ObjectiveTo explore the clinical application value of CIE 1976 L*a*b*（Lab） color space in the differential diagnosis of early esophageal cancer and non-cancerous lesions. MethodsWe selected the endoscopic images of patients with esophageal lesions confirmed by pathology who underwent white light imaging endoscopy （WLI） and narrow band imaging endoscopy （NBI）. Five regions of interest （ROI） were selected respectively from the mucosa of the lesion area and the mucosa of the surrounding normal area for labeling. The Lab color space parameters were extracted and counted， and the color difference values（ΔE*）were calculated. ResultsA total of 213 eligible patients were included for analysis in the study. In WLI and NBI modes， there were differences in mucosal color between the early esophageal cancer group and the non-cancer group （P<0.05）. Compared with WLI mode， NBI mode could significantly increase the color difference between early esophageal cancer and non-cancerous lesions （P<0.05）. The lightness component value （L* value） of the early esophageal cancer lesion area was lower than that of the non-cancerous lesion area， and this color difference was more significant in the NBI mode （P<0.05）. In WLI mode， there was no significant difference in yellow-blue component value （b* value） between the mucosa of early esophageal cancer and non-cancerous lesions. However， in the NBI mode， the b* value of the mucosa in the non-cancerous lesion area was higher than that in the early esophageal cancer lesion area （P<0.05）. On the red-green axis， the mucosa of the early esophageal cancer and non-cancerous lesions was red in WLI mode and green in NBI mode. There was no significant difference in red-green component value （a* value） between the two groups. ConclusionThere are color differences between early esophageal cancer and non-cancerous lesions under WLI and NBI. The color of early esophageal cancer is darker under WLI， and the color of non-cancerous lesions is yellower under non-magnified NBI mode. Lab color space is helpful to identify early esophageal cancer and non-cancerous lesions.

Objective:To describe the distribution of lipoprotein (a) [Lp(a)] levels in non-arteriosclerotic cardiovascular disease (ASCVD) population in China and explore its influencing factors.Methods:This study was based on a nested case-control study in the CKB study measured plasma biomarkers. Lp(a) levels was measured using a polyclonal antibody-based turbidimetric assay certified by the reference laboratory and ≥75.0 nmol/L defined as high Lp(a). Multiple logistic regression model was used to examine the factors related to Lp(a) levels.Results:Among the 5 870 non-ASCVD population included in the analysis, Lp(a) levels showed a right-skewed distribution, with a M ( Q1, Q3) of 17.5 (8.8, 43.5) nmol/L. The multiple logistic regression analysis found that female was associated with high Lp(a) ( OR=1.23, 95% CI: 1.05-1.43). The risk of increased Lp(a) levels in subjects with abdominal obesity was significantly reduced ( OR=0.68, 95% CI: 0.52-0.89). As TC, LDL-C, apolipoprotein A1(Apo A1), and apolipoprotein B(Apo B) levels increased, the risk of high Lp(a) increased, with OR (95% CI) for each elevated group was 2.40 (1.76-3.24), 2.68 (1.36-4.93), 1.29 (1.03-1.61), and 1.65 (1.27-2.13), respectively. The risk of high Lp(a) was reduced in the HDL-C lowering group with an OR (95% CI) of 0.76 (0.61-0.94). In contrast, an increase in TG levels and the ratio of Apo A1/Apo B(Apo A1/B) was negatively correlated with the risk of high Lp(a), with OR (95% CI) of 0.73 (0.60-0.89) for elevated triglyceride group, and OR (95% CI) of 0.60 (0.50-0.72) for the Apo A1/B ratio increase group (linear trend test P≤0.001 except for Apo A1). However, no correlation was found between Lp(a) levels and lifestyle factors such as diet, smoking, and physical activity. Conclusions:Lp(a) levels were associated with sex and abdominal obesity, but less with lifestyle behaviors.

