The liver is the largest visceral organ in the human body, responsible for multiple important functions such as metabolism, detoxification, nutrient storage, and immune regulation. Hepatocytes located along the portal-central vein axis have heterogeneity in gene expression and function, which led to the concept of liver zonation. Cells in different regions play different roles in metabolic processes, and the coordination and cooperation between these cells are crucial for maintaining normal liver function. In recent years, the advancements in single-cell genomics and spatial transcriptomics technologies have significantly improved our understanding of liver zonation. This article summarizes the important role of metabolic zonation in maintaining liver function and its relationship with disease and aging, providing a theoretical basis for further research and therapeutic strategies.

The liver is the largest visceral organ in the human body, responsible for multiple important functions such as metabolism, detoxification, nutrient storage, and immune regulation. Hepatocytes located along the portal-central vein axis have heterogeneity in gene expression and function, which led to the concept of liver zonation. Cells in different regions play different roles in metabolic processes, and the coordination and cooperation between these cells are crucial for maintaining normal liver function. In recent years, the advancements in single-cell genomics and spatial transcriptomics technologies have significantly improved our understanding of liver zonation. This article summarizes the important role of metabolic zonation in maintaining liver function and its relationship with disease and aging, providing a theoretical basis for further research and therapeutic strategies.

A 65-year-old female patient with paranoid schizophrenia switched to amisulpride due to poor treatment efficacy with risperidone, and gradually increased the dosage (0.1 g twice daily for 3 days, 0.2 g, twice daily for 2 days, and finally 0.4 g in the morning and 0.2 g in the evening). After 4 days of medication, electrocardiogram showed sinus bradycardia, with heart rate 49 beats/min and QT interval 492 ms; after 7 days of medication, dynamic electrocardiogram showed heart rate 25 beats/min (average heart rate 42 beats/min) and sinus arrest (207 R-R intervals greater than 2.0 s, with a maximum of 2.47 s). Sinus arrest in the patient mostly occurred at night. Amisulpride was reduced to 0.2 g once daily orally, and ECG monitoring was given. The next day, echocardiography showed left ventricular dyskinesia, mild mitral regurgitation, and abnormal left ventricular filling. It was considered that sinus arrest may be related to amisulpride. The drug was discontinued immediately, the dose of olanzapine increased from 5 mg/d to 10 mg/d, and other treatments remain unchanged. On the day after discontinuation of amisulpride, the number of sinus arrest in electrocardiogram monitoring significantly decreased compared to before. Three days after discontinuation, no sinus arrest was found on the dynamic electrocardiogram; 26 days later, the ECG showed sinus rhythm, with a heart rate of 60 beats/min.

A 65-year-old female patient with paranoid schizophrenia switched to amisulpride due to poor treatment efficacy with risperidone, and gradually increased the dosage (0.1 g twice daily for 3 days, 0.2 g, twice daily for 2 days, and finally 0.4 g in the morning and 0.2 g in the evening). After 4 days of medication, electrocardiogram showed sinus bradycardia, with heart rate 49 beats/min and QT interval 492 ms; after 7 days of medication, dynamic electrocardiogram showed heart rate 25 beats/min (average heart rate 42 beats/min) and sinus arrest (207 R-R intervals greater than 2.0 s, with a maximum of 2.47 s). Sinus arrest in the patient mostly occurred at night. Amisulpride was reduced to 0.2 g once daily orally, and ECG monitoring was given. The next day, echocardiography showed left ventricular dyskinesia, mild mitral regurgitation, and abnormal left ventricular filling. It was considered that sinus arrest may be related to amisulpride. The drug was discontinued immediately, the dose of olanzapine increased from 5 mg/d to 10 mg/d, and other treatments remain unchanged. On the day after discontinuation of amisulpride, the number of sinus arrest in electrocardiogram monitoring significantly decreased compared to before. Three days after discontinuation, no sinus arrest was found on the dynamic electrocardiogram; 26 days later, the ECG showed sinus rhythm, with a heart rate of 60 beats/min.

Objective To explore the clinical application value of second-generation dual-source CT combined with intelligent modulation and iterative reconstruction in emergency aortic dissection imaging.Methods A total of 40 emergency patients with clinical suspected aortic dissection were included in this study.Conventional scanning was performed in the control group,and large-pitch intelligent modulation and iterative reconstruction were performed in the test group.The mean CT value,mean noise,signal noise ratio(SNR),contrast noise ratio(CNR),effective dose,image quality and aortic root image quality were evaluated and analyzed.Results Totally 40 patients successfully completed CT aortic dissection imaging.There was no difference in image quality between the two groups (P＞ 0.05).The quality of aortic root images in the test group was better than that in the control group,and the difference was statistically significant(x2=22.556,P＜0.05).The mean CT value and mean noise of aorta in the control group were slightly higher than those in the test group.However,SNR and CNR in the test group were higher than those in the control group,and the difference was statistically significant (t =-21.042,-15.924,8.530,11.495,P＜0.05).The effective dose of the control group [(10.59±3.89)mSv] was significantly higher than that [(6.39±0.81) mSv] of the test group,the difference was statistically significant (t =-12.327,P＜0.05).Conclusions The combined intelligent modulation technique and iterative reconstruction technique with dual-source CT large pitch scanning can meet the requirements of image quality and reduce the effective dose,and can be used as a conventional imaging method for emergency CT of aortic dissection.

