Objective To analyze the incidence and risk factors of colorectal adenomatous polyps (CAP) in recipients after liver transplantation. Methods Seventy-seven liver transplant recipients and 231 individuals undergoing colonoscopy during physical examination were recruited in this study. The incidence of CAP and pathological examination results were analyzed. Clinical data of liver transplant recipients were collected. According to the incidence of CAP, liver transplant recipients were divided into the CAP group (n=28) and non-CAP group (n=49). The risk factors of CAP after liver transplantation were identified. Results The 5-year cumulative incidence rates of colorectal polyps in liver transplant recipients and physical examination individuals were 43% and 34%, and 29% and 23% for the 5-year cumulative incidence rates of CAP, with no significant differences (both P > 0.05). Among all liver transplant recipients, 65 polyps were detected. The quantity of polyps in 1 case was excessively high and not counted. Multiple polyps were identified in certain recipients. Five polyps were not prepared for pathological examination due to small size. Pathological examination of 60 polyps demonstrated 25 inflammatory polyps, 33 CAP (8 complicated with low-grade intraepithelial neoplasia and 3 complicated with high-grade intraepithelial neoplasia), and 2 well-differentiated adenocarcinoma. Cox model analysis prompted that use of ciclosporine after liver transplantation was an independent risk factor for CAP in the recipients. Conclusions The risk of CAP is slightly elevated after liver transplantation. Postoperative use of ciclosporine is an independent risk factor for CAP in recipients after liver transplantation. Colonoscopy should be emphasized in the recipients after liver transplantation.

Co-delivery of chemotherapeutics and immunostimulant or chemoimmunotherapy is an emerging strategy in cancer therapy. The precise control of the targeting and release of agents is critical in this methodology. This article proposes the asynchronous release of the chemotherapeutic agents and immunostimulants to realize the synergistic effect between chemotherapy and immunotherapy. To obtain a proof-of-concept, a co-delivery system was prepared

Objective:To evaluate the radiosensitivity enhancement effect of FePd@CNTs nanocomposites on human breast cancer MCF-7 cells.Methods:FePd@CNTs nanocomposites were synthesized by chemical reduction method. Transmission electron microscope and energy dispersive spectrometer were utilized to characterize the surface morphology and chemical composition of FePd@CNTs nanocomposites. The compatibility of FePd@CNTs nanocomposites with human normal breast epithelial MCF-10A cells was determined by CCK-8 assay. The radiosensitivity enhancement effect of FePd@CNTs nanocomposites on MCF-7 cells was assessed by CCK-8 assay, flow cytometry and clony formation assay.Results:FePd nanospheres were successfully modified on the surface of CNTs by chemical reduction method. FePd@CNTs nanocomposites showed a low toxicity to MCF-10A cells (IC 50=738.3 μg/m), and effectively enhanced the effect of X-ray radiation on MCF-7 cells (sensibilization ratio=1.22). Conclusion:FePd@CNTs nanocomposites exhibit a promising potential for treating breast cancer and enhancing radiosensitivity effect.

Objective To investigate the incidence of de novo malignant tumors of the digestive system after liver transplantation (LT) in China. Methods Relevant literature review was performed from Wanfang data, China National Knowledge Infrastructure (CNKI) and Chongqing VIP. The retrieval time started from the establishment of each database to May 9, 2019. The Chinese search terms were liver transplantation+ postoperative/de novo+ malignant tumor/cancer. The age distribution, sex composition, time of diagnosis, involved organs, treatment and clinical prognosis of recipients with de novo malignant tumors of the digestive system after LT in China were retrospectively analyzed. Results After literature screening, 16 articles were eventually selected including 47 cases of de novo malignant tumors of the digestive system after LT. A majority of them were male recipients. The age of the recipients was 51 (23-65) years old, most of them were middle age (45-59 years old). The average time of diagnosis of de novo malignant tumors of the digestive system after operation was 43 (2-156) months, with the highest number of cases within postoperative 1-3 years. Colon and stomach were the most common tumor sites. Surgery combined with radiotherapy and chemotherapy remained the main treatment option. However, the overall clinical prognosis of patients with de novo malignant tumors of the digestive system after LT was poor with a mortality rate of 51%. Conclusions In China, colon cancer and gastric cancer are the main de novo malignant tumors of the digestive system after LT. The overall clinical prognosis of patients with de novo malignant tumors of the digestive system is poor. Sufficient attention should be paid to postoperative monitoring and prevention.

