Objective: To investigate the impact of temperature changes between neighboring days (TCN) on the mortality risk of respiratory diseases, so as to provide the evidence for the study of deaths from respiratory diseases caused by climate change. Methods: The monitoring data of deaths from respiratory diseases in Zibo City from 2015 to 2019 were collected from Shandong Provincial Management Information System for Chronic Diseases and Cause of Death Surveillance. The meteorological and air pollutant data of the same period were collected from China Meteorological Data Website and ChinaHighAirPollutants dataset. The effect of TCN on the risk of deaths from respiratory diseases was examined using a generalized additive model combined with a distributed lag non-linear model, and subgroup analyses for gender and age were conducted. The disease burden attributed to TCN at different intervals was assessed by calculating attributable fraction. Results: Totally 11 767 deaths from respiratory diseases were reported in Zibo City from 2015 to 2019, including 6 648 males (56.50%) and 5 119 females (43.50%). There were 1 307 deaths aged <65 years (11.11%), and 10 460 deaths aged 65 years and older (88.89%). A monotonically increasing exposure-response relationship was observed between TCN and deaths from respiratory diseases in the general population, females, and the population aged 65 years and older. The 95th percentile of TCN (P95, 3.84 ℃) reached the peak at a cumulative lagged of day 11 (RR=2.063, 95%CI: 1.261-3.376). The results of subgroup analyses showed greater impacts on females and the population aged 65 years and older, with cumulative lagged effects peaking at day 12 (RR=3.119, 95%CI: 1.476-6.589) and day 11 (RR=2.107, 95%CI: 1.260-3.523). The results of attributional risk analysis showed that next-day warming might increase the attributable risk of deaths from respiratory diseases, and next-day cooling might decrease the attributable risk. Conclusion Next-day warming may increase the mortality risk of respiratory diseases, and has greater impacts on females and the population aged 65 years and older.

Objective:To investigate the thyroid function status and levothyroxine ( L-T 4) replacement therapy strategy in pregnant women after 131I treatment of hyperthyroidism. Methods:From January 2005 to December 2019, 88 patients (age: (27.3±3.7) years) who received 131I treatment in Nanjing Drum Tower Hospital were retrospectively analyzed. They became pregnant at least half a year after 131I treatment with normal thyroid function and delivered successfully. Thyroid stimulating hormone (TSH), free triiodothyronine (FT 3) and free thyroxine (FT 4) were respectively detected at 1-3 months before pregnancy, 4-7, 8-12, 13-22, 23-28, ≥29 weeks of pregnancy, and 6 weeks, 3 months, 6 months of postpartum. According to the 2011 American Thyroid Association guidelines, L-T 4 replacement therapy was performed to maintain normal thyroid function. Repeated measures analysis of variance and the least significant difference t test were used to analyze data. Results:There were significant differences in TSH, FT 3, FT 4 and L-T 4 among different time periods before pregnancy, pregnancy and postpartum ( F values: 5.94, 3.32, 3.49, 9.63, all P<0.05). In order to maintain normal thyroid function in each period of pregnancy, the doses of L-T 4 replacement therapy were increased to (82.33±35.06) μg and (100.75±36.77) μg at 4-7, 8-12 weeks of pregnancy compared with the dose ((64.52±34.32) μg) before pregnancy ( t values: 7.33, 10.44, both P<0.001). The doses of L-T 4 were increased slowly after 13 weeks of pregnancy. In the third trimester (≥29 weeks), the dose was 76.69% higher than that before pregnancy. There were significant changes of TSH, FT 3 and FT 4 at 6 weeks of postpartum compared with those in the third trimester (TSH: (1.21±1.08) vs (2.99±1.42) mU/L, FT 3: (5.23±1.07) vs (3.90±0.55) pmol/L, FT 4: (21.29±4.96) vs (15.37±2.29) pmol/L, t values: -2.48, 6.05, 5.88, P values: 0.017, <0.001, <0.001). Compared with that in the third trimester, the dose of L-T 4 was decreased significantly at 6 weeks of postpartum ( t=-6.85, P<0.001), but doses of L-T 4 at 6 weeks, 3 months and 6 months of postpartum were still higher than that before pregnancy ( t values: 4.67-4.71, all P<0.001). Conclusions:TSH, FT 3 and FT 4 should be regularly monitored at 1-3 months before pregnancy, gestation period and 6 weeks of postpartum in pregnant women after 131I treatment of hyperthyroidism. The dose of L-T 4 should be adjust to the serum TSH level as soon as possible.