Objective : To compare the diagnostic efficacy of three screening methods，including the epidemiological survey and the new gastric cancer scoring system proposed in the Expert Consensus Opinion on Early Gastric Cancer Screening Process in China ( Shanghai，2017) ，and the Kyoto classification score for screening gastric in early gastric cancer diagnosis． Methods: Patients who underwent endoscopic submucosal dissection and were pathologically confirmed were included in the gastric cancer group，patients with non-gastric cancer in the same period were consecutively included in the control group．Questionnaires and serological tests were performed in all enrolled patients，and the endoscopic presentations was recorded according to the classification of Kyoto gastritis during gastroscopy．The risk stratification and the detection rates of gastric cancer were estimated by different screening methods，and the receiver operating characteristic curve (ROC curve) of subjects diagnosed with each screening method alone and in combination were plotted to compare the area under the ROC curve (AUC) and the diagnostic efficacy . Results: Among all participants，84 were patients with gastric cancer and 120 were normal people without gastric cancer．The Kyoto risk score had the highest diagnostic value (AUC = 0. 79) among the others，and its sensitivity and specificity were 72. 6% and 79. 1% ，respectively，but the combined diagnosis of different methods did not significantly improve the diagnostic efficacy．The Kyoto risk score had a more discriminative value in the medium to high-risk group delineated by the new scoring system． Conclusion The Kyoto risk score has high clinical value in the diagnosis of early gastric cancer and can be used in conjunction with the new scoring system for early gastric cancer risk assessment.

Autoimmune hepatitis (AIH) is a severe globally distributed liver disease that could occur at any age. Human menstrual blood-derived stem cells (MenSCs) have shown therapeutic effect in acute lung injury and liver failure. However, their role in the curative effect of AIH remains unclear. Here, a classic AIH mouse model was constructed through intravenous injection with concanavalin A (Con A). MenSCs were intravenously injected while Con A injection in the treatment groups. The results showed that the mortality by Con A injection was significantly decreased by MenSCs treatment and liver function tests and histological analysis were also ameliorated. The results of phosphoproteomic analysis and RNA-seq revealed that MenSCs improved AIH, mainly by apoptosis and c-Jun N-terminal kinase/mitogen-activated protein signaling pathways. Apoptosis analysis demonstrated that the protein expression of cleaved caspase 3 was increased by Con A injection and reduced by MenSCs transplantation, consistent with the TUNEL staining results. An AML12 co-culture system and JNK inhibitor (SP600125) were used to verify the JNK/MAPK and apoptosis signaling pathways. These findings suggested that MenSCs could be a promising strategy for AIH.
Mice ; Animals ; Humans ; Hepatitis, Autoimmune/pathology* ; Signal Transduction ; Disease Models, Animal ; Stem Cells

Objective: To investigate the correlation between clinicopathologic features like human epidermal growth factor receptor type 2(HER2) status and lymph node metastasis, meanwhile, to establish a prediction model for the risk of lymph node metastasis in early gastric cancer. Methods: Multiple data of 157 patients who underwent early gastric cancer radical gastrectomy were involved and analyzed. Further, the risk prediction model was established for lymph node metastasis of early gastric cancer. Results: Among these 157 patients, 31 cases were reported lymph node metastasis, with a rate of 19.7%. Analysis showed that female patients, HER2 IHC(3+), infiltrating into submucosa, poor degree of differentiation and vascular invasion accounted for a large proportion in lymph node metastasis(P<0.05). Analysis also showed that HER2 IHC(3+), infiltrating into submucosa, poor degree of differentiation and vascular invasion were independent risk factors for lymph node metastasis in early gastric cancer(P<0.05). According to the above analysis results, the prediction models for lymph node metastasis risk of early gastric cancer were established respectively included or excluded HER2 status, and the area under the ROC curve(AUC) was 0.800 and 0.759, respectively. Meanwhile, differentiated tumor accounted for a large proportion in HER2 IHC(3+)(P<0.05). Conclusion HER2 IHC(3+), infiltrating into submucosa, poor degree of differentiation and vascular invasion were independent risk factors of lymph node metastasis in early gastric cancer. The new established model including HER2 status has good sensitivity and specificity, which may provide a reference for predicting the risk of lymph node metastasis in early gastric cancer.