The rational clinical examination is important. The authors raised the concept of "medical imaging clinical appropriateness (MICA) " to meet the medical need in clinic (for diagnosis or assessment of a kind of disease or syndrome), which means radiologists and clinicians work together to carefully evaluate the necessity and rationality of an examination according to evidence of evidence-based medicine, expertise, experience, and patient′s willing.The necessity is prerequisite, the rationality is the core, the evaluation of evidence is the basis, the application of evidence-based medicine is the important method. This work will provide us a series of criteria in the format of guidelines, providing evidence of rational examination for clinicians. Based on hard working and cooperation between radiologists and clinicians, we will establish the system of MICA in China, standardizing medical process, promoting rationalization, optimizing medical resources allocation and usage.

The rational clinical examination is important. The authors raised the concept of "medical imaging clinical appropriateness (MICA) " to meet the medical need in clinic (for diagnosis or assessment of a kind of disease or syndrome), which means radiologists and clinicians work together to carefully evaluate the necessity and rationality of an examination according to evidence of evidence-based medicine, expertise, experience, and patient′s willing.The necessity is prerequisite, the rationality is the core, the evaluation of evidence is the basis, the application of evidence-based medicine is the important method. This work will provide us a series of criteria in the format of guidelines, providing evidence of rational examination for clinicians. Based on hard working and cooperation between radiologists and clinicians, we will establish the system of MICA in China, standardizing medical process, promoting rationalization, optimizing medical resources allocation and usage.

The research and development of innovative drugs targeting the clinical cure of chronic hepatitis B has become active in recent years. In the clinical trials of new drugs for hepatitis B, the use of new design concepts, new methods, and new technologies to evaluate the efficacy of innovative drugs is expected to shorten the clinical research process of candidate new drugs and reduce the cost of new drug development. However, the new designs such as seamless adaptive design and master plan design have few practical applications in clinical trials of innovative hepatitis B drugs. This article will focus on the methodological factors in the design of phase II/III clinical trials of innovative hepatitis B drugs, and introduce the key points of the new clinical trial design in order to provide methodological references for the development of innovative hepatitis B drugs.

OBJECTIVETo investigate the relationship between homocysteine (Hcy), von willebrand factor (vWF), soluble intercellular adhesion molecule-1 (sICAM-1) and the risk of cardio-cerebrovascular events among Inner Mongolians.

METHODSA survey was conducted among 2 589 Inner Mongolians from May 2002 to June 2003, and they were followed up for about ten years. The 182 individuals who developed cardio-cerebrovascular events in the cohort were defined as cases and those whose age, gender and residence 1:1 matched to cases were selected from the individuals who did not developed cardio-cerebrovascular events as controls. Then, a nested case-control study was used to analyze the relationship between Hcy, vWF and sICAM-1 and risk of cardio-cerebrovascular events. Conditonallogistic regression analysis was used to calculate OR values and 95% CI.

RESULTSThe cases had a higher baseline blood pressure, higher prevalence of hypertension and family history of hypertension compared to controls (all P values < 0.05), however, there were no significantly different between TC, TG, LDL-C, HDL-C, FBG, smoking and drinking rates (all P values > 0.05). The M (P(25)-P(75)) of Hcy were 10.68 (7.84-14.98) and 10.02 (6.64-13.94) µmol/L, vWFs were 10.88 (8.14-14.58) and 10.42 (7.97-13.50) mg/L, sICAM-1 were 336.48 (260.68-409.87) and 335.12 (269.87-409.87) ng/ml. They were not significantly different between the two groups (Z values were 0.89, 0.94 and 0.29, respectively, all P values >0.05). After adjustment for the family history of hypertension, hypertension, TC, FPG, BMI, smoking and drinking rate, the conditional logistic regression showed that OR (95% CI) of risk of cardio-cerebrovascular events were 1.00 (0.52-1.93), 2.37 (1.25-4.49), and 0.81 (0.45-1.47) for the participants with increased Hcy, vWF, and sICAM-1, compared with those with normal Hcy, vWF, and sICAM-1, respectively.

