OBJECTIVES: To establish a three-dimensional (3D) visualization-based classification of the left hepatic portal vein (LHPV) and left hepatic vein (LHV) systems using 3D reconstruction technology to facilitate precise segmental/subsegmental resection of left liver lesions. METHODS: Thin-slice contrast-enhanced CT datasets from 244 patients were reconstructed using MI-3DV Works software. The spatial anatomy (origins, branching patterns, and spatial relationships) of the LHPV and LHV branches was analyzed to determine their 3D classifications and segmental liver divisions for guiding surgical planning for anatomical left liver resections. RESULTS: The 3D models of the third- and fourth-order branches of the LHPV and LHV were successfully reconstructed for all the 244 patients. Two types of the LHPV system were identified, where the LHPV either had independent origins [242 cases (99.1%)] or had right anterior portal branches arising from the LHPV trunk [2 cases (0.9%)]. 3D classifications identified two types of the Segment II of the LHPV (based on branch number), 3 types of the Segment III (by spatial distribution of the branches), compact vs dispersed types of the left lateral lobe (determined by Segment II/III branches proximity), 3 types of the Segment IV (by branch number and origin), and 3 types the fourth hilar vessels (transverse branches of the left portal vein) for their supplied segments. The LHV system had two drainage types into the inferior vena cava, and the umbilical fissure veins were classified into 3 types by drainage patterns and distance to the venous roots. These classifications combined with liver segmentations allowed individualized surgical planning for segment-specific resections. CONCLUSIONS The 3D classification of the LHPV and LHV provides valuable clinical guidance for precise anatomical resections of left liver lesions using liver segments or subsegments as anatomical units to enhance surgical accuracy and improve the outcomes of hepatobiliary surgery.
Humans ; Hepatectomy/methods* ; Imaging, Three-Dimensional ; Hepatic Veins/anatomy & histology* ; Portal Vein/anatomy & histology* ; Liver/surgery* ; Liver Neoplasms/blood supply* ; Tomography, X-Ray Computed ; Female

Objective:To investigate the differential expression and methylation level of tripartite-motif protein 59(TRIM59)in hepatocellular carcinoma(HCC)tissues and its clinical significance.Methods:The expression of TRIM59 in HCC tissue and normal liver tissue was analyzed using the TIMER2.0 and University of ALabama at Birmingham CANcer(UALCAN)databases.The prognostic correlation between TRIM59 and HCC patients was investigated through the TIMER2.0 and Kaplan-Meier Plotter databases.The cBioPortal database was utilized to explore the genetic mutations of TRIM59 in HCC and its co-expressed genes.Gene Ontology(GO)analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis of TRIM59 co-expressed genes were conducted using the DAVID database.The CpG sites of TRIM59 were searched in the University of California Santa Cruz(UCSU)database,and the methylation level of TRIM59 and its correlation with HCC patient prognosis were analyzed in the Shiny Methylation Analysis Resource Tool(SMART)database.Results:TRIM59 was highly expressed in HCC tissue and lowly expressed in normal liver tissue.This differential expression was closely related to the prognosis of HCC patients.Based on GO and KEGG enrichment analyses,TRIM59 co-expressed genes were primarily involved in biological processes such as cell cycle regulation and cytoskeletal organization,as well as signaling pathways including TNF signaling,Hippo signaling,and cytoskeletal regulation.In HCC tissues,the expression of TRIM59 was positively correlated with the infiltration of immune cells such as B lymphocytes,CD8+T lymphocytes,and CD4+T lymphocytes.Additionally,the methylation level of TRIM59 was significantly reduced in HCC tissues,and its expression level was inversely correlated with methylation status.HCC patients with high methylation of TRIM59 had a significantly longer prognosis than those with low methylation.Conclusions:TRIM59 exhibits high expression and low methylation levels in HCC tissues,which are closely associated with the prognosis of HCC patients.Furthermore,differential expression of TRIM59 regulated by methylation plays a crucial role in the development and progression of HCC.

