Objective:To investigate the clinical, pathological, and molecular biological characteristics of gastric hepatoid adenocarcinoma (HAS) in order to provide reference for clinical treatment.Methods:Thirty-two patients diagnosed with hepatoid adenocarcinoma after radical gastrectomy for gastric cancer at Shanxi Cancer Hospital were included from January 2019 to December 2021. Immunohistochemistry, in situ hybridization, and next-generation sequencing (NGS) methods were used to analyze immune markers and molecular characteristics in the pathological tissues from 32 patients with HAS. Cox regression analysis and Kaplan-Meier method were used to analyze the prognostic factors of overall survival and disease-free survival.Results:Among the 32 patients with HAS, 26 were male, 6 were female; aged 28-77 years, with an median age 62.0 (53.8, 67.2) years. Fifteen cases of HAS were located in the cardia, 10 cases in the antrum, and 7 cases in the body of the stomach. The maximum diameter of the mass was 3-10 cm, and mainly ulcerative in gross. The immunohistochemistry and in situ hybridization results showed that the positive rates of AFP, SALLA4, and Glypican-3 were 68.8% (22/32), 68.8% (22/32), 78.1% (25/32), respectively; Seven patients had microsatellite status of dMMR. Two cases of HER2 gene amplification and 2 cases of EB virus positivity. The NGS results showed that HAS was often accompanied by multiple gene mutations, with 23 cases having ≥ 2 gene mutations and 6 cases having ≥10 gene mutations. The TP53 gene had the highest mutation frequency; 4 cases had genetic structural variations; 28 cases had copy number variation. In addition, there were 7 cases of MSI-H and 9 cases of TMB-H. Follow-up results showed that 12 cases died, 9 cases developed metastasis, and the shortest survival time was 5 months.Conclusions:Gastric HAS is a type of tumor with high invasiveness and poor prognosis. The combined detection of AFP, SALLA4 and Glypican-3 can improve the diagnostic rate of tumors. dMMR/MSI-H and TMB-H patients in HAS are significantly higher than those in ordinary gastric cancer, and the high frequency mutation genes in HAS are often accompanied by multiple potential therapeutic targets. Immunotherapy combined with chemotherapy and targeted therapy are expected to become the treatment direction of HAS.

Objective:To investigate the clinical, pathological, and molecular biological characteristics of gastric hepatoid adenocarcinoma (HAS) in order to provide reference for clinical treatment.Methods:Thirty-two patients diagnosed with hepatoid adenocarcinoma after radical gastrectomy for gastric cancer at Shanxi Cancer Hospital were included from January 2019 to December 2021. Immunohistochemistry, in situ hybridization, and next-generation sequencing (NGS) methods were used to analyze immune markers and molecular characteristics in the pathological tissues from 32 patients with HAS. Cox regression analysis and Kaplan-Meier method were used to analyze the prognostic factors of overall survival and disease-free survival.Results:Among the 32 patients with HAS, 26 were male, 6 were female; aged 28-77 years, with an median age 62.0 (53.8, 67.2) years. Fifteen cases of HAS were located in the cardia, 10 cases in the antrum, and 7 cases in the body of the stomach. The maximum diameter of the mass was 3-10 cm, and mainly ulcerative in gross. The immunohistochemistry and in situ hybridization results showed that the positive rates of AFP, SALLA4, and Glypican-3 were 68.8% (22/32), 68.8% (22/32), 78.1% (25/32), respectively; Seven patients had microsatellite status of dMMR. Two cases of HER2 gene amplification and 2 cases of EB virus positivity. The NGS results showed that HAS was often accompanied by multiple gene mutations, with 23 cases having ≥ 2 gene mutations and 6 cases having ≥10 gene mutations. The TP53 gene had the highest mutation frequency; 4 cases had genetic structural variations; 28 cases had copy number variation. In addition, there were 7 cases of MSI-H and 9 cases of TMB-H. Follow-up results showed that 12 cases died, 9 cases developed metastasis, and the shortest survival time was 5 months.Conclusions:Gastric HAS is a type of tumor with high invasiveness and poor prognosis. The combined detection of AFP, SALLA4 and Glypican-3 can improve the diagnostic rate of tumors. dMMR/MSI-H and TMB-H patients in HAS are significantly higher than those in ordinary gastric cancer, and the high frequency mutation genes in HAS are often accompanied by multiple potential therapeutic targets. Immunotherapy combined with chemotherapy and targeted therapy are expected to become the treatment direction of HAS.