Malignant tumors pose a serious threat to human health and are one of the main causes of human death worldwide.In order to further improve the therapeutic outcomes of malignant tumors and prolong patients'survival time,clarifying the pathogenesis of malignant tumors and searching for new diagnostic and therapeutic targets become particularly important.It has been found that the occurrence and development of malignant tumors are the results of the interaction between tumor cells and the tumor microenvironment(TME).Versican,encoded by the VCAN gene,is a type of chondroitin sulfate proteoglycan belonging to the exogenous lectin proteoglycan family.It is a major component of the extracellular matrix and plays an important role in embryonic development and inflammatory responses.As an important component of TME,versican is abnormally expressed in various tumor tissues such as renal cell carcinoma,hepatocellular carcinoma,and gastric cancer,and is closely related to the clinical pathological characteristics and prognosis of the patients.It is a potential biomarker for early diagnosis and prognostic evaluation of tumors.Further researches have shown that versican can promote tumor development in a number of ways,such as promoting tumor cell proliferation,invasion and metastasis,inhibiting tumor cell apoptosis,promoting tumor angiogenesis,and inhibiting anti-tumor immune responses.This article reviews the current research status of the expression and biological effects of versican in malignant tumors,aiming to provide reference for subsequent research,clinical diagnosis and treatment of tumors.

Heterogeneous nuclear ribonucleoprotein(hnRNP)and heterogeneous nuclear RNA(hnRNA)form complexes that regulate RNA splicing and transportation.hnRNPH1 is a member of the hnRNP family of proteins and plays an important role in physiological processes,including embryonic development of the nervous and reproductive systems.hnRNPH1 is highly expressed in various tumor tissues and tumor cells,and its overexpression correlates with poor prognosis in patients.hnRNPH1 enhances tumor cell proliferation and metastasis through the regulation of alternative splicing of genes,modulation of gene expression,formation of fusion genes with other genes,and involvement in epigenetic regulation.Recent studies have shown that hnRNPH1 could serve as a potential biomarker for certain tumors,and hnRNPH1-targeting drugs show preliminary efficacy in a mouse model of melanoma.This article reviews the role and research progress of hnRNPH1 in the initiation and progression of malignant tumors.

Heterogeneous nuclear ribonucleoprotein(hnRNP)and heterogeneous nuclear RNA(hnRNA)form complexes that regulate RNA splicing and transportation.hnRNPH1 is a member of the hnRNP family of proteins and plays an important role in physiological processes,including embryonic development of the nervous and reproductive systems.hnRNPH1 is highly expressed in various tumor tissues and tumor cells,and its overexpression correlates with poor prognosis in patients.hnRNPH1 enhances tumor cell proliferation and metastasis through the regulation of alternative splicing of genes,modulation of gene expression,formation of fusion genes with other genes,and involvement in epigenetic regulation.Recent studies have shown that hnRNPH1 could serve as a potential biomarker for certain tumors,and hnRNPH1-targeting drugs show preliminary efficacy in a mouse model of melanoma.This article reviews the role and research progress of hnRNPH1 in the initiation and progression of malignant tumors.