OBJECTIVE To investigate the awareness of the patients receiving Sanjin tablets in knowledge-attitude-practice （KAP） aspect， and its influential factors. METHODS Demographic characteristics， medication knowledge， attitude and practice of outpatients and inpatients who used Sanjin tablets in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from June to December 2020 were investigated online and offline for questionnaire survey and scale scoring.Oneway variance analysis and multiple linear regression analysis were used to screen the influential factors for KAP of the patient receiving Sanjin tablets. RESULTS A total of 503 valid questionnaires （effective recovery rate of 99.60%） were collected in this survey. The drug use knowledge score of Sanjin tablet users was （26.74±6.82） points， the drug use attitude score was （7.82±3.75） points， and the drug use practice score was （21.72±5.56） points. The overall scores were good， excellent and good， respectively.The results of oneway variance analysis showed that there were significant differences in drug use knowledge and drug use practice scores among the patients receiving Sanjin tablets with different ages，occupations and medical insurance types （P＜0.05）； there were significant differences in drug use attitude scores among the patients receiving Sanjin tablets with different ages， occupations， education levels and medical insurance types （P＜0.05）. The results of multiple linear regression analysis showed that ages， occupations， education levels and medical insurance types were the main factors affecting the drug use knowledge and drug use attitude of the patients receiving Sanjin tablets （P＜0.05）； education levels and medical insurance types were the main factors affecting the drug use practice of the patients receiving Sanjin tablets （P＜0.05）. CONCLUSIONS Most of the patients receiving Sanjin tablets have a good attitude towards the acquisition of safe medication information， but the knowledge to drug use and the actual drug use practice still have certain hidden danger in security； it is necessary to strengthen drug use education and publicity for individual age groups， low-educational background groups and other people， carry out the drug education among the population with different vocational characteristics and medical insurance types in order to promote safe and rational drug use.

Objective:A retrospective analysis was performed on clinical characteristics and deoxyguanosine kinase DGUOK gene mutations in a family with hepatocerebral mitochondrial DNA depletion syndrome (MTDPS). Methods:The clinical data, treatment process and gene detection results of a child with MTDPS in the second hospital of Hebei Medical University in April 2019 were analyzed and summarized.Results:Proband was a girl.From the first week of infantile, she suffered from recurrent hypoglycemia, hyperlactic acid, progressive cholestatic liver dysfunction, coagulopathy, difficult feeding, slow growth of body mass, microcephaly, hypotonia, and gradul intermittent binocular tremors, and eventually failed to thrive.Gene testing identified two compound heterozygous mutations c. 42-c.43insTTCA(p.F15fs129X)/c.808-1(IVS6)G>A in DGUOK gene.The former was a frame-shift mutation resulted in truncated protein and the later was a splicing mutation resulted in abnormal splicing.Each parent was a heterozygous carrier, and there were no mutations in the two sites with her elder sister. Conclusions:Both mutations were first reported worldwide. DGUOK gene mutations with MTDPS are important causes of infant liver failure.When hypoglycemia, hyperlactic acidemia and liver dysfunction occur in newborn and infant, MTDPS related gene DGUOK gene sequencing screening should be considered for early definitive diagnosis, or, when acute liver failure happen in infant and childhood, neuromuscular involvement is insufficient.