Objective:To investigate the effect of peer support education on family function of breast cancer patients with breast reconstruction.Methods:Totally 146 patients who received surgical treatment in the department of plastic surgery for breast cancer from June 2017 to June 2019 were randomly divided into the experimental group and the control group by the method of random number table, 73 cases each. The control group received routine education. Patients in the observation group received regular education and peer support education. The intervention time was from admission to 6 months after discharge, and the control group received routine nursing care. Quality of life questionnaire was used to evaluate the quality of life of the patients at six months after operation, family care index questionnaire was used to evaluate the family function of the patients, and comprehend social support scale was used to evaluate the level of social support, then various indicators of the two groups of patients were compared.Results:6 months after operation, the scores of quality of life function and symptom dimension of the intervention group were 6.43±1.54. 5.83±1.47, while control group were 6.02±1.59; 6.39±1.63. There were statistically significant differences between the two groups ( t values were 4.30, 5.01, P < 0.05); family care scores of the two groups were compared, the intervention group was 8.78±2.04. The control group was 8.43±2.05. There were statistically significant differences between the two groups ( t value was 2.02, P < 0.05); the comprehension support score of the two groups was compared, and that of the intervention group was 62.24±14.81. The control group was 55.74±13.58. There were statistically significant differences between the two groups ( t value was 4.26, P < 0.05). Conclusion:Peer support education can improve the quality of life and family care of breast cancer patients with breast reconstruction.

A 50-year-old male patient was treated with adefovir dipivoxil 10 mg/d once daily for chronic hepatitis B. Seven years later, the patient developed multiple bone pains all over the body, which were gradually aggravated and restricted his movements. X-ray, CT, and magnetic resonance imaging examinations showed old fractures of the left 8th rib and the right 7th rib and fracture of the right femoral neck. Laboratory tests showed that serum creatinine was 111 μmol/L, serum phosphorus was 0.41 mmol/L, and alkaline phosphatase was 216 U/L. Bone mineral density examination showed osteoporosis in the 1st to 4th lumbar vertebrae, femoral necks, and total hipbones. Adefovir dipivoxil-induced hypophosphatemia was diagnosed. Adefovir dipivoxil was discontinued and replaced by entecavir, and oral phosphorus supplementation was given. After 2 months of treatments, the patient′s symptoms were improved. After 6 months of treatments, the bone pain basically disappeared and alkaline phosphatase, serum creatinine, and phosphorus returned to normal.

A 50-year-old male patient was treated with adefovir dipivoxil 10 mg/d once daily for chronic hepatitis B. Seven years later, the patient developed multiple bone pains all over the body, which were gradually aggravated and restricted his movements. X-ray, CT, and magnetic resonance imaging examinations showed old fractures of the left 8th rib and the right 7th rib and fracture of the right femoral neck. Laboratory tests showed that serum creatinine was 111 μmol/L, serum phosphorus was 0.41 mmol/L, and alkaline phosphatase was 216 U/L. Bone mineral density examination showed osteoporosis in the 1st to 4th lumbar vertebrae, femoral necks, and total hipbones. Adefovir dipivoxil-induced hypophosphatemia was diagnosed. Adefovir dipivoxil was discontinued and replaced by entecavir, and oral phosphorus supplementation was given. After 2 months of treatments, the patient′s symptoms were improved. After 6 months of treatments, the bone pain basically disappeared and alkaline phosphatase, serum creatinine, and phosphorus returned to normal.

