Objective:To explore the application value of laparoscopic contrast enhanced ultrasound in laparoscopic surgery for patients with hepatocellular carcinoma combined with cirrhosis.Methods:The clinical data of 71 patients with hepatocellular carcinoma combined cirrhosis from February 2018 to February 2020 in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology were retrospectively analyzed. The patients underwent preoperative enhanced CT and multi-parameter MRI examination, followed by laparoscopic partial hepatectomy, and intraoperative laparoscopic contrast enhanced ultrasound examination. Based on histological examination and follow-up results, the diagnostic efficacy of preoperative imaging and preoperative imaging combined with intraoperative laparoscopic contrast enhanced ultrasound in patients with hepatocellular carcinoma combined with cirrhosis was compared.Results:Among the 71 patients, 69 completed laparoscopic surgery and 2 converted to open surgery. One hundred and ten HCC lesions were diagnosed by preoperative imaging examination, 105 lesions were detected by intraoperative ultrasound among them, of which 98 lesions were diagnosed as HCC by intraoperative laparoscopic contrast enhanced ultrasound. There were no statistically significant difference in sensitivity, specificity, accuracy, positive predictive value and negative predictive value between preoperative imaging and preoperative imaging combined with intraoperative laparoscopic contrast enhanced ultrasound in the diagnosis of malignant liver lesions: 94.4% (102/108) vs. 99.1% (107/108), 81.0% (34/42) vs. 66.7% (28/42), 90.6% (136/150) vs. 90.0% (135/150), 92.7% (102/110) vs. 88.4% (107/121) and 85.0% (34/40) vs. 96.6% (28/29), P>0.05. Laparoscopic contrast enhanced ultrasound revealed an additional 11 suspected malignant lesions, of which 5 lesions were histologically confirmed as HCC. Seven patients underwent surgical strategy changes. Conclusions:Laparoscopic contrast enhanced ultrasound in patients with HCC combined with cirrhosis during laparoscopic surgery can be used to detect, identify, accurately locate of the lesions and modify the surgical plan.

Optimizing operation management mode is the core task to promote the high-quality development of public hospitals.Drawing on the typical experiences and practices of operation and management of representative in-ternational hospitals in the United States,the United Kingdom,Singapore and West China Hospital of Sichuan Univer-sity,Shanghai Jiao Tong University School of Medicine Affiliated Xinhua Hospital,Jilin University China-Japanese Union Hospital of Jilin University,and carrying out a full range of comparative analyses.Put forward the new situation of China's public hospital operations and management to establish a"big operations management"concept.By iden-tifying the operation management role,rationalizing the operation management organization structure and training operation management compound talents to discuss stablishing a committee system,integrating multi-departmental resources to form a scientific and sound problem identificaiton,feedback,consultation and improvement of working mechanism,and promote the high-quality development of publit hospitals.

The access evaluation of new medical technology is an important part of the preclinical application of medical technology and plays a vital role in ensuring the quality and safety of medical services.However,in the con-crete practice of access evaluation,there are still some problems such as imperfect access theoretical framework,imperfect evaluation index system.With the strategic support of health policies,laws,and regulations,the theory and method of HB-HTA are used for reference,core elements such as assessment subject,assessment object,and assessment content are comprehensively considered,the index system is designed from the dimensions of tech-nical characteristics,safety,effectiveness,economy and applicability,and the access evaluation framework of im-ported medical new technologies is constructed.To offer a theoretical framework and evidence-based basis for medi-cal facility medical technology access management.