Objective:To investigate the differential expression and methylation level of tripartite-motif protein 59(TRIM59)in hepatocellular carcinoma(HCC)tissues and its clinical significance.Methods:The expression of TRIM59 in HCC tissue and normal liver tissue was analyzed using the TIMER2.0 and University of ALabama at Birmingham CANcer(UALCAN)databases.The prognostic correlation between TRIM59 and HCC patients was investigated through the TIMER2.0 and Kaplan-Meier Plotter databases.The cBioPortal database was utilized to explore the genetic mutations of TRIM59 in HCC and its co-expressed genes.Gene Ontology(GO)analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis of TRIM59 co-expressed genes were conducted using the DAVID database.The CpG sites of TRIM59 were searched in the University of California Santa Cruz(UCSU)database,and the methylation level of TRIM59 and its correlation with HCC patient prognosis were analyzed in the Shiny Methylation Analysis Resource Tool(SMART)database.Results:TRIM59 was highly expressed in HCC tissue and lowly expressed in normal liver tissue.This differential expression was closely related to the prognosis of HCC patients.Based on GO and KEGG enrichment analyses,TRIM59 co-expressed genes were primarily involved in biological processes such as cell cycle regulation and cytoskeletal organization,as well as signaling pathways including TNF signaling,Hippo signaling,and cytoskeletal regulation.In HCC tissues,the expression of TRIM59 was positively correlated with the infiltration of immune cells such as B lymphocytes,CD8+T lymphocytes,and CD4+T lymphocytes.Additionally,the methylation level of TRIM59 was significantly reduced in HCC tissues,and its expression level was inversely correlated with methylation status.HCC patients with high methylation of TRIM59 had a significantly longer prognosis than those with low methylation.Conclusions:TRIM59 exhibits high expression and low methylation levels in HCC tissues,which are closely associated with the prognosis of HCC patients.Furthermore,differential expression of TRIM59 regulated by methylation plays a crucial role in the development and progression of HCC.

Objective To investigate the prevalence of Cryptosporidium infection and the distribution of parasite species and genotypes among HIV-positive individuals in Jiangxi Province. Methods HIV-positive individuals' sociodemographic and clinical data were collected from three AIDS designated hospitals in Jiangxi Province from January 2022 to March 2023. Subjects' stool samples were collected, and genomic DNA was extracted from stool samples. Nested PCR assay was performed based on the small subunit ribosomal RNA (SSU rRNA) gene of Cryptosporidium, and Cryptosporidium gp60 gene was amplified in stool samples positive for the SSU rRNA gene. The second-round PCR amplification product was checked with 1.5% agarose gel electrophoresis, and the products of suspected positive amplifications were sequenced, followed by sequence alignment. The phylogenetic tree was created using the Neighbor-Joining method with the software MEGA 11.0, to characterize the species, genotypes and sub-genotypes of Cryptosporidium. Results A total of 382 HIV-positive individuals were enrolled, with two cases identified with Cryptosporidium infection (0.52% prevalence), and both cases had no abdominal pain or diarrhea. Following sequencing and sequence alignment, the gene sequences of these two Cryptosporidium isolates shared 99.76% and 99.88% similarity with the gene sequence of C. meleagridis isolates. Phylogenetic analysis based on the Cryptosporidium SSU rRNA gene sequence identified the species of these two Cryptosporidium-positive stool samples as C. meleagridis. Following nested PCR amplification of the Cryptosporidium gp60 gene, sequencing and sequence alignment, the two C. meleagridis isolates were characterized as III eA17G2R1 and III bA25G1R1a sub-genotypes, and the sub-genotype III bA25G1R1a was firstly described in humans. Conclusion The prevalence of Cryptosporidium is low among HIV-positive individuals in Jiangxi Province. The likelihood of Cryptosporidium infection cannot be neglected among HIV-positive individuals without diarrhea.

