone acetate (8.75 mg·kg-1·d-1) , mice in the combination group were given the above two kinds of medicine, and mice in the model group and normal control group were given physiological saline. After medication for 7 weeks, spleens and kidneys in all of the groups were taken out for the experiment. Th17 cells in splenic mononuclear cell suspension were detected by flow cytometry, the pathological changes of renal tissue were observed under light microscope, and activity index (AI) of renal tissue in lupus nephritis mice was scored. Results The proportion of Th17 cells in the model group was significantly higher than that of normal control group ( P<0.05) . The proportion of Th17 cells in Chinese medicine group and combination group was lower than that of the model group ( P<0.05) , and prednisone group had higher proportion of Th17 cells than Chinese medicine group ( P<0.05) . Compared with the model group, pathological changes of renal tissue were relieved, and AI scores were decreased in Chinese medicine group, the prednisone group and the combination group ( P<0.05) . Except for the normal control group , AI scores in all groups were positively correlated with the proportion of Th17 cells ( r=0.77, P<0.01) . Conclusion Modified QBD can inhibit the expression of Th17 cells and improve the pathological changes of MRL/lpr mice with lupus nephritis.