Integrins are a family of transmembrane receptors that connect the extracellular matrix and actin skeleton, which mediate cell adhesion, migration, signal transduction, and gene transcription. As a bi-directional signaling molecule, integrins can modulate many aspects of tumorigenesis, including tumor growth, invasion, angiogenesis, metastasis, and therapeutic resistance. Therefore, integrins have a great potential as antitumor therapeutic targets. In this review, we summarize the recent reports of integrins in human hepatocellular carcinoma (HCC), focusing on the abnormal expression, activation, and signaling of integrins in cancer cells as well as their roles in other cells in the tumor microenvironment. We also discuss the regulation and functions of integrins in hepatitis B virus-related HCC. Finally, we update the clinical and preclinical studies of integrin-related drugs in the treatment of HCC.
Humans ; Integrins/metabolism* ; Carcinoma, Hepatocellular/genetics* ; Liver Neoplasms/genetics* ; Cell Adhesion ; Carcinogenesis ; Cell Transformation, Neoplastic ; Tumor Microenvironment

OBJECTIVE: To investigate the causes of soft tissue complications in patients with dorsal displacement distal radius fractures (DRF) after volar locking plate surgery. METHODS: From July 2016 to May 2021, 112 patients with dorsal displacement DRF were treated with volar locking plate surgery, including 45 males and 67 females. The average age was (46.24±10.08) years old, ranging from 18 to 85 years old. According to whether there were soft tissue complications after operation, they were divided into complication group (40 cases) and non complication group (72 cases). Compared with preoperation, the radial metacarpal inclination and ulnar deflection angle, wrist flexion activity and dorsal extension activity, and grip strength of patients after operation were significantly improved (P<0.05). Compared with the non complication group, the proportion of patients in the complication group whose age was>60 years, body mass index (BMI) more than 30 kg·m^-2, smoking, diabetes, fracture type C, open fracture and operation time more than 90 min was higher (P<0.05). The age, BMI, smoking, diabetes, fracture AO classification, fracture type and operation time were analyzed by multifactor Logistic regression to determine the independent risk factors affecting the occurrence of postoperative soft tissue complications of patients, establish a nomogram prediction model, and evaluate the model. RESULTS: At the latest follow-up, the excellent and good rate of wrist joint function recovery was 83.93% (94/112), and the excellent and good rate of fracture reduction was 84.82% (95/112). Multivariate Logistic regression analysis showed that age more than 60 years old, diabetes, fracture type C, open fracture and operation time more than 90 min were independent risk factors for postoperative soft tissue complications (P<0.05). The receiver operating characteristic (ROC), calibration curve and clinical decision curve of the nomogram prediction model showed discrimination, accuracy and validity were good. CONCLUSION Age more than 60 years, diabetes mellitus, fracture type C, open fracture, and operation time more than 90 min are all independent risk factors for soft tissue complications after DRF volar plate fixation. In clinical treatment, perioperative soft tissue management should be done in such patients to prevent complications.
Female ; Male ; Humans ; Adult ; Middle Aged ; Adolescent ; Young Adult ; Aged ; Aged, 80 and over ; Wrist Fractures ; Fractures, Open ; Risk Factors ; Wrist Joint/surgery* ; Metacarpal Bones

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Objective:To explore our self-designed classification system of irreducible intertrochanteric fractures based on reduction stage and bone block position and to evaluate the reduction techniques guided by the classification system.Methods:A retrospective study was conducted to analyze the data of 115 patients with irreducible intertrochanteric fracture who had been admitted to Department of Orthopedics, Beijing Hospital from September 2014 to November 2022. There were 24 males and 91 females with a mean age of (80.9±11.0) years. The reduction for the fractures was divided into a diaphysis reduction stage (Phase Ⅰ) and a cortical reduction stage (Phase Ⅱ). Based on the relative positions of the intraoperative bone blocks, Phase Ⅰ was divided into an anterior and posterior interlocking type (Phase Ⅰa) and a distal bone block sinking displacement type (Phase Ⅰb) while Phase Ⅱ into a proximal lifting type (Phase Ⅱa), a posterior angulation type (Phase Ⅱb), a positive support type (Phase Ⅱc), and a negative support type (Phase Ⅱd). Depending on the difficulties encountered in different reduction stages, corresponding close reduction strategies (such as top rod support, percutaneous prying, and Joystick technique) were adopted to restore the proximal femoral neck shaft angle, anteversion angle, anterior medial cortex, and length of the affected limb before fixation with intramedullary nails. Recorded were the patient's surgical time, intraoperative bleeding, quality of postoperative reduction, fracture union time, and complications.Results:The surgical time for this group of patients was 70.0(60.0, 92.0) minutes, and the intraoperative blood loss 200.0 (170.0, 200.0) mL. According to the standards by Baumgaertner et al., the quality of postoperative reduction was evaluated as excellent in 103 cases and as good in 12 cases, with an excellent and good rate of 100.0% (115/115). Of the 115 patients, 86 were followed up for more than 6 months to reveal fracture union in all after a duration of 6.0 (4.0, 8.0) months. One patient died of an acute cardiovascular event in the hospital 5 days after surgery. Two patients lost their mobility within 3 months after surgery due to acute cerebral infarction. There was no internal fixation failure requiring secondary surgery or no incision infection.Conclusion:Guided by our self-designed classification system of irreducible intertrochanteric fractures based on the intraoperative reduction stage and the relative position of bone block, real time intraoperative fluoroscopy images can be used to effectively clarify the difficulty of fracture reduction in stages so that corresponding reduction strategies can be adopted, leading to fine clinical efficacy.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Objective:To develop a novel method for detection of genomic RNA of 2019-nCoV with reverse-transcription thermophilic helicase-dependent amplification (tHDA) and lateral flow dipsticks.Methods:This study included 143 PCR-negative nucleic acid specimens and 20 PCR- positive nucleic acid specimens collected from patients from January to April 2020 at Institute of Clinical Laboratory, Jinling Hospital. 5 pairs of primers were designed for conserved sequence of both gene N and E of 2019-nCoV, and the amplicons were analyzed by gel electrophoresis to screen out the most efficient primers. High level (5×10 5 copies/ml) and low level (5×10 2 copies/ml) templates were amplified, and lateral flow dipsticks (LFD) were used to detect amplification products. The amplification time and visualization time were optimized to visualize the results, and the optimal tHDA-LFD reaction system was established. Simulated specimens with low, medium, and high concentrations were detected for 15 times, and precision was assessed. The limit of detection was evaluated using tenfold serial dilutions of 2019-nCoV in contrived samples. To evaluate the cross-reactivity, six samples of respiratory viruses, including influenza A virus, influenza B virus, human adenovirus, human respiratory syncytial virus, human parainfluenza virus and coronavirus 229E were tested using this assay. The tHDA-LFD assay was performed to detect 2019-nCoV in 163 clinical specimens stored in our laboratory. The clinical diagnostic efficacy was determined. Results:The established RT-tHDA one-step method combined with LFD was adopted, which could be conducted within 60 min and was reproducible with good precision, showing 100% positive concordance rate. The assay showed no cross reaction with other six human respiratory pathogens. The limit of detection of the RT-tHDA assay was 5×10 2 copies/ml for both N and E genes detected by LFD. The diagnostic efficacy evaluation showed that the sensitivity of the method was 95.00%(19/20), and the specificity was 100.00%(143/143). The positive predicted value of the method was 100.00% (19/19)and the negative predicted value was 99.31%(143/144). Compared with real-time RT-qPCR assay, it showed Kappa value of 0.971 ( P<0.0001). Conclusion:The proposed tHDA-LFD assay is a rapid and visualized method to detect 2019-nCoV.