Objective: To examine the impact of metabolic syndrome (MS) on the clinicopathological characteristics and prognosis of patients with colorectal cancer (CRC). Methods: The clinical data of 650 patients with CRC admitted in Shanxi Provincial Cancer Hospital between January 2010 and December 2011 were retrospectively analyzed. Among 650 patients there were 190 cases complicated with MS (MS group) and 460 cases without MS (non-MS group), the clinicopathological features and prognosis were compared between two groups. Results: The serum insulin and insulin-like growth factor-1 (IGF-1) levels in MS group were significantly higher than those in non-MS group [(9.2±4.7) vs.(6.8±4.7)μIU/L, t=8.88, P<0.01 and (200.2±44.1) vs.(136.7±63.2)mg/L,t=12.63, P<0.01]. The proportions of stage T₃ and T₄ cancer, extra-regional lymph node metastasis (ELN), and TNM stage Ⅲ and Ⅳ patients in MS group were significantly higher than those in non-MS group [(83.2% (158/190) vs. 72.6% (334/460), χ²=8.19, P=0.04; 9.5% (18/190) vs. 4.8%(22/460),χ²=8.61, P=0.04; 56.3% (107/190) vs. 45.2%(208/460), χ²=8.22, P=0.04, respectively]. The 5-year disease-free survival (DFS) in MS group was significantly lower than that in non-MS group [57.9%(99/171)vs. 66.1%(279/422), P<0.01]. Multivariate analysis indicated that MS(HR=1.623, 95%CI:1.511-1.963, P=0.03), IGF(HR=1.382, 95%CI:1.031-1.765, P=0.02) and, ELN(HR=4.270, 95%CI:2.177-7.463, P<0.01)were independent factors affecting the prognosis of CRC patients. Conclusion Metabolic syndrome is one of the risk factors affecting the prognosis of CRC patients.

BACKGROUND: It is unclear whether autophagy mediates the long-term exercise adaptation of the skeletal muscle induced by high-intensity interval training (HIIT) . OBJECTIVE: To identify the influence of HIIT on skeletal muscle autophagy of middle-aged rats over time, and to understand the potential regulatory effects of autophagy on maintaining the muscle mass and improving aerobic capacity by HIIT. METHODS: Rats were randomly divided into quiet, moderate training group (50-minute running at the intensity of 60% VO2 max) and HIIT group (6 times of 3-minute running at 80% VO2 maxand 3-minute active recovery at 50% VO2 maxwith a 7-minute warm-up and a 7-minute cool-down at 60% VO2 max). All rats were tested for VO2 max, exhaustive running time and distance at baseline and after 4, 8 and 12 weeks of exercise, respectively. The soleus muscle were collected and weighted, and then the expression levels of autophagy-related protein Beclin 1, LC3 and P62 were detected by western blot assay. RESULTS AND CONCLUSION: The soleus muscle mass in the quiet group decreased at the 12thweek (P < 0.01), while the moderate training and HIIT groups improved this decline (P < 0.05). The HIIT group dramatically improved the VO2 maxfrom the 4thweek when compared with the pre-experiment and the quiet group, until the 12thweek. The expression levels of Beclin1 and LC3II in the quiet group declined at the 12thweek (P < 0.05, P < 0.001), but the expression level of LC3II and ratio of LC3II/LC3I raised from the 4thand 8thweeks till the 12thweek compared with the pre-experiment and the quiet group, and the expression level of LC3II and ratio of LC3II/LC3I point time significantly raised in the moderate training group at the 12thweek (P < 0.001, P < 0.01). In the quiet group, the content of P62 significantly increased at the 4th and 8thweeks (P < 0.05), and decreased at the 12thweek (P < 0.001), but the content of P62 remained at the low level in the moderate exercise and HIIT groups. These results imply that an equivalent or better effects on improving basic autophagy level, skeletal muscle mass and aerobic capacity of the middle aged rats,by HIIT versus moderate training,providing the theory and empirical data that highlight the role of HIIT in health promotion.

