ObjectiveTo investigate the association between intrahepatic portoportal venous collateral vascular formation and postoperative liver hyperplasia in patients undergoing liver partition and portal vein ligation. MethodsThe clinical data of patients with hepatocellular carcinoma who underwent liver partition and portal vein ligation at the Center of Hepato-Pancreatico-Biliary Surgery in the First Affiliated Hospital of Sun Yat-sen University from April 2013 to June 2022 were retrospectively analyzed. All the patients were grouped according to the number of open collateral vessels in the liver after first-stage surgery， including the group with no formation of intrahepatic portoportal venous collateral vessel （IPCs=0）， the group with 1 formation of intrahepatic portoportal venous collateral vessel （IPCs=1）， and the group with more than 2 formations of intrahepatic portoportal venous collateral vessels （IPCs ≥ 2）. The differences in the distribution of the three groups in terms of preoperative， intraoperative and postoperative liver function， formation of intrahepatic portoportal venous collateral vessels on both sides， and second-stage surgery were analyzed firstly， and then multiple linear regression analysis was used to explore the factors affecting the number of IPCs. ResultsOf all the 37 patients with hepatocellular carcinoma who were finally included in this study， there were no significant differences in preoperative data between the three groups （P>0.05）. The surgical procedure was different between the three groups. The proportion of patients with ≥ 2 open vessels who underwent laparoscopic microwave ablation liver partition was greater than that of patients with split liver （57.14% vs. 42.56%，P=0.031）. There was a statistically significant difference in the daily hypertrophy volume of future liver remnant （FLR） ［IPCs ≥ 2 vs. IPCs=1 vs. IPCs=0，（14.25±8.81 vs. 20.65±9.85 vs. 30.10±19.31） mL，P=0.018］. There was no difference in the proportion of patients between the three groups who underwent second-stage resection （P=0.363）. However， the number of days between surgeries was significantly longer in those with ≥2 open collateral vessels than in those with no opening or only 1 opening （16.31±5.44 vs. 10.30±3.40 vs. 12.78±3.35） days，P=0.023. Multiple linear regression analysis found that the surgical procedure was the only factor affecting the number of intrahepatic collateral vessel openings （P=0.031）. The number of IPCs after laparoscopic microwave ablation liver partition and split liver was ［2.0 （1.5） vs. 1.0 （1.0），P=0.031］. ConclusionsThe number of IPCs after liver partition and portal vein right branch ligation is negatively associated with the hypertrophy rate of FLR and split of liver is recommended to reduce the formation of IPCs.

Objective: To establish a survival prediction model based on the independent prognostic factors of long-term prognosis after laparoscopic liver resection(LLR) for intrahepatic cholangiocarcinoma(ICC). Methods: The clinical and pathological data of 351 consecutive patients with ICC who received radical LLR in 13 Chinese medical centers from August 2010 to May 2021 were collected retrospectively. There were 190 males and 161 females,aged(M(IQR)) 61(14)years(range:23 to 93 years). The total cohort was randomly divided into a training dataset(264 cases) and a validation dataset(87 cases). The patients were followed up by outpatient service or telephone,and the deadline for follow-up was October 2021. Based on the training dataset,the multivariate Cox proportional hazards regression model was used to screen the independent influencing factors of long-term prognosis to construct a Nomogram model. The Nomogram model's discrimination,calibration,and clinical benefit were evaluated through internal and external validation,and an assessment of the overall value of two groups was made through the use of a receiver operating characteristic(ROC) curve. Results: There was no significant difference in clinical and pathological characteristics and long-term survival results between the training and validation datasets(all P>0.05). The multivariate Cox analysis showed that CA19-9,CA125,conversion to laparotomy during laparoscopic surgery,and lymph node metastasis were independent prognostic factors for ICC patients after LLR(all P<0.05). The survival Nomogram was established based on the independent prognostic factors obtained from the above screening. The ROC curve showed that the area under the curve of 1, 3 and 5-year overall survival rates of patients in the training dataset were 0.794(95%CI:0.721 to 0.867),0.728(95%CI:0.618 to 0.839) and 0.799(95%CI:0.670 to 0.928),and those in the validation dataset were 0.787(95%CI:0.660 to 0.915),0.831(95%CI:0.678 to 0.983) and 0.810(95%CI:0.639 to 0.982). Internal and external validation proved that the model exhibited a certain discrimination,calibration,and clinical applicability. Conclusion: The survival Nomogram model based on the independent influencing factors of long-term prognosis after LLR for ICC(including CA19-9,CA125,conversion to laparotomy during laparoscopic surgery,and lymph node metastasis) exhibites a certain differentiation,calibration,and clinical practicability.
Bile Duct Neoplasms/surgery* ; Bile Ducts, Intrahepatic/pathology* ; CA-19-9 Antigen ; Cholangiocarcinoma/diagnosis* ; Female ; Humans ; Laparoscopy ; Lymphatic Metastasis ; Male ; Nomograms ; Prognosis ; Retrospective Studies