CONCLUSIONIn the Inner Mongolians, increased vWF at baseline may increase the risk of cardio-cerebrovascular events, and increased Hcy and sICAM-1 were not significantly associated with the risk of cardio-cerebrovascular events.

Cardiovascular Diseases ; Case-Control Studies ; Cytokines ; Homocysteine ; Humans ; Hypertension ; Intercellular Adhesion Molecule-1 ; Logistic Models ; Prevalence ; Risk ; Risk Factors ; Stroke ; von Willebrand Factor

OBJECTIVETo investigate the relationship between interleukin-6 (IL-6), endothelin-1 (ET-1), E-selectin and the risk of cardio-cerebrovascular events.

METHODSBased on a cohort study in which 2 589 Mongolians had been followed up for 10 years, a nested case-control study was carried out to analyze the relationship between IL-6, ET-1, E-selectin and the risk of cardio-cerebrovascular events. Logistic regression analysis was used to calculate the odds ratio (OR) and 95% confidence intervals (95%CI).

RESULTSThe average level of IL-6 (7.66 vs. 8.77 pg/ml), ET-1 (0.74 vs. 0.75 pg/ml) and E-selectin (17.96 vs. 18.32 ng/ml)were not significantly different between the case and the control groups (P > 0.05). Data from the logistic regression analysis showed that IL-6, ET-1 and E-selectin were not significantly associated with the risk of cardio-cerebrovascular events. The multivariable adjusted ORs (95%CI) on the risk of cardio-cerebrovascular events were 0.69 (0.41-1.16), 1.10 (0.66-1.85) and 1.19 (0.71-2.00) for the participants with IL-6>23.91 pg/ml, ET-1>1.33 pg/ml and E-selectin>24.43 ng/ml, respectively, compared with those having IL-6≤23.91 pg/ml, ET-1≤1.33 pg/ml or E-selectin≤24.43 ng/ml.

CONCLUSIONData from our study indicated that the levels of IL-6, ET-1 and E-selectin at baseline were not significantly associated with the risk of cardio-cerebrovascular events in people from Inner Mongolia.

Cardiovascular Diseases ; epidemiology ; Case-Control Studies ; Cerebrovascular Disorders ; epidemiology ; China ; epidemiology ; Cohort Studies ; E-Selectin ; blood ; Endothelin-1 ; blood ; Humans ; Interleukin-6 ; blood ; Odds Ratio ; Risk

Objective To study the clinical effect of posterior lumbar interbody fusion (PLIF) using expandable cage in treatment of lumbar spondylolisthesis.Methods Twenty patients who underwent PLIF using expandable cage for lumbar spondylolisthesis were retrospectively analyzed.The operative time and transoperative bleeding were recorded.Postoperative regularity follow-up X-ray and CT,the olisthy rate,intervertebral height index and intervertebral fusion were observed.The lumbar function improvement was assessed by Oswestry disability index (ODI).Results All the patients were successfully operated,the operative time was 100-160 (123.3 ± 16.4) min,transoperative bleeding was 350-600 (464.0 ± 78.7) ml.The follow-up time was 12-36 (24.3 ± 7.3) months,symptoms were significantly improved.During the follow-up duration,20 patients obtained bony fusion.According to the reforming Macnab grade standard,excellent was in 14 cases,good was in 4 cases,acceptable was in 2 cases,the rate of excellent and good was 90.0％(18/20).The ODI score and olisthy rate postoperative 6 months and last follow-up were significantly lower than preoperative,and ODI score last follow-up was significantly lower than that postoperative 6 months,there were statistical differences (P ＜ 0.05).The intervertebral height index postoperative 6 months and last follow-up were significantly higher than that preoperative,there were statistical differences (P ＜0.05).There was no statistical difference in olisthy reset rate between postoperative 6 months and last followup (P ＞0.05).The last followed-up,There were no expandable cage subsidence or displacement,intervertebral space collapse and intervertebral height loss.Conclusions As a new production,expandable cage is an effective tool on treating lumbar spondylolisthesis,it can effectively restore the intervertebral height and the biological mechanical properties of the lumbar vertebrae.This study indicates that expandable cage is an effective and safe products for lumbar interbody fusion,which maintained a lower complication rate and better results.