Objective:To investigate the expression of INHBA in colorectal cancer and its relationship with microsatellite status and clinicopathological features.Methods:Bioinformatics analysis was conducted based on Gene Expression Omnibus (GEO) database and Gene Expression Profiling Interaction Analysis (GEPIA) database, and the differentially expressed prognosis-related target genes in colorectal cancer were selected. Wax mass tissues of 107 patients with colorectal cancer who underwent surgery from January 2016 to June 2022 in the Third Affiliated Hospital of Jinzhou Medical University were collected, and the tissue microarrays were prepared. The clinicopathological microsatellite status [positive expressions of the mismatch repair (MMR) proteins MLH1, MSH2, MSH6, and PMS2 were mismatch repair proficient (pMMR), which represented low microsatellite instability or microsatellite stabilization; if any of these indexes was negative, it was judged to be mismatch repair deficient (dMMR), which represented high microsatellite instability] and INHBA expression in colorectal cancer tissues were detected by immunohistochemistry, data of the patients were retrospectively analyzed. The relationship between INHBA and microsatellite status as well as clinicopathological features was analyzed.Results:Three data sets of colorectal cancer were selected from GEO database: GSE110223 (13 cancer tissues, 13 paracancerous tissues), GSE110224 (17 cancer tissues, 17 paracancerous tissues), GSE113513 (14 cancer tissues, 14 paracancerous tissues), and the top 50 genes that were differentially up-regulated and down-regulated between cancer tissues and paracancerous tissues were screened. Intersection genes of 3 data sets were analyzed by Venn diagram, and 12 up-regulated genes and 17 down-regulated genes were screened out. According to GEPIA database, AQP8, ZG16 and INHBA genes among the up-regulated and down-regulated differential genes were associated with the prognosis of colorectal cancer. INHBA was higher expressed in colorectal cancer tissues than in paracancerous tissues (≥5 cm from the tumor margin) ( P < 0.05), and INHBA gene was selected for analysis. Immunohistochemical detection of collected colorectal cancer wax samples showed that the proportion of patients with high INHBA expression in colorectal cancer tissues was higher than that in paracancerous tissues [85.05% (91/107) vs. 67.29% (72/107), P < 0.05]. The high expression of INHBA in cancer tissues was related to the lesion site [right colon vs. left colon: 94.00% (47/50) vs. 77.19% (44/57)], maximum tumor diameter [>5 cm vs. ≤5 cm: 92.73% (51/55) vs. 76.92% (40/52)] and the depth of invasion [stage T 3-4 vs. stage T 1-2: 96.43% (54/56) vs. 72.55% (37/51)], differentiation degree [low and medium differentiation vs. high differentiation: 91.04% (61/67) vs. 75.00% (30/40)], lymph node metastasis [yes vs. no: 93.02% (40/43) vs. 78.13% (50/64)] (all P < 0.05), but had no correlation with age, sex, thrombus and nerve invasion (all P > 0.05). The proportion of patients with high expression of INHBA in colorectal cancer tissues in pMMR group was higher than that in dMMR group [93.22% (55/59) vs. 75.00% (36/48), χ2 = 6.91, P = 0.008]. Conclusions:INHBA is highly expressed in colorectal cancer tissues, and the highly expressed INHBA is closely related to clinicopathological features and microsatellite status of colorectal cancer. INBHA may be a new target for diagnosis, treatment and prognosis of colorectal cancer.

Objective To investigate the clinical and pathological features of children with glycogen storage disease (GSD). Methods A retrospective analysis was performed for ten children with GSD who were admitted to the Third Hospital of Hebei Medical University and The Fifth Medical Center of Chinese PLA General Hospital from January 2002 to January 2022, based on medical history, liver biochemistry, and liver biopsy, and population characteristics, clinical manifestations, biochemical parameters, and liver histopathological characteristics were compared and analyzed. Results All ten children had developmental retardation and a short stature, with the manifestations of abnormal liver function, mild weakness, poor appetite, yellow urine, and yellow eyes, and four children had hepatosplenomegaly. Among the ten children, six had the clinical manifestations of hypoglycemia, and one had bilateral gastrocnemius hypertrophy and positive Gower sign. Two children had positive CMV IgG. Liver histopathological manifestations included diffuse enlargement of hepatocytes, light cytoplasm, and small nucleus in the middle like plant cells, with or without fibrous tissue proliferation. Conclusion Most patients with GSD have developmental retardation and abnormal aminotransferases, and liver pathological examination shows specific pathological features.

Tumor necrosis factor-alpha-induced protein 8-like 2 (TIPE2) can negatively regulate innate immunity and adaptive immunity and participate in the development and progression of various liver diseases, such as hepatitis, liver cirrhosis, and hepatocellular carcinoma, by affecting a variety of signaling pathways. This article summarizes the current research on the involvement of TIPE2 in the pathogenesis of different liver diseases and points out that TIPE2 may become a new target for the treatment of liver diseases.