Objective:To summarize the clinical and pathological features of intravascular NK and T cell lymphoma for better understanding of such disease to reduce misdiagnosis and miss-diagnosis.Methods:Clinical and pathological features were analyzed retrospectively in one case of intravascular peripheral T-cell lymphoma, not otherwise specified (IVPTCL, NOS) , with literatures review.Results:The case presented in this study was a 66-year-old man. PET/CT scan showed multiple lymph nodes enlargement throughout the body. Normal lymph node structure could not be observed by tissue biopsy, while lymph follicles were partially disrupted. High-power light microscope revealed a large number of blood vessels with diffuse proliferation and dilation, where atypical lymphoid cell mass was restricted in the lumen and partially infiltrated the large blood vessel wall. These tumor cells were medium to large with moderate cytoplasm. The nucleus was irregular, single or multiple nucleoli could be seen, chromatin was condensed, some were empty and bright, and mitotic figures could be seen. Immunohistochemical staining showed that the neoplastic cells were positive for expression of CD3, CD43, CD8, GrB, TIA-1 and perforin. EBER in situ hybridization result was negative. Polymerase chain reaction test identified a clonal gene rearrangement of T-cell receptor γ. The patient was treated with CHOP in combination with chidamide, but died of infection and cardiopulmonary failure within 2 months. 56 cases of intravascular NK/T cell lymphoma with definite classification were collected from relevant literatures, including 47 cases with nasal type of extranodal NK/T cell lymphoma (27 were male and 20 were female) , 8 cases with anaplastic large cell lymphoma (3 males and 5 females) , and only one case with de nova IVPTCL, NOS in brain. We report the second case of IVPTCL,NOS, and notably originated from lymph node for the first time.Conclusions:Intravascular NK/T cell lymphoma is a highly aggressive disease with no effective treatment at present. Involvement of Lymph node has rarely been reported, and further studies on more cases are necessary.

Tripterygium wilfordii Hook. F. (TWF) belongs to celastraceae under Tripterygium family. It is a traditional Chinese medicine with a variety of pharmacological effects such as anti- inflammatory, analgesic, anti- tumor, immunomodulation and so on, which is applied for many diseases because of its significant effects. However, its toxic and side effects frequently occur, especially liver injury, affecting its safety in clinical practice. In this paper, the clinical characteristics of liver injury of TWF were preliminarily explored by combining with literature analysis and single center clinical epidemiological investigation. Furthermore, the main toxic constituents and mechanism of TWF are reviewed. Finally, the key issues have been raised and analyzed on clinical diagnosis, clinical characteristics and toxicological mechanism of liver injury of TWF, and brought forward the future research directions.

Objective To observe the effects and characteristics of vestibular illusions and vestibular autonomic reactions induced by short arm centrifuge exposure,and to search the appropriate rotation speed of short arm centrifuge for vestibular illusion simulation training on the ground.Methods Ninety healthy pilots were divided into 3 groups by the rotation speed of 21,30 and 37 r/min that generated by SAC-Ⅲ short arm centrifuge.By referencing the vestibular illusions simulation training on electric rotating chair,they were exposure to the simulation of counter-rotatory illusion and Coriolis illusion.Vestibular illusions and vestibular autonomic reactions were compared.Results ①When the speed was 21 r/min,the induced rates of the counter-rotatory illusion,Coriolis tumbling illusion (including head turn to right and to left) and Coriolis somatogyral illusion (including head pitched up and down) were lower than the induced rates under the speed of 30 r/min and 37 r/min (X2＝6.477 20.000,P＜0.01 or P＜0.05).And when the speed was 30 r/min and 37 r/min,the induced rates showed no significant difference (x2 ＝0.073-0.351,P＞0.05).②The expressions and characteristics of the centrifuge evoked counter-rotatory illusion were approximately the same under three different rotation speeds,while the illusion strength was enhanced with the speed increase.The expressions and characteristics of the Coriolis tumbling illusion induced by different speed showed no significant difference (X2 ＝0.090,0.056,P＞0.05).And the expressions of the Coriolis somatogyral illusions were multiform.Under three different speeds,the Coriolis somatogyral illusions showed no significant difference when the pilot's head pitched down (X2 ＝ 1.810,P＞0.05).The case of Coriolis somatogyral illusions was very rare when pilot's head pitched up and the result was not taken into account.③The scores of vestibular autonomic reaction were increased with the rotation speed increase,and showed significant difference (F＝ 15.058,P＜0.01).When the speed was 37 r/min,the score of vestibular autonomic reaction was significantly higher than the scores of 21 r/min and 30 r/min (P＜0.01 or P＜0.05),and there was no significant difference between the scores of 21 r/min and 30 r/min (P＞0.05).Conclusions When the speed of centrifuge was 30 r/m in,the induced rate of the vestibular illusions was the highest and the vestibular autonomic reaction was mild.For the 2 m arm centrifuge,the 30 r/min rotation was appropriate for pilots' vestibular illusion simulation training on the ground.