Humans ; Nasal Obstruction/surgery* ; Nasal Septum/surgery* ; Rhinoplasty

Objective: To assess the incidence of symptomatic torus tubarius hypertrophy (TTH) in recurred OSA in children, and to explore the preliminary experience of partial resection of TTH assisted with radiofrequency ablation. Methods: From January 2004 to February 2020, 4 922 children, who diagnosed as OSA and received adenotonsillectomy at the Department of Otolaryngology, The 4th Medical Center of the PLA General Hospital, were retrospectively reviewed. There were 3 266 males and 1 656 females, the age ranged from 1 to 14 years old(median age of 5.0 years). Twenty-two cases were identified with recurrence of OSA syndrome, and the clinical data, including sex, age of primary operation, age of recurrence and presentation, and opertation methods were analyzed. Follow-up was carried out by outpatient visit or telephone. Graphpad prism 5.0 software was used for statistical analysis. Results: Twenty-two cases were identified as recurred OSA and received revised surgery in 4 922 cases. Among these 22 cases, 11 cases were diagnosed as TTH resulting in an incidence of 2.23‰(11/4 922), 1 case was cicatricial adhesion on tubal torus (0.20‰, 1/4 922), 10 cases were residual adenoid combined with tubal tonsil hypertrophy (2.03‰, 10/4 922). Median age of primary operation was 3.0 years (range:2.4 to 6.0 years) in 11 TTH cases. Recurrent interval varied from 2 months to 5.5 years (2.4±1.9 years) after first operation. Age of revised partial resection of TTH was 7.0±2.7 years (range: 4.0 to 12.0 years). Average time interval between primary operation and revised operation was 3.5±2.1 years (range: 0.5 to 6.0 years). Individualized treatments were carried out based on partial resection of TTH assisted with radiofrequency ablation. All of 11 cases received satisfied therapeutic results without nasopharyngeal stenosis occured. Twenty-two cases were followed up for 1.6 to 13 years (median follow-up time was 6.2 years). Conclusions: TTH contributed to recurred OSA in child. TTH might be misdiagnosed as tubal tonsil hypertrophy. Partial resection of TTH assisted with radiofrequency ablation was a safty and effective treatment.
Adenoidectomy ; Adenoids/surgery* ; Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Hypertrophy/surgery* ; Infant ; Male ; Retrospective Studies ; Sleep Apnea, Obstructive/surgery*

OBJECTIVE: To investigate the therapeutic effect of Yixin Ningshen Tablet (YXNS) on comorbidity of myocardial infarction (MI) and depression in rats and explore the underlying mechanism. METHODS: The Sprague-Dawley rats were randomly divided into 5 groups with 7 rats in each group according to their weights, including control, model, fluoxetine (FLXT, 10 mg/kg), low-dose YXNS (LYXNS, 100 mg/kg), and high-dose YXNS (HYXNS, 300 mg/kg) groups. All rats were pretreated with corresponding drugs for 12 weeks. The rat model of MI and depression was constructed by ligation of left anterior descending coronary artery and chronic mild stress stimulation. The echocardiography, sucrose preference test, open field test, and forced swim test were performed. Myocardial infarction (MI) area and myocardial apoptosis was also detected. Serum levels of interleukin (IL)-6, IL-1β, tumor necrosis factor-α (TNF-α), 5-hydroxytryptamine (5-HT), adrenocorticotrophic hormone (ACTH), corticosterone (CORT), and norepinephrine (NE) were determined by enzyme linked immunosorbent assay. The proteins of adenosine 5'-monophosphate -activated protein kinase (AMPK), p-AMPK, peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α), and nuclear respiratory factor 1 (NRF1) in heart were detected by Western blot analysis. The expression levels of TNF-α, IL-6, indoleamine 2,3-dioxygenase (IDO1), kynurenine 3-monooxygenase (KMO), and kynureninase (KYNU) in hippocampus were detected by real-time quantitative polymerase chain reaction. RESULTS: Compared with the model group, the cardiac function of rats treated with YXNS improved significantly (P<0.01). Meanwhile, YXNS effectively reduced MI size and cardiomyocytes apoptosis of rats (P<0.01 or P<0.05), promoted AMPK phosphorylation, and increased PGC-1α protein expression (P<0.01 or P<0.05). HYXNS significantly increased locomotor activity of rats, decreased the levels of TNF-α, IL-6 and IL-1β, and increased the serum levels of 5-HT, NE, ACTH, and CORT (all P<0.05). Moreover, HYXNS decreased the mRNA expressions of IDO1, KMO and KYNU (P<0.05). CONCLUSIONS YXNS can relieve MI by enhancing myocardial energy metabolism. Meanwhile, YXNS can alleviate depression by resisting inflammation and increasing availability of monoamine neurotransmitters. It may be used as a potential drug to treat comorbidity of MI and depression.
AMP-Activated Protein Kinases/metabolism* ; Adrenocorticotropic Hormone ; Animals ; Comorbidity ; Depression/drug therapy* ; Energy Metabolism ; Interleukin-6/metabolism* ; Myocardial Infarction/pathology* ; Neurotransmitter Agents ; Rats ; Rats, Sprague-Dawley ; Serotonin/metabolism* ; Tablets ; Tumor Necrosis Factor-alpha/metabolism*

