Objective To observe area of coagulation necrosis after microwave ablation(MWA)of rabbit liver showed on contrast-enhanced ultrasound(CEUS)in comparison with pathological findings.Methods Twenty-five healthy male experimental rabbits were equally randomly divided into L0,M0,H0,M7 and M14 groups.MWA was achieved with different power and time,and then CEUS and pathological examinations were performed,respectively.Four target areas of rabbit liver were ablated under 20 W for 1 min in L0 group,under 30 W for 1 min in M0 group and under 30 W for 3 min in H0 group,and the ablated areas were observed on the same day after MWA,while 2 target areas of rabbit liver were ablated under 30 W for 1 min in M7 and M14 groups,and the ablated areas were observed 7 days and 14 days after MWA,respectively.The ablated foci and ablated foci+edema band(inflammatory reaction band,IRB)showed on CEUS and pathology were compared,and their differences and changes with time going were analyzed.Results On the day of ablation,the extent of ablation foci,ablation foci+IRB as well as IRB in L0,M0 and H0 groups showed on CEUS were all larger than pathological findings under light microscopy(all P＜0.05),and the difference value of the length of the ablation foci between 2 methods increased sequentially among group L0,M0 and H0(all adjusted P＜0.05).Seven days after ablation,the area of ablation foci measured with CEUS in M 7 group was slightly larger than that measured with pathology(adjusted P=0.045),but no significant difference of the length nor the short diameter was found(both adjusted P＞0.05).Fourteen days after ablation,no significant difference of the length,the short diameter nor the area of ablation foci was detected between 2 methods in M14 group(all adjusted P＞0.05).The length,short diameter and area of ablation foci in M0 group measured with CEUS or pathology were all smaller than those in M 7 and M14 groups(all adjusted P＜0.05),while no significant difference was found between the latter 2 groups(all adjusted P＞0.05).Conclusion On the day of MWA of rabbit liver with different power and time settings,the areas of ablation foci,ablation foci+IRB and IRB showed on CEUS were larger than pathological findings.The range of ablation foci showed on CEUS 7 days after ablation was basically in line with pathology,indicating that CUES should be reexamined 7 days after ablation to evaluate the actual extent of coagulation and necrosis of ablation foci.

Objective:To explored the feasibility and efficacy of a rapid ramp-up,2-week maximum regimen of venetoclax(VEN)plus low-dose cytarabine(LDAC)for treating relapsed/refractory acute myeloid leukemia(R/R AML).Methods:We retrospectively analyzed patients with venetoclax-na?ve R/R AML treated with VEN+LDAC between October 2018 and November 2023.On the first day,patients received 200 mg of VEN,and the dose was quickly increased to 400 mg for the rest of the treatment;cytarabine was administered subcutaneously at a low dose of 20 mg/m2/day.The treatment duration was 10 or 14 days,depending on the condition of bone marrow hyperplasia determined on the 8th day of treatment.No patients received venetoclax monotherapy.All patients responding to salvage therapy received VEN+LDAC until disease progression or transplantation.Results:Among the patients,the median follow-up duration was 27.5 months.No clinical mani-festations of tumor lysis syndrome(TLS)occurred during the treatment.The overall response rate(ORR)was 68.75%,including four com-plete responses(CR),one complete remission with incomplete hematologic recovery(CRi),and six partial responses(PR).The median num-ber of best treatment result cycles was one cycle.The median overall survival(OS)in the whole cohort was 5.8(0.5-47.2)months;the medi-an progression-free survival(PFS)was 22.2(7.3-42.9)months.The major adverse events were grade 3-4 hematologic adverse events and in-fections.Conclusions:The 8th-day myelosuppression-adjusted VEN+LDAC regimen is a feasible salvage option with a reasonable safety pro-file in patients with venetoclax-na?ve R/R AML.Most patients tolerated the 14-day treatment;the response was generally rapid in the re-sponding patients.

Humans ; COVID-19/genetics* ; SARS-CoV-2/genetics* ; Clustered Regularly Interspaced Short Palindromic Repeats/genetics* ; CRISPR-Cas Systems/genetics* ; RNA, Viral/genetics*

