Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.

OBJECTIVE: To detect the ABO / RhD blood type of infants younger than 6 months in different gestational age and month old with automatic microcolumn glass sphere and tube method, and compare the result of the two methods. METHODS: The data of 896 samples of infants younger than 6 months from January 2018 to February 2019 was collected. The two methods were used to detect ABO/RhD blood type in all samples and compare the detection rate of ABO/RhD antigen and ABO reverse typing and agglutination intensity of the two methods. RESULTS: Three hundred and eight cases of type A (34.4%), 281 cases of type B (31.4%), 210 cases of type O (23.4%), 97 cases of type AB (10.8%), and 896 positive cases of RhD blood type were detected out by two methods. There were no significant differences of ABO/RhD antigen agglutination intensity between two methods (P > 0.05). Except for type AB, the detection rate of ABO reverse typing in infants with type B was significantly higher than that with type A and type O (P < 0.05). The agglutination intensity of type A reverse cell was higher than type B reverse cell (P < 0.05). The fully automatic microcolumn glass sphere method exhibited higher detection rate of ABO reverse typing in the samples of type A and type O group and agglutination intensity of ABO reverse typing in all types as compared with the tube method (P < 0.05). The detection rate and agglutination intensity of ABO reverse typing in term group were significantly higher than those in preterm group (P < 0.05). The fully automatic microcolumn glass sphere method exhibited higher detection rate of ABO reverse typing and agglutination intensity compared with the tube method between two groups (P < 0.05). The detection rate and agglutination intensity of ABO reverse typing in group IV (4-6 months old) were significantly higher than those in groups I, II and III (young than 3 months old) (P < 0.05). The fully automatic microcolumn glass sphere method exhibited higher detection rate of ABO reverse typing in I, II, III groups and agglutination intensity of ABO reverse typing in the 4 groups compared with the tube method (P < 0.05). CONCLUSION ABO / RhD blood group antigen can be accurated detected in majority of infants, but the detection rate of ABO antibody is related to gestational age and month age of infants. The detection rate and agglutination intensity of the fully automatic microcolumn glass sphere method in ABO reverse typing are higher than those of the tube method, especially for premature infants and children within 3 months old.
ABO Blood-Group System ; Blood Grouping and Crossmatching ; Humans ; Infant

Objective:To investigate the relationship between indicators of carotid atherosclerosis and onset of ischemic stroke in patients with non-valvular atrial fibrillation (NVAF).Methods:This is a case-control study, a total of 397 NVAF patients with newly diagnosed ischemic stroke (case group) and 3 038 NVAF patients without ischemic stroke (control group) from January 2015 to December 2017 were included in the study. Differences in general clinical features and carotid atherosclerosis indexes between the two groups were compared. Univariate and multivariate logistic regressions were used to analyze the correlation between carotid atherosclerosis indexes and ischemic stroke.Results:Proportions of patients with carotid intima thickening, carotid plaque, stable plaque, unstable plaque, and moderate to severe stenosis were higher in the ischemic stroke group than those in the control group (82.1% vs. 64.4%, 69.3% vs. 50.3%, 43.6% vs. 30.6%, 25.7% vs. 19.7%, and 7.3% vs. 4.0%, respectively, all P <0.05). After adjustment of age, gender, heart failure, hypertension, low density lipoprotein -cholesterol and drug use, multivariate analyses showed that subjects with carotid intima thickening, carotid plaque, stable plaque, unstable plaque, moderate to severe stenosis had 1.766, 2.111, 1.892, 2.256 and 1.824 times the risk for the development of ischemic stroke compared with the subjects without any carotid atherosclerosis indicators. Conclusion:Carotid atherosclerosis, especially with unstable carotid plaque, is associated with ischemic stroke in patients with NVAF.