Objective To study the incidence of moderate and severe preoperative anxiety and its related risk factors in patients undergoing elective general anesthesia.Methods A total of 562 pa-tients undergoing selective anesthesia 225 males and 337 females,aged 18-85 years,ASA physical status Ⅰ-Ⅲ,were selected in the affiliated hospital of Xuzhou medical university.State-trait anxiety inventory (STAI)was used to assess the degree of preoperative anxiety and the patients were divided into mild anxiety group (SAI ≤ 37,n=294)and moderate and severe anxiety group (SAI > 37,n=268)according to SAI score.The factors related to preoperative anxiety such as age,gender,edu-cational background,marital status,history of previous surgery,presence of pain,preoperative diag-nosis of tumor and presence or absence of hypertension were collected.Results The incidence of moderate and severe preoperative anxiety in our study was 268 (47.7%).Logistic regression analysis showed that female (OR=1.846,95%C I 1.298-2.624),single (OR=2.208,95%C I 1.218-4.004) might be the risk factors of preoperative anxiety.Conclusion Females and single individuals may be independent risk factors for preoperative anxiety.

Objective To investigate the related risk factors of cerebral microbleeds (CMBs) and their relations with leukoaraiosis and lacunar infarction in patients with cerebrovascular disease.Methods One hundred and sixty-four patients with cerebrovascular disease,admitted to our hospital from January 2015 and January 2017 were chosen;susceptibility weighted imaging (SWI) was performed,and the distribution and number of CMBs were recorded by Microbleed Anatomical Rating Scale (MARS).The demographic data,personal history,previous medical history,biochemical indices and imageological examination results of the patients were collected and multivariate Logistic regression analysis was carried out on the basis of these data.Spearman dependence analysis was used to analyze the relations of CMBs with leukoaraiosis and lacunar infarction.Results Age (OR=1.071,P=0.024,95％ CI:1.009-1.137),hypertension (OR=3.875,P=0.012,95％CI:1.347-11.148),leukoaraiosis(OR=2.080,P=0.005,95％ CI:1.245-3.475),lacunar infarction (OR=2.326,P=0.003,95％ CI:1.336-4.050) were independently associated with CMBs.And number of CMBs had positive correlation with severity of leukoaraiosis and number of lacunar cerebral infarcts (r=0.564,P=0.000;r=0.762,P=0.000).Conclusion Age,hypertension,leukoaraiosis,and lacunar infarction are the independent risk factors of CMBs;the severity of CMBs is positively correlated with severity of leukoaraiosis and lacunar infarction.

STUDY DESIGN: Retrospective, case control evaluation of 86 patients who underwent microendoscopic discectomy (MED) and percutaneous transforaminal endoscopic discectomy (PTED) for the treatment of lumbar disc herniation (LDH). PURPOSE: To evaluate the safety and the outcomes of MED and PTED for the treatment of LDH. OVERVIEW OF LITERATURE: MED and PTED are minimally invasive surgical techniques for lower back pain. Studies to date have shown that MED and PTED are safe and effective treatment modalities for LDH. METHODS: A retrospective study was performed in patients with LDH treated with MED (n=50) and transforaminal endoscopic discectomy (PTED; n=36) in our hospital. All patients were followed-up with self-evaluation questionnaires, Oswestry disability index (ODI), medical outcomes study 36-item short form health survey and MacNab criteria. All the patients in both groups were followed up to 12 months after the operation. RESULTS: ODI questionnaire responses were not statistically different between the MED and PTED groups (53.00 vs. 48.72) before treatment. Average scores and minimal disability after 5 days to 12 months of follow-up were 4.96 in the MED group and 3.61 in the PTED group. According to MacNab criteria, 92.0% of the MED group and 94.4% of the PTED group had excellent or good results with no significant difference. CONCLUSIONS: There was no significant difference between MED and PTED outcomes. Further large-scale, randomized studies with long-term follow-up are needed.
Case-Control Studies ; Diagnostic Self Evaluation ; Diskectomy* ; Follow-Up Studies ; Health Surveys ; Humans ; Intervertebral Disc Degeneration ; Low Back Pain ; Retrospective Studies* ; Surgical Procedures, Minimally Invasive