Plasticity in the glutamatergic synapses on striatal medium spiny neurons (MSNs) is not only essential for behavioral adaptation but also extremely vulnerable to drugs of abuse. Modulation on these synapses by even a single exposure to an addictive drug may interfere with the plasticity required by behavioral learning and thus produce impairment. In the present work, we found that the negative reinforcement learning, escaping mild foot-shocks by correct nose-poking, was impaired by a single in vivo exposure to 20 mg/kg cocaine 24 h before the learning in mice. Either a single exposure to cocaine or reinforcement learning potentiates the glutamatergic synapses on MSNs expressing the striatal dopamine 1 (D1) receptor (D1-MSNs). However, 24 h after the cocaine exposure, the potentiation required for reinforcement learning was disrupted. Specific manipulation of the activity of striatal D1-MSNs in D1-cre mice demonstrated that activation of these MSNs impaired reinforcement learning in normal D1-cre mice, but inhibition of these neurons reversed the reinforcement learning impairment induced by cocaine. The results suggest that cocaine potentiates the activity of direct pathway neurons in the dorsomedial striatum and this potentiation might disrupt the potentiation produced during and required for reinforcement learning.

OBJECTIVE: To detect potential variant in a male neonate affected with congenital nephrogenic diabetes insipidus (CNDI). METHODS: Clinical data of the patient was collected. Genomic DNA was extracted from peripheral blood samples from the child and his parents. The whole coding regions of the arginine vasopressin V2 receptor (AVPR2) gene were amplified by PCR and subjected to Sanger sequencing. RESULTS: The patient presented recurrent fever and polyuria after birth. Multiple blood gas analyses indicated hypernatremia. Ultrasound showed bilateral hydronephrosis and hydroureter. The patient was partially responsive to hydrochlorothiazide. DNA analysis identified a hemizygous frameshift variant c.890-899delACCCGGAGGC in exon 2 of the AVPR2 gene in the proband. His mother was heterozygous for the same variant. CONCLUSION The c.890-899delACCCGGAGGC variant of the AVPR2 gene probably underlies the CNDI in the child. Above discovery has enriched to spectrum of CNDI associated variants.
Adult ; Diabetes Insipidus, Nephrogenic/genetics* ; Exons ; Female ; Frameshift Mutation ; Humans ; Hydrochlorothiazide/therapeutic use* ; Infant, Newborn ; Male ; Pedigree ; Receptors, Vasopressin/genetics*

Objective:To evaluate the incidence of deeply infiltrating endometriosis (DIE) among patients of pelvic endometriosis confirmed by pathology and to make analysis of its clinical and pathological characteristics.Methods:From January 1, 2018 to December 31, 2018, clinical data of 240 cases of pelvic endometriosis diagnosed by laparoscopy and pathology hospitalized in Peking University First Hospital were analyzed retrospectively for the characteristics of symptoms, pelvic examination and anatomic distribution of endometriosis foci.Results:(1) Among 240 cases of pelvic endometriosis, 94 were diagnosed with DIE with an incidence of 39.2% (94/240); of them the diagnosis were made preoperatively in 44 cases (46.8%, 44/94). (2) Compared with those without DIE, patients with DIE had higher rates of secondary dysmenorrhea [53.2% (50/94) versus 38.4% (56/146), P=0.033], anal pain [43.6% (41/94) versus 28.1% (41/146), P=0.013], dyspareunea [39.4% (37/94) versus 18.5% (27/146), P=0.001] and frequent bowel movement [33.0% (31/94) versus 15.8%(23/146), P=0.002]. (3) Patients with DIE had higher rates of bad movement of uterus [21.3% (20/94) versus 6.8% (10/146), P=0.001], painful nodularity on uterosacral ligaments [26.6% (25/94) versus 6.2% (9/146), P<0.01], painful nodularity of posterior fornix [19.1% (18/94) versus 4.8% (7/146), P<0.01], blue nodule in vaginal wall [6.4% (6/94) versus 0 (0/146), P=0.003] by pelvic examination compared with those without DIE. (4) Ninety-four patients with DIE had a total of 162 nodules, of those 88 (54.3%, 88/162) located in uterosacral ligaments, 14 (8.6%, 14/162) in the rectum, 7 (4.3%, 7/162) in vaginal wall, 6 (3.7%, 6/162) in ureter, 4 in bladder (2.5%, 4/162), 2 (1.2%, 2/162) in Douglas pouch. Forty-three DIE patients (45.7%, 43/94) had more than one nodules. Patients with DIE had concomitant ovarian endometriosis in 69 cases (73.4%, 69/94), with a total of 103 endometrial cysts. (5) Patients with DIE had a higher rate of obliterated Douglas pouch [76.6% (72/94) versus 19.2% (28/146), P<0.01]. Conclusions:More than one third of patients with pelvic endometriosis have concomitant DIE with a lower rate of preoperative diagnosis. Pelvic pains, bad movement of uterus and painful nodulirity around cervix suggest the presence of DIE.