Objective:To explore the value of video-electroencephalography (VEEG) combined with amplitude-integrated electroencephalography (aEEG) in evaluating the condition and prognosis of neonatal hyperbilirubinemia brain injuries.Methods:A total of 120 children with hyperbilirubinemia treatedin the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from July 2019 to July 2020 were enrolled. According to MRI with or without T 1 weighted imging (T 1WI) hyperintensity changes in the globus pallidus, they were divided into the brain injury group (52 cases) and the normal group(68 cases). According to the severity of brain injury, the brain injury group was divided into bilirubin encephalopathy group (23 cases) and subclinical bilirubin brain injury group (29 cases). According to the scores of Gesell Development Scale, the brain injury group was divided into good prognosis group (37 cases)and poor prognosis group (15 cases). The diagnostic value in brain injury with hyperbilirubinemia, the evaluation of the severity of brain injury and the predictive value of VEEG and aEEG were analyzed. Results:The abnormal rates of VEEG and aEEG in the brain injury group were higher than those in the normal group: 76.92% (40/52) vs. 8.82% (6/68), 80.77% (42/52) vs. 11.76% (8/68), the differences were statistically significant ( χ2 = 57.81 and 57.73, P<0.01). The abnormal rates of VEEG and aEEG in bilirubin encephalopathy group were higher than those in subclinical bilirubin brain injury group: 91.30% (21/23) vs. 65.52% (19/29), 95.65% (22/23) vs. 68.97% (20/29), the differences were statistically significant ( χ2 = 4.80 and 5.88, P<0.05). There was no significant difference in abnormal rates of VEEG and aEEG between the good prognosis group and poor prognosis group ( P>0.05). The results of operating characteristic curve analysis showed that the areas under the curve of VEEG combined with aEEG in the diagnosis of brain injury with hyperbilirubinemia, evaluation of the severity of brain injury, predicting the prognosis of children were higher than those of each examination method used alone ( P<0.05). Conclusions:VEEG combined with aEEG has diagnostic value for neonatal brain injury with hyperbilirubinemia, and has evaluation value for severity and prognosis of the disease.

Objective:To explore the effect of mini-clinical evaluation exercise (MiniCEX) and direct observation of procedural skills (DOPS) formative evaluation in standardized residency training of respiratory and critical care medicine.Methods:The residents who participated in standardized residency training of Zhongshan Hospital, Fudan Unviersity in 2019 were collected in study group, and the residents received the training in previous were collected in control group. The graduation examination scores, the effect of progressive rotations and the satisfaction of residents and examiners were compared between the two groups.Results:The scores of medical history writing, operation and clinical abilities were higher in the study group who were received MiniCEX-DOPS formative evaluation than those in the control group ( P<0.05). The scores of MiniCEX-DOPS evaluation in the third rotation were better than those in the first rotation ( P<0.05). The residents and examiners were generally satisfied with MiniCEX-DOPS evaluation. Conclusion:MiniCEX-DOPS evaluation is effective in residents training of respiratory and critical care medicine, and it is worth popularizing.

OBJECTIVE: To explore the effect of heparanase (HPSE) on apoptosis of microvascular endothelial cells (MVECs) and trans-endothelial migration of hepatocellular carcinoma (HCC) cells. METHODS: A HCC cell line with high HPSE expression was selected by real-time quantitative PCR (qRT-PCR) and Western blotting and transefected with a lentiviral vector containing an interfering RNA sequence of HPSE. Transwell migration assay was performed to detect the trans-endothelial migration (TEM) rate of the transfected HCC cells across human umbilical vein endothelial cells (HUVECs). In a Transwell indirect co-culture system, the effect of HPSE silencing in the HCC cells was determined on apoptosis of HUVECs . A nude mouse model of HCC was used to verify the effect of HPSE on apoptosis of MVECs and liver metastasis of the tumor. RESULTS: HCCLM3 cell line highly expressing HPSE was selected for the experiment. Transfection of the HCC cells with the lentiviral vector for HPSE interference the HCC cells resulted in significantly lowered TEM rate as compared with the cells transfected with the control vector ( < 0.01). In the indirect co-culture system, the survival rate of HUVECs co-cultured with HCCLM3 cells with HPSE interference was significantly higher and their apoptotic index was significantly lower than those in the control group ( < 0.05). Ultrastructural observation showed no obvious apoptosis of HUVECs co-cultured with HCCLM3 cells with HPSE interference but revealed obvious apoptotic changes in the control group. In the animal experiment, the tumor formation rate in the liver was 100% (6/6) in the control group, significantly higher than that in RNAi group (33.3%, 2/6) ( < 0.05). Under optical microscope, necrosis and apoptosis of the MVECs was detected in the liver of the control mice, while the endothelial cells remained almost intact in RNAi group. CONCLUSIONS HPSE promotes the metastasis of HCC cells by inducing apoptosis of MVECs.
Animals ; Apoptosis ; Carcinoma, Hepatocellular ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Endothelial Cells ; Gene Expression Regulation, Neoplastic ; Glucuronidase ; Humans ; Liver Neoplasms ; Mice