OBJECTIVE: To explore the effect of selective lumbosacral posterior rhizotomy(SPR) on lower limb spasticity and gross motor function in patients with cerebral palsy. METHODS: From January 2018 to October 2018, 47 patients with cerebral palsy were treated with rehabilitation alone and SPR combined with rehabilitation. According to whether SPR was performed, the patients were divided into group A and group B. Group A was treated with rehabilitation combined with SPR at lumbosacral level, and group B was treated with rehabilitation alone. There were 23 cases in group A, including 15 males and 8 females, with an average age of (7.30±3.25) years old; 24 cases in group B, 13 males and 11 females, with an average age of (7.00±3.09) years old. Forty-seven patients were assessed with modified Ashworth(MAS) and Gross Motor Function Scale(GMFM-88 items) before and after treatment. The changes of MAS and GMFM-88 scores before and after treatment were compared to evaluate the degree of spasm and the improvement of gross motor function in the two groups. RESULTS: All 47 patients were followed up. At 6 months after treatment, the MAS classification of the two groups was significantly improved(<0.05), and the improvement of group A was more obvious than that of group B(<0.05). Six months after treatment, the D, E and total scores of GMFM-88 between two groups were significantly improved compared with those before operation(<0.05). The improvement of D and total scores in group A was more obvious than that in group B. There was no significant difference in the improvement of area E between two groups. CONCLUSIONS Selective posterior rhizotomy combined with rehabilitation can significantly improve the spastic state and gross motor function of lower limbs in children with cerebral palsy, and can effectively promote the reconstruction and recovery of motor function of lower limbs in children with cerebral palsy.
Cerebral Palsy ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Lower Extremity ; Male ; Movement ; Muscle Spasticity ; Rhizotomy

Objective To investigate the effect of tamoxifen on the estrogen receptor α36 (ERα36) in breast cancer patients and its mechanism.Methods The patients with breast cancer treated from January 2010 to January 2015 were randomly selected.Among the 100 patients treated with tamoxifen,20 mg · d-1 tamoxifen was given daily for the treatment group.And receive starch slices of 100 patients,as the control group.After 5 d of treatment,ERα36 cells were sorted out of the breast cancer suppressor cell population of the two groups by fluorescence activated cell sorting device from the ERα36 membrane-targeting receptor.The expression of ERα36 was detected by immunohistochemistry.Then the proliferation and metastasis of ERα36 cells were compared between the two groups.Finally,combined with disease-free surial (DSF) and average no transfer surial (MFS) in two groups.Results The positive expression of ERα36 in treatment group and control group were 42,53 cases;the less than 2 cm in tumor size in the 2 group were 11,24 cases;comparison between two groups,the difference was statistically significant (all P ＜ 0.05).It indicating that the expression of ERα36 was associated with the deterioration of breast cancer cells.Of the treatment group of patients with 58 cases of metastatic cases,significantly higher than the control group of 42 cases,and the treatment group died in 28 cases,while the control group died in 19 cases,the difference was statistically significant between the 2 groups (all P ＜ 0.05).Multivariate regression analysis showed that tamoxifen treatment was negatively correlated with DFS and MFS in these patients.It indicating that compared with the absence of tamoxifen treatment,the prognosis of patients treated with tamoxifen was worse,and the mortality and metastasis were higher in patients treated with tafloxacin,the absence of metastatic survival of ERα36 tumors treated with tamoxifen was significantly shorter.Conclusion Selective tamoxifen will result in acquired and primary drug resistance in breast cancer patients,with significant side effects on ERα36 in patients with breast cancer.

OBJECTIVETo compare the differences between weak ABO antigen patients and normal ABO antigen patients with acute leukemia, and to explore the clinical significance of weak ABO antigen in acute leukemia.

METHODSThe ABO blood group was detected in 110 newly diagnosed acute leukemia patients(including 68 cases of AML and 42 cases of ALL) and 68 normal controls. Then the leukemia subtype, age, sex, laboratory test, risk status of leukemia patients, and DNA methylation of ABO promoter were compared between patients with weak and normal ABO antigen.