Humans ; Esophageal Squamous Cell Carcinoma ; Esophageal Neoplasms/pathology* ; Carcinoma, Squamous Cell ; Microbiota

Objective:To investigate the clinical efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) with the use of Viator stent in the treatment of cirrhotic portal hypertension.Methods:43 cases with cirrhotic portal hypertension were implanted with Viatorr stent during TIPS procedure from March 2016 to August 2018. Serological indicators, color Doppler ultrasound, gastroscopy, rebleeding, ascites and hepatic encephalopathy were regularly followed up. Portal venous pressure, liver and kidney function, coagulation indexes were compared by t-test. Stent patency rate, hepatic encephalopathy incidence, rebleeding rate and survival rate were calculated by Kaplan-Meier curve.Results:TIPS procedure success rate was 100% in all patients. Portal pressure gradient was decreased from (25.57 ± 5.50) mmHg to (9.76 ± 2.92) mmHg before and after operation. Alanine aminotransferase (ALT) was significantly higher at 1 month after operation than before operation, but there was no significant difference between 3 and 6 months after and before operation. Total bilirubin, serum ammonia and prothrombin time at 1, 3, and 6 months after operation were higher than before operation. Albumin had no significant change compared with before operation, and creatinine and urea nitrogen were lower than before operation. The cumulative rebleeding rates at 12 and 24 months after operation was 0% and 9%, respectively. Of the 26 patients with ascites, 22 cases (84.6%) had complete disappearance of ascites and 3 (11.5%) had significant decrease of ascites. The cumulative incidence of hepatic encephalopathy at 3, 6, 12 and 24 months after surgery was 11.6%, 17.3%, 21.9% and 21.9%, respectively. The cumulative incidence of stent dysfunction at 12 and 24 months after surgery was 5.6% and 23.7%, respectively. The cumulative survival rate at 12 months and 24 months after surgery was 91.9%.Conclusion:TIPS procedure with Viatorr stent can effectively reduce portal pressure and rebleeding rate, improve intrahepatic shunt patency rate, and will not increase the risk of postoperative hepatic encephalopathy, and has a higher cumulative survival rate.

Objective To evaluate the effect of desflurane-remifentanil anesthesia on balance between cerebral oxygen supply and demand during cerebral revascularization in the patients with moyamoya disease.Methods Forty patients of both sexes with moyamoya disease,aged 18-64 yr,with body mass index of 18-25 kg/m2,undergoing superficial temporal artery-middle cerebral artery anastomosis,were allocated into 2 groups using a random number table method:desflurane-remifentanil group (D group) and propofol-remifentanil group (P group),with 20 cases in each group.Anesthesia was induced by intravenously injecting etomidate 0.3 mg/kg,sufentanil 0.4-0.5 μg/kg,and cis-atracurium 0.15-0.2 mg/kg.The patients were mechanically ventilated after tracheal intubation,and the end-tidal pressure of carbon dioxide was maintained at 35-45 mmHg.Anesthesia was maintained with propofol 4-6 mg · kg-1 · h-1 (group P),4％-6％ desflurane (group D),remifentanil 0.1-0.3 μg· kg-1 · min-1,remifentanil 0.1-0.3 μg · kg-1 · min-1 and intermittent intravenous boluses of cis-atracurium,and BIS value was maintained at 40-60.At 15 min after intubation (T1),30 min after skin incision (T2),immediately after opening the dura mater (T3),immediately after vascular bypass and patency (T4),and at the end of surgery (T5),blood samples were obtained from the radial artery and internal jugular bulb for blood gas analysis,jugular venous oxygen saturation (SjvO2) was recorded,and arteriovenous blood O2 content difference (Da-jvO2) and cerebral O2 extraction rate (CERO2) were calculated.Results Compared with group P,Da-jvO2 at T3-6 and CERO2 at T4-6 were significantly decreased,and SjvO2 was increased at T4-6 in group D (P＜0.05).Compared with the value at T1,Da-jvO2 was significantly decreased,and SjvO2 was increased at T5 in group D (P＜0.05).CERO2 was significantly lower,and SjvO2 was higher at T5 than at T3 in group P (P＜0.05).Compared with the values at T4,CERO2 was significantly decreased,and SjvO2 was increased at T5 in P and D groups (P＜ 0.05).Conclusion Compared with propofol-remifentanil anesthesia,desflurane-remifentanil anesthesia can maintain the balance between cerebral oxygen supply and demand better during cerebral revascularization in the patients with moyamoya disease.

10.3969/j.issn.1008-9691.2013.03.004