Objective To assess the value of cardiac magnetic resonance (CMR) imaging in left ventricular structure and function in patients with end stage renal disease (ESRD).Methods Twenty-five patients with ESRD and 10 healthy subjects underwent CMR.Left ventricular end diastolic volume(EDV),end-diastolic diameter(EDD),end-systolic volume(ESV),end-systolic diameter(ESD),stroke volume(SV),ejection fraction(EF),LVM and interventricular septum (IVS) thickness were measured and compared.The parameters from CMR and 2DTTE were compared.Results The EF in patients with ESRD was significantly lower than that in controls (P＜0.001),while ESV,ESD,IVS and LVM were respectively higher than these in controls (P＜0.05).There was no significant difference (P＞0.05) in ESV between CMR and 2DTTE,but EF of CMR was significantly higher than this of 2DTTE (P＜0.05).There was no significant difference (P =0.296) in left ventricular systolic functional category.Bland-Altman plots showed a good agreement between the two methods.Conclusion CMR is a helpful tool to assess left ventricular structure and function in patients with ESRD.

Objective To investigate the feasibility and clinical value of anteroposterior and lateral scout scan combined with Care Dose 4D and Care kV in chest CT scan.Methods A total of 60 patients of clinical diagnosis with lung tumor were enrolled.Those patients were randomly divided into test group and control group.Control group underwent a scan protocol with lateral scout scan combined with Care Dose 4D and Care kV,while anteroposterior and lateral scout scan combined with Care Dose 4D and Care kV were performed in test group.The signal-to-noise ration (SNR),contrast-to-noise ratio (CNR),and overall image quality of two groups of images and diseased tissues were analyzed and evaluated by two high-grade radiologists using double-blind method.Effective doses (E) were also calculated.Results All the 60 patients had successfully completed the chest CT scans.Test group overall image quality (4.57 ± 0.45) and control group overall image quality (4.73 ± 0.45) had no statistically significant difference (P ＞ 0.05).The control group image SNR,CNR and diseased tissue SNR,CNR compared with test group had no statistical significance difference (P ＞ 0.05).The difference of the volume CT dose index (CTDIvol),dose-length product (DLP) and effective dose (E) of test group and control group was statistically significant (t =8.514,8.464,8.464,P ＜ 0.001).Compared with control group,the effective dose of test group decreased by 33.3％.Conclusions Compared with lateral scout scan,the technology of anteroposterior and lateral scout scan combined with Care Dose 4D and Care kV can decrease radiation dose without reducing the image quality.This technology can therefore be considered as a regular imaging modality for chest CT scan.

Objective To explore the effect of infrared spectral analysis in analyzing of the chemical composition of renal staghorn calculi and its relationship with urinary tract infections. Methods From June 2014 to June 2016, the clinical data of 186 patients with renal staghorn calculi were collected. The stone composition were analyzed by infrared spectroscopy and traditional chemical titration, and the stones infection were detected by microbial analysis system. The relation between stones infection, urinary tract infection and stone composition were analyzed. Results The results of infrared spectroscopy and traditional chemical titration in detecting renal staghorn calculi ingredient had no significant differences (P>0.05). In 186 patients, 56 patients (30.11%) was in infected group, and 130 patients (69.89%)was in non-infected group. The abnormal urine rate, urinary tract infection rate, medistream urine positive infection rate and cotton swabs positive infection rate in infected group were was significantly higher than those in non-infected group: 73.21%(41/56) vs. 50.77%(66/130), 19.64%(11/56) vs. 3.85%(5/130), 50.00%(28/56) vs. 6.15%(8/130), 67.86%(38/56) vs. 8.46%(11/130), P<0.01. The carbonate apatite stones rate and six water magnesium ammonium phosphate rate in infected group were significantly higher than those in non-infected group: 21.43%(12/56) vs. 5.37%(7/130), 57.14%(32/56) vs. 2.31%(3/130), P<0.01. The calcium oxalate rate and uric acid rate in non-infected group were significantly higher than those in infected group:50.00%(65/130) vs. 5.36%(3/56), 24.62%(32/130) vs. 1.79%(1/56), P<0.01. Conclusions Analysis of staghorn calculi ingredient caused by urinary bacterial infection with infrared spectroscopy is simple, reliable and easy to operate. It is important for postoperative infection prevention.