RESULTSThe weak ABO antigen was found in patients with newly diagnosed acute leukemia, and was not found in ALL patients or normal group. No statistical differences were found in the distribution of ABO blood group, age, hepatosplenomegaly, lymphadenovarix, plt, precursor cell clusters derived from bone marrow, immunopheno-typing, LDH level, and risk status between AL patients of weak and normal ABO antigen groups (P>0.05). Compared with patients in normal ABO antigen group, the pateins in weak ABO antigen group had higher percentage of male(77.8% vs 30%), lower WBC(32.26×10/L vs 82.69×10/L) and Hb level(64.00 g/L vs 85.94 g/L) and higher DNA methylation level (18.91% vs 10.76%) (P<0.05).

CONCLUSIONThe cases of weak ABO antigen frequently appear in the male AML patients, the DNA methylation level of ABO gene promoter in patients with weak ABO antigen is significantly higher than that in patients with normal ABO antigen.

BACKGROUND: Alloying can improve the corrosion resistance and slow the degradation of pure magnesium. In addition, increasing studies have shown that zinc has good antitumor effect. OBJECTIVE: To evaluate the effect of zinc-containing magnesium alloy on the proliferation and apoptosis of human osteosarcoma U2OS cells in vitro.METHODS: The corrosion resistance of pure magnesium and different zinc-containing (2%, 4%, 6%) magnesium alloys were observed and compared by the hydrogen release assay in the Hank's solution. MTT assay was used to examine the effects of different zinc-containing magnesium alloy extractions on the proliferation of U2OS cells (or MC3T3-E1 cells) after co-culture of 1, 3, 5 days. After 24-hour co-culture with pure magnesium, different zinc-containing magnesium alloys and titanium alloy extractions, the apoptotic rates of U2OS cells were analyzed by flow cytometry, and the expression of apoptosis-related proteins were detected by western blot assay.RESULTS AND CONCLUSION: The corrosion resistance of pure magnesium was improved after addition of Zn within the initial 100 hours, and the magnesium alloy containing 4% zinc exhibited the optimal corrosion resistance. Different zinc-containing magnesium alloy extractions obviously inhibited the U2OS proliferation in a zinc level-depended manner, and the cytotoxicity of different zinc-containing magnesium alloy extractions to MC3T3-E1 was graded 0-1. Different zinc-containing magnesium alloy extractions could also induce obvious apoptosis in U2OS cells in a zinc level-depended manner. Different zinc-containing magnesium alloy extractions, especially the magnesium alloy containing 4% zinc, up-regulated the expression of p53 and Bax proteins and down-regulated the expression of Bcl-2 protein in U2OS cells, leading to the disorder of Bcl-2/Bax. These findings suggest that different zinc-containing magnesium alloy extractions can inhibit the proliferation and induce apoptosis of U2OS cells in vitro.

The study was designed to test the role of 5,2',4'-trihydroxy-6,7,5'-trimethoxy flavone nanoparticle (TTF1-NP) on lipopoiysaccharide (LPS)-induced inflammatory response, and to explore the anti-inflammatory mechanism in human hepatocellular carcinoma cells. Inflammatory responses were induced in human hepato-cellular carcinoma HepG2 cells with LPS; Proliferation effect of TTF1-NP in LPS-stimulated HepG2 cells were detected by MTT assay; The expression of TLR4, AKT/mTOR signaling related proteins and IL-6 were detected by Western blot assay. The results showed that TTF1-NP inhibited the proliferation of HepG2 cells induced by LPS in a dose-dependent manner; TTF1-NP inhibited the expression of TLR4, the activation of AKT and mTOR, and expression of IL-6 in a dose-dependent manner; TTF1-NP inhibited the activation of AKT/mTOR signaling pathway and TLR4 proteins leading to suppression of IL-6 expression in HepG2 cells stimulated by insulin. These results suggest that TTF1-NP inhibited inflammatory responses from LPS treatment with a potential mechanisms in the inhibition of AKT/mTOR pathway.