Objective To investigate the expression and the potential roles of long non-coding RNA(lncRNA)cancer susceptibility candidate 2(CASC2)and imprinted gene H19 in extrahepatic cholangiocarcinoma(ECC). Methods Four samples from patients with ECC were collected for high-throughput sequencing which was conducted to reveal the transcriptomic profiles of lncRNA CASC2 and H19.Bioinformatics tools were employed to predict the potential roles of the two genes.Another 22 ECC tissue samples and the cholangiocarcinoma cell lines(RBE,QBC939,HuH-28,and HuCCT1)with different degrees of differentiation were selected for validation.The para-carcinoma tissue and normal human intrahepatic biliary epithelial cell(HIBEC)were used as the control groups.The expression levels of lncRNA CASC2 and H19 in carcinoma tissue,para-carcinoma tissue,and cell lines were determined by real-time quantitative polymerase chain reaction(qRT-PCR).The correlation analysis was carried out for the clinical indicators of patients with the expression levels of the target genes. Results The two target genes showed significantly different expression between carcinoma tissue and para-carcinoma tissue(all P<0.05).Specifically,CASC2 had higher expression level in the carcinoma tissue than in the para-carcinoma tissue(t=1.262,P=0.025),whereas the expression of H19 showed an opposite trend(t=1.285,P=0.005).The expression levels of CASC2 in QBC939(t=8.114,P=0.015)and HuH-28(t=9.202,P=0.012)cells were significantly higher than that in the control group.The expression levels of H19 were significantly lower in RBE(t=-10.244,P<0.001),QBC939(t=-10.476,P<0.001),HuH-28(t=-19.798,P<0.001),and HuCCT1(t=-16.193,P=0.004)cells than in the control group.Bioinformatics analysis showed that CASC2 was mainly involved in the metabolic process and H19 in the development of multicellular organisms.Both CASC2 and H19 were related to catalytic activity.The expression level of lncRNA CASC2 was correlated with pathological differentiation(χ ²=6.222,P=0.022)and lymph node metastasis(χ²=5.455,P=0.020),and that of lncRNA H19 with pathological differentiation(χ²=1.174,P=0.029)and tumor size(χ²=-0.507,P=0.037). Conclusions In the case of ECC,lncRNA CASC2 and H19 have transcription disorders.lncRNA CASC2 is generally up-regulated in the carcinoma tissue,while H19 is down-regulated.Both genes have the potential to become new molecular markers for ECC.
Bile Duct Neoplasms/genetics* ; Bile Ducts, Intrahepatic/metabolism* ; Cholangiocarcinoma/genetics* ; Gene Expression Regulation, Neoplastic ; Humans ; RNA, Long Noncoding/genetics* ; Tumor Suppressor Proteins/genetics*