Objective To explore the effect of comprehensive intervention on postoperative pain of patients with rectal disease. Methods A total of 200 patients with postoperative pain after the treatment of anorectal perianal disease from May 2015 to May 2016 were randomly divided into two groups with 100 cases each. The control group was treated with drugs and usual nursing, the observation group were adopted drugs and comprehensive nursing intervention. The improvement of pain, psychological states and the quality of sleep were compared between two groups. Results The VAS pain scores at 4, 6, 12, 24, 48 h after treatment was (2.1 ± 0.6), (3.3 ± 0.4), (3.5 ± 0.3), (2.3 ± 0.5), (1.9 ± 0.5) points in the observation group, and (3.0 ± 0.5), (5.1 ± 0.6), (6.2 ± 0.6), (5.7 ± 0.8), (5.8 ± 0.5) points in the control group, and the difference was statistically significant (t=8.539-38.806, P < 0.05). The Self-rating Anxiety Scale was (20.32 ± 6.16) points in the observation group, and (35.58 ± 7.43) points in the control group, and the difference was statistically significant (t=41.188, P<0.05). The sleep quality, the amount of sleep , sleep time, sleep efficiency of Pittsburgh Sleep Quality Index Questionnaire scores was (0.91±0.28), (0.86±0.2), (0.83±0.27), (0.59±0.31), (0.62±0.27), (0.58±0.41), (4.39±1.79) points in the observation group, and (1.61± 0.88), (1.32 ± 0.75), (1.59 ± 0.89), (1.34 ± 0.58), (1.36 ± 0.45), (1.29 ± 0.86), (8.51 ± 3.55) points in the control group, and the difference was statistically significant (t=4.557-17.740, all P<0.05). Conclusions The comprehensive intervention on postoperative pain relief in patients with anal disease is significant, it is beneficial to relieve the pain response, improve sleep quality, and achieve physical and psychological comfort, and has a positive effect to clinical.

Objective To compare the clinical effect between retropubic extraperitoneal laparoscopic prostatectomy with prostatic urethra preservation and transurethral resection of the prostate (TURP) for giant benign prostatic hyperplasia (BPH).MethodsThe clinical data and follow-up of 128 cases of giant BPH were analyzed retrospectively.Seventy-two cases underwent TURP (TURP group) and 56 cases underwent retropubic extraperitoneal laparoscopic prostatectomy with prostatic urethra preservation ( laparoscopic group ).The operation time,blood loss,gland mass excision,bladder washing time,catheterization time,hospital stay,hospital cost,international prostate symptoms score (IPSS) and quality of life questionnaires (QOL),maximum flow rate (MFR),residual urine volume (RUV) were compared between two groups.ResultsThe bladder washing time,catheterization time,hospital stay in laparoscopic group were less than those in TURP group[0 d vs.(2.8 ± 1.2) d,(2.3 ± 0.6) d vs.(5.2 ± 1.5) d,(4.2 ± 0.5) d vs.(7.5 ±0.5) d],gland mass excision in laparoscopic group was more than that in TURP group [(100.2 ±25.4) g vs.(85.6 ± 15.5) g],there were significant differences between two groups(P＜ 0.05).There was no significant difference in the operation time,blood loss,hospital cost between two groups (P ＞ 0.05).There were significant differences in IPSS,QOL,RUV and MRF before and after 3,6 months treatment for two groups [ laparoscopic group:(9.1 ± 3.4),(7.5 ± 2.5 ) scores vs.(27.5 ± 5.8) scores,( 1.8 ± 1.1 ),( 1.6 ± 0.8)scores vs. (5.5 t0.5) scores,(26.5 ± 11.5),(22.4 ± 12.6) ml vs. (145.0 ±48.0) ml,(17.6 ±8.4),(20.2 ± 5.4) ml/s vs.(8.3 ± 3.5) ml/s;TURP group:(9.2 ± 3.8),(7.8 ± 2.2) scores vs.(28.5 ± 5.4) scores,( 1.9 ± 1.2),( 1.7 ± 0.6) scores vs.(5.0 ± 0.5 ) scores,(28.5 ± 12.9),(23.0 ± 11.7) ml vs. ( 155.0 ± 47.0) ml,( 17.8 ± 9.2),( 19.8 ± 4.5 ) ml/s vs.(7.2 ± 3.2 ) ml/s ] (P ＜ 0.01 ),but there was no significant difference between two groups (P ＞ 0.05).ConclusionsThe clinical effect of two microtrauma surgery are good.Laparoscopic technique is a feasible treatment option for patients suffered from giant BPH for which has the benefit of a quicker recovery,shorter hospital stay,less complications,no bladder washing.