Skin wound healing is a complex event, and interrupted wound healing process could lead to scar formation. The aim of this study was to examine the morphological changes of scar tissue. Pathological staining (HE staining, Masson's trichrome staining, methenamine silver staining) was used to evaluate the morphological changes of regenerating epidermis in normal skin and scar tissue, and immunofluorescence staining to detect the expression of collagen IV, a component of basement membrane (BM), and the expression of integrinβ4, a receptor for BM laminins. Additionally, the expression of CK14, CK5, and CK10 was measured to evaluate the proliferation and differentiation of keratinocytes in normal skin and scar tissue. The results showed that the structure of the skin was histologically changed in scar tissue. Collagen IV, expressed under the epidermis of normal skin, was reduced distinctly in scar tissue. Integrinβ4, expressed in the basal layer of normal skin, was found absent in the basal layer of scar tissue. Additionally, it was found that keratinocytes in scarring epidermis were more proliferative than in normal skin. These results indicate that during the skin wound healing, altered formation of BM may affect the proliferation of keratinocytes, reepithelial and tissue remodeling, and then result in scar formation. Thus, remodeling BM structure during wound repair may be beneficial for improving healing in cutaneous wounds during clinical practice.
Adolescent ; Adult ; Cicatrix ; metabolism ; pathology ; Collagen Type IV ; metabolism ; Female ; Humans ; Integrin beta4 ; metabolism ; Keratinocytes ; cytology ; metabolism ; pathology ; Male ; Skin ; cytology ; metabolism ; pathology

BACKGROUNDChromosomal abnormalities have been shown to play an important prognostic role in multiple myeloma (MM). Interphase fluorescence in situ hybridization (i-FISH) has been much more effective to identify cytogenetic aberrations in MM than conventional cytogenetic technique (CC). To clearly determine the cytogenetic features of Chinese MM patients and identify their prognostic implications, we designed a multicenter study based on i-FISH including 672 patients from 52 hospitals in China.

METHODSAll 672 patients were systematically screened for the following genomic aberrations: del(13q), IgH rearrangement, del(p53) and 1q21 amplifications.

RESULTSThe analysis showed that the chromosomal changes were detected in 22.1% patients by CC and in 82.3% patients by i-FISH. The most common abnormalities by CC were chromosome 1 aberrations (48.4%), -13/13q- (37.6%), hyperdiploidy (36.6%), hypodiploidy (30.1%) and IgH rearrangements (23.7%). The most frequent abnormalities by FISH was del(13q), which was found in 60.4% patients, whereas IgH rearrangement, 1q21 amplification and p53 deletions were detected in 57.6%, 49.0% and 34.7% cases, respectively. By statistical analysis, -13/13q- by CC was associated with low level of platelet (P = 0.015), hyperdiploidy was associated with low level of serum albumin (P = 0.028), and IgH rearrangement by FISH was associated with high level of β2 microglobulin (P = 0.019). Moreover, 1q21 amplification and del(p53) by FISH conferred a high incidence of progressive disease (PD) after initial therapy. Metaphase detection of IgH rearrangements and chromosome 1 aberrations concurrently was associated with a short progression free survival (PFS) (P = 0.036). No significant prognostic implications of other cytogenetic abnormalities were found associated with overall survival and PFS.

CONCLUSIONSChinese MM patients had similar cytogenetic abnormalities compared with the previous reported studies. However, the prognostic significance of FISH aberrations were not clearly determined and further study is required.

Adult ; China ; Chromosome Aberrations ; Chromosomes, Human, Pair 1 ; genetics ; Cytogenetic Analysis ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Male ; Middle Aged ; Multiple Myeloma ; genetics ; pathology