Objective:To clarify the clinical efficacy of Yiqi Huoxue recipe in the treatment of liver fibrosis of chronic viral hepatitis.Methods:An open, positive-drug, parallel-controlled study method was applied. A total of 207 cases of liver fibrosis with chronic hepatitis B and C diagnosed with liver biopsy and transient elastography were selected. According to the principle of syndrome differentiation in traditional Chinese medicine, self-made Yiqi Huoxue recipe ( n = 127) and Fuzheng Huayu capsule ( n = 80) were used for the treatment course of 24-48 weeks. Change score of TCM symptom, liver biochemistry, liver stiffness measurement (LSM), and noninvasive liver fibrosis index [aspartate transaminase to platelet ratio index (APRI), and fibrosis-4 score (FIB-4)] were compared between the two groups to evaluate the therapeutic effect of Yiqi Huoxue recipe on liver fibrosis. Results:Yiqi Huoxue recipe group and Fuzheng Huayu capsule group baseline LSM, APRI and FIB-4 was compared, and there was no statistically significant difference between them ( P > 0.05). Yiqi Huoxue recipe and Fuzheng Huayu capsule received patients had improved symptom scores to a certain extent. Hepatic facies, discomfort over liver area, and soreness and weakness of waist and knees ( P < 0.05) was significantly improved in Yiqi Huoxue recipe than Fuzheng Huayu capsule. Liver biochemical indicators (ALT, AST, GGT, ALP) had gradually relapsed with the extension of treatment duration and the normalization rate between the two groups after 24 to 48 weeks had reached 100% vs. 100%, 100% vs. 93.8%, 96.8% vs. 92.3% and 87.5% vs. 81.8%. After 12 weeks of treatment, APRI values ??of both groups had significantly reduced, and after 48 weeks of treatment, LSM values of both groups had significantly improved. Moreover, Yiqi Huoxue recipe FIB-4 score was significantly improved after 48 weeks of treatment, and the difference was statistically significant compared to Fuzheng Huayu capsule group ( P < 0.05). After treatment, LSM, APRI, and FIB-4 total effectiveness in the two groups were 80.0% vs. 63.6%, P = 0.046; 68.4% vs. 52.0%, P = 0.052; 68.4% vs. 62.0%, P = 0.437, respectively. LSM total effectiveness was significantly higher in Yiqi Huoxue recipe treated group than Fuzheng Huayu capsule group. Conclusion:Traditional Chinese medicine Yiqi Huoxue decoction can be used as an optimal treatment for liver fibrosis of chronic viral hepatitis.

OBJECTIVE: To investigate the effect of vitamin D3 on polarization of monocyte macrophages induced by serum from patients with ankylosing spondylitis (AS). METHODS: Twenty AS naïve patients and 20 healthy controls from Wenzhou People's Hospital during January 2016 and December 2017 were enrolled. The macrophages were differentiated from THP1 cells induced by phorbol 12-myristate 13-acetate (PMA), and then co-cultured with the serum from healthy subjects (control group) or AS patients. Vitamin D3 was added in the medium mixed with serum from AS patients. Flow cytometry was used to analyze the ratio of CD68 and CD206 positive cells, and RT-PCR was performed to detect the mRNA expression of inducible nitric oxide synthase(iNOS) and arginase-1(Arg-1). RESULTS: THP1 cells could be polarized into mononuclear-macrophages with the induction of PMA. The proportion of CD206 positive cells in AS-serum group was lower than that in the control group (=9.434, <0.05), while the proportion of CD68 positive cells was higher than that in the control group (=43.920, <0.05). The proportion of CD206 positive cells in vitamin D3 group was higher than that in AS-serum group (=8.895, <0.05), while the proportion of CD68 positive cells was lower than that in AS-serum group (=9.089, <0.05). mRNA expression of Arg-1 in AS-serum group was lower than that in the control group (=8.899, <0.05), while mRNA expression of iNOS was higher than that in the control group (=3.656, <0.05). mRNA expression of Arg-1 in vitamin D3 group was higher than that in AS-serum group (=6.219, <0.05), while mRNA expression of iNOS was lower than that in AS-serum group (=5.876, <0.05). CONCLUSIONS Vitamin D3 can regulate the polarization of mononuclear macrophages for immunoregulation in patients with AS.
Adjuvants, Immunologic ; pharmacology ; Cell Differentiation ; drug effects ; Cholecalciferol ; pharmacology ; Humans ; Monocytes ; drug effects ; Spondylitis, Ankylosing ; blood ; physiopathology