Background Organic ultraviolet (UV) filters are widely used in personal care products. So far, relevant studies on organic UV filters in indoor dust have been reported. Objective This study aims to establish a thermal desorption combined with gas chromatography-mass spectrometry (TD-GCMS) method to identify organic UV filters in indoor air collected from different indoor environments, so as to reveal the pollution levels and characteristics of organic UV filters in indoor environment. Methods Based on the standard indoor air sampling protocol, a total of 60 samples were collected from eight different kinds of indoor environments (male and female dormitory rooms, offices, labs, barber shops, printing shops, hotels, and private cars) on and nearby Minhang Campus of Shanghai Jiao Tong University from August to November, 2020. The concentrations of six common organic UV filters, including homosalate (HMS), 2-ethylhexyl salicylate (EHS), 3-(4-methylbenzylidene)-camphor (4-MBC), isoamyl 4-methoxycinnamate (IMC), octocrylene (OC), and octyl 4-methoxycinnamate (EHMC), in the air of different indoor environments were detected by TD-GCMS. Furthermore, the correlations of individual organic UV filters in different indoor environments were analysed. Results Under optimized detection conditions, the correlation coefficients of the quantitative standard curves of selected six organic UV filters were all at or above 0.997. The relative standard deviations of 1 mg·L⁻³ samples ranged from 1.74% to 7.11%, and the recoveries ranged from 67.17% to 106.5%. The relative standard deviations of 10 mg·L⁻³ samples ranged from 3.59% to 8.76%, and the recoveries ranged from 78.80% to 126.60%. The detection rates of the other five organic UV filters except IMC were all at or more than 92% in eight different kinds of indoor air. The median concentration of total organic UV filters was 75.17 ng·m⁻³, and EHS presented the highest median concentration of 28.55 ng·m⁻³. Regarding different indoor environments, the highest concentration of total organic UV filters was found in the female dormitory samples, 154.98 ng·m⁻³. The respective pair-analysis among HMS, EHMC, OC, and EHS of all indoor air samples reached a significant level of correlation (r=0.40-0.61, P<0.01). Conclusion The TD-GCMS method is satisfactory for the determination of organic UV filters in indoor air. EHS, EHMC, HMS, OC, and 4-MBC are identified in selected eight indoor environments, and they may have similar sources of pollution.

Diabetes Mellitus, Type 2/complications* ; Humans ; Overweight/complications* ; Sarcopenia ; Ventricular Dysfunction, Left ; Ventricular Function, Left ; Ventricular Remodeling

To reveal the main nutrients and functional ingredients in the flowers of Polygonatum cyrtonema and P. filipes, the content of the polysaccharides, saponins, amino acids, total phenols, mineral elements, and the DPPH free radical scavenging rates were determined. The flowers and rhizomes of P. cyrtonema were collected from Qingyang in Anhui and Qingyuan in Zhejiang, while the flowers and rhizomes of P. filipes were collected from Longyou in Zhejiang, respectively. The results showed that the polysaccharides content in flowers varied from 60.88 to 97.00 mg·g~(-1), about half of that in rhizomes. The saponins content in flowers varied from 32.55 to 40.93 mg·g~(-1), which was close to the content in rhizomes. The content of total phenols ranged from 40.79 to 50.95 mg·g~(-1), approximately 4.5 times of that in rhizomes. The total amino acids content in flowers was 111.85 to 131.03 mg·g~(-1), about 2.3 times of the content in rhizomes. The essential trace element content was abundant in flowers. The contents of heavy metal elements were all within the limits set by the standards. The DPPH free radical scavenging rate IC_(50) varied from 1.77 to 3.25 mg·mL~(-1), less than one-fifth of that in rhizomes, showing a significant superiority of antioxidant activity compared to rhizomes. The results initially revealed the fundamental of "the flowers exceed the rhizomes in effect", the common saying about the traditional Chinese medicinal herbs over the years, indicating a great developing potential of the flowers. Besides, as polysaccharides, saponins, amino acids, total phenols and other nutritive substances in flowers differ widely among species and provenances, it's important to develop variety breeding to improve the quality and yield of flowers.
Amino Acids/analysis* ; Antioxidants/analysis* ; China ; Flowers/chemistry* ; Nutrients/analysis* ; Nutritive Value ; Plant Extracts ; Polygonatum/chemistry* ; Rhizome/chemistry* ; Trace Elements/analysis*

OBJECTIVE: To investigate the use of antibiotics in children with community-acquired pneumonia (CAP) in multiple regions of China, and to provide a reference for CAP standard treatment and rational antibiotic use in children. METHODS: The medical data of 1 383 children with CAP who were hospitalized in the department of pediatrics in 10 grade A tertiary hospitals from 9 cities between April 14, 2014 and January 1, 2016 were reviewed, to analyze the status of antibiotic use in hospitalized children in North China, Northeast China, East China, and South China. RESULTS: The overall rate of antibiotic use in children with CAP was 89.08%, with 88.7% in North China, 95.5% in Northeast China, 83.3% in East China, and 86.6% in South China. The main types of antibiotics used were cephalosporins, macrolides, compound preparations of β-lactam antibiotics, polyphosphoric broad-spectrum antibiotics and other β-lactam antibiotics. The selection of antibiotics was generally rational, but antibiotics were still used in some patients with viral infection alone or a combined use of ≥2 kinds of antibiotics were noted in some patients with infection caused by one kind of pathogen. Irrational antibiotic use was observed in 131 children (10.63%). CONCLUSIONS There are high rates of antibiotic use and irrational use of antibiotics among children with CAP. Standard management of antibiotic use in children with CAP should be strengthened.
Anti-Bacterial Agents ; therapeutic use ; Child ; Child, Hospitalized ; China ; Community-Acquired Infections ; drug therapy ; Humans