This paper aimed at exploring methods and their effectiveness of cultivating the scientific research quality in medical undergraduates in the early stage of. In combination with teachers' scientific research projects, 3 to 5 medical undergraduates in 3rd grade who applied for the projects initiatively were selected every year to enter into different research groups in the department. According to students' wishes, they may participate in some experiments in scientific research projects, or complete small projects independently, or write a review on a certain topic under teachers' guidance. In the past 10 years, 25 students participated in the program of our section and published 19 papers in total. Most students who participated in the experimental research program were able to carry out some scientific experiments independently with improved scientific research ability and practical ability. Students who wrote reviews not only broadened their knowledge, but also developed the skills of literature search, reading, comprehensive writing and critical thinking. Therefore, it was concluded that the cultivation of scientific research quality in students in the early stage could motivate students to actively participate in scientific research; both scientific experiments and themed reviews could enhance the scientific research ability and scientific research quality of undergraduates from different angles.

About 80％ of the patients with pancreatic cancer have glucose metabolism alterations,which suggests an association between diabetes and the occurrence and development of pancreatic cancer.Studies have shown that diabetes and hypoglycemic agents are closely related to the occurrence risk,clinical manifestation and prognosis of pancreatic cancer.Recent findings demonstrate that insulin resistance,hyperinsulinemia,the expression level of insulin-like growth factor related protein and inflammatory reaction are the possible mechanisms of the interaction between diabetes and pancreatic cancer.However,the definite mechanism still remains unclear,and further researches are still needed.

Sepsis is a frequently met syndrome with complex clinical symptoms and high mortality in emergency department. Early diagnosis of sepsis and timely treatment can improve survival. In recent years, the application of biomarkers [such as procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6)] are commonly used in the early diagnosis of sepsis, but their specificity and sensitivity are limited because of the long lag of report time. Soluble leukocyte differentiation antigen 14 sub type (sCD14-ST, namely presepsin) is a kind of novel biomarkers. Presepsin has a high specificity and sensitivity in the diagnosis of sepsis. It has some value to evaluate the severity of sepsis, antibiotic treatment of antibiotics, and prognosis of the patients with sepsis, and its latest detection method is fast and accurate, so it has the feasibility of clinical application.

Objective To investigate the effect of resveratrol on miRNA-106b in Alzheimer′s disease ( AD ) animal model.Methods Fifty Kunming male mice were divided into five groups by completely randomized block sampling.The five groups included three dosage resveratrol groups , an AD model group and a control group.The AD models were established in one month prior to treatments. Subsequently, from the 31st day various doses of resveratrol were provided intragastricly for 60 days.Then the memory function was observed by the step-down test.Meanwhile, the varying expressions of APP , P62, ApoA1, miRNA-106b, ABCA1 were tested in each group to determine whether there is the binding site for miRNA-106b in APP 3′UTR sequence.Results Compared with the control group by step-down test, the memory function of the AD model group mice decreased in different degree , which in the drug treatment group was higher than that in the model group (P<0.05).Compared with the AD group, the expression of APP (1.131 ±0.035) in the drug treatment group was higher than that in the model group (0.652 ± 0.026), while the P62 (0.412 ±0.022) and ApoA1 (0.534 ±0.032) were lower than the model group ( all P<0.05 ).High and medium dose groups of resveratrol treatment reduced varying degrees of APP (0.733 ±0.018,0.929 ±0.019,F=177.733) levels, and increased P62(0.954 ±0.035,0.633 ±0.015, F=434.5 ) and ApoA1 ( 1.042 ±0.051, 0.824 ±0.034, F=286.582 ) levels ( all P<0.05 ).The expression of miRNA-106b (0.464 ±0.313) and ABCA1(0.293 ±0.042) in the model group was lower than that in the control group (miRNA-106b 1.064 ±0.032, F=238.159; ABCA1 0.781 ±0.027,F=341.61;both P<0.05).The miRNA-106b (0.843 ±0.034, 0.601 ±0.012) and ABCA1 (0.882 ± 0.025, 0.624 ±0.036) levels in the high, medium dose resveratrol treatment groups increased to different extent ( both P<0.05 ).After the drug treatment , luciferase reporter vector experiments showed that the APP 3′UTR sequence contains the binding site of miRNA-106b.Conclusions APP is one of the target genes of miRNA-106b.Resveratrol is capable of improving AD by enhancing the expression of miRNA-106b and down-regulating the target genes including APP , P62 and ApoA1.This provides a new theoretical basis for the clinical treatment of AD.