Objective There are few researches for the serum betatrophin level and diabetic nephropathy (DN) recently.The aim of this study was to investigate the change of serum betatrophin level and the correlation of serum betatrophin and urinary albumin-to-creatintine ratio (UACR) in patients with type 2 diabetes mellitus (T2DM).Methods A total of 150 Chinese subjects from Mar 2013 to Jul 2016 were enrolled in the study, including 90 patients with type 2 diabetes and 60 healthy controls.According to the level of UACR, the diabetic patients were divided into two groups:normal UACR group (UACR<30 mg/g, n=60) and abnormal UACR group(UACR>30 mg/g, n=30).Serum betatrophin was measured by enzyme linked immunosorbent assay (ELISA).UACR was measured by turbidimetric inhibition immune assay.Blood glucose blood lipid were measured simultaneously.Results The serum betatrophin level was significantly higher in abnormal UACR group than that in normal UACR group[677.37±59.02 vs 486.13±41.22 pg/mL, P<0.05];Serum betatrophin level in T2DM patients was positively correlated with age (r=0.246), waist hip ratio (WHR) (r=0.240), fasting blood glucose (FPG) (r=0.234), 2 hour plasma glucose (2hPG) (r=0.363), glycosylated hemoglobin (HbA1c) (r=0.346), fasting insulin (FINS) (r=0.249), insulin resistance index (HOMA-IR) (r=0.309), blood urea nitrogen (BUN) (r=0.223), creatinine (CREA) (r=0.277) and UACR (r=0.244) (P<0.05),and negatively correlated with glomerular filtration rate (GFR) (r=0.308) (P<0.01).Serum betatrophin level in normal UACR group was positively correlated with age, HbA1c and UACR (P<0.05);Serum betatrophin level in abnormal UACR group was positively correlated with WHR (r=0.504), 2hPG (r=0.600), HbA1c (r=0.449), HOMA-IR (r=0.395) (P<0.05).The WHR, HbA1c, HOMA-IR and GFR were the influential factors of the serum betatrophin level.Conclusion The level of serum betatrophin was significantly increased in T2DM patients with albuminuria, which suggests that the betatrophin might play an important role in the pathogenesis of DN.

Objective To investigate the effects of tripterygium glycosides combined with methotrexate in treatment of rheumatoid arthritis (RA) curative effect and peripheral blood of patients with IL-6, effects of IL-10 and TNF- alpha. Methods 80 patients with RA from February 2014 to August 2016 in our hospital were retrospectively analyzed. According to the different treatment methods by for the observation group, the control group (40 cases). To compare and analyze the curative effect before and after short-term treatment and treatment of patients in the 2 groups were the main clinical symptoms and signs of change and ESR, RF, CRP, IL-6, TNF- alpha, IL-10 index. Results The total effective rate of observation group (92.50％) was significantly higher than the control group (77.50％), the difference was statistically significant (P<0.05), 2 groups of patients before treatment of main clinical symptoms and signs, there was no significant difference, after treatment, clinical symptoms and signs of 2 groups of patients were compared with those before treatment was statistically significant to alleviate the differences (P<0.05), and the observation group of main clinical symptoms and signs were lower than the control group and the remission (down), the difference was statistically significant (P<0.05).Before ESR, the treatment of 2 patients with RF, CRP, TNF- IL-6, alpha, IL-10 index level, no statistical significance, the 2 groups after treatment in patients with ESR, RF, CRP, IL-6, TNF- alpha, IL-10 index level than before treatment with significant difference (P<0.05), and the observation group ESR, RF, CRP, TNF- alpha, IL-6 average index of water compared with the control group decreased significantly, IL-10 index increased significantly than the control group. The difference was statistically significant (P<0.05). Conclusion Tripterygium glycosides combined with methotrexate in treatment of rheumatoid arthritis And it can effectively inhibit the expression of peripheral serum L-6 and TNF- alpha, promote the expression of IL-10 and alleviate the inflammatory reaction