The clinical manifestation, laboratory findings, and imaging examination of a baby with familial glucocorticoid deficiency were summarized. The patient presented achypnea, cyanosis, and pigmentation of the whole body skin, no convulsion and hypoglycemia found. Laboratory findings revealed low blood cortisol and high blood ACTH levels. A 1-bp homozygous deletion(c.106+ 1delG) in intron 3 of melanocortin 2 receptor accessory protein(MRAP) gene in the patient was found. His parents were found to be heterozygous carrier for the same mutation, without any clinical manifestation.

Objective:To explore the clinical and genetic characteristics of a Chinese baby with perinatal hypophosphatasia (HPP) and his parents for better understanding of the disease.Methods:The clinical data of the patient with HPP was carefully collected. The laboratory and radiographic examination data were taken for this baby patient. Sequencing for all the twelve tissue-nonspecific alkaline phosphatase(ALPL) exons and the flanking exon-intron junctions were performed in the proband and his parents with their genomic DNA from peripheral blood.Results:The blood level of alkaline phosphatase was decreased in this patient while serum calcium level was increased. His bone revealed chondrodysplasia-like change. Compound heterozygous mutations were found in the proband, with c. 346G>A(p.A116T) in exon 5 and c. 1171C>T(p.R391C) in exon 10. His father and mother were without clinical manifestation while respectively carried c. 346G>A(p.A116T and c. 1171C>T(p.R391C) missense mutations, suggesting an autosomal recessive inheritance in this family.Conclusion:Perinatal HPP has a high mortality rate. Skeletal deformities, hypercalcemia, and low level of ALP are important in the differential diagnosis of perinatal HPP.

Objective To explore the effects of rapid response first-aid case on bedside emergency gastroscopy hemostatic treatment. Methods A total of 52 patients with esophageal-fundal varices in liver cirrhosis from January 2014 to June 2015 were divided into control group (n=25) and experimental group (n=27). The patients of control group received the routine nursing; then we summarized the experience and mistakes of operation cooperation, optimized process;next we designed rapid response first-aid case and used in the experimental group. The blood transfusion time, goods preparation time, blood loss, blood transfusion volume were compared in two groups. Results The data of the experimental group in average bleeding to transfusion time (90. 22 ± 36. 47)min, materials preparation time (14. 66 ± 3. 48) min, the average amount of bleeding (369. 62 ± 158. 90) ml, average blood transfusion amount (322. 40 ± 117. 82) ml were lower than those of the control group [ average bleeding to blood transfusion time ( 123. 60 ± 51. 87 ) min, materials preparation time ( 22. 44 ± 2. 59 ) min, average bleeding volume ( 660. 20 ± 181. 82 ) ml, average blood transfusionamount(458.00±140.63)ml](P<0.05).Conclusions Theimplementationofrapidresponse first-aid case can effectively shorten the rescue time, reduce bleeding and blood transfusion time, the blood loss, the wastage of human resources and medical resources, improve the efficiency of nursing work in the department and the success rate of rescue.