Objective:To compare the short-term outcomes of patients undergoing laparoscopic pancreaticoduodenectomy (LPD) and those with open pancreaticoduodenectomy (open pancreatiloduodenectomy, OPD).Methods:The clinical data of 85 patients with LPD and 103 patients with OPD at our hospital from Jun 2017 to Jun 2019 were analyzed retrospectively.Results:There was no significant difference in clinical data and between the two groups ( P>0.05). Compared with OPD group, the operation time in LPD group was longer [(407.6±117.4) min vs. (220.8±23.9) min]( P<0.05), but the intraoperative blood loss was less [(285.1±21.9) ml vs. (550.5±65.5) ml]( P<0.05). There was more lymph node dissection (13.5±1.4 vs. 8.8±0.6) ( P<0.05), earlier feeding per month ( P<0.05), shorter time for the use of analgesia and hospital stay ( P<0.05). There was no significant difference in the incidence of postoperative complications such as pancreatic fistula, biliary fistula, gastroparesis and intra abdominal bleeding ( P>0.05). Conclusions:LPD is as safe and reliable as OPD, LPD has the advantages of more precise display during operation, while less traumatic and quicker recovery after operation.

Objective To investigate the clinical application value of fluorescence laparoscopy in radical resection of hepatocellular carcinoma (HCC).Methods Data of totally 113 patients with HCC in Henan Provincial People's Hospital between June 2016 to June 2018 were retrospectively analyzed.Among the 113 patients,46 patients underwent laparoscopic hepatectomy (LLR),and 67 patients underwent fluorescence guided laparoscopic hepatectomy (FLLR).Results No significant differences were observed between LLR group and FLLR group in terms of age,male proportion,liver function classification,surgical resection methods,and operation time (P＞0.05).The positive ratio of specimen surgical margin in LLR group was significantly higher than that in FLLR group,13.0％ vs.3.0％,and the difference was statistically significant (P＜0.05).In the FLLR group,22 patients received fluorescence guided anatomic hepatectomy with indocyanine green (ICG),10 with positive staining and 12 with negative staining,and fluorescence imaging was observed 2 minutes after ICG injection.There was no significant difference in operation time,hospitalization cost and length of stay between positive and negative staining (P＞ 0.05).Conclusion Fluorescence laparoscopy has certain advantages in hepatectomy,and can display the boundary of hepatocellular carcinoma in real time to ensure the safe margin of tumor resection.

Objective: To establish and hevaluate a detection method for influenza virus using reverse transcriptase-recombinase polymerase amplification (RT-RPA). Methods: RT-RPA was developed for detection of influenza viruses (type A and B) and subtyping of H1 and H3 using the primers targeted matrix and hemagglutinin (HA) genes of influenza A virus, and non-structural (NS) protein gene of influenza B virus. The specificity and sensitivity of RT-RPA were determined. Results: The RT-RPA for the detection of influenza viruses showed specific amplification products of corresponding target gene, but no amplification products for other respiratory viruses, indicating that the method had good specificity. The detection limits of RT-RPA were 100 copies/μl. RT-RPA combined with SYBR Green I was used for the detection of influenza B virus with the detection limit of 100 copies/μl. Conclusions The feasibility of detecting influenza virus by RT-RPA was preliminarily confirmed.

Objective: To construct a scientific behavioral research of pasta matrix reaching task (PMRT) and comprehensively evaluate sensory-motor dysfunction caused by brain injury. Methods: Twenty-one SD rats were subjected to 14-days pasta matrix grasping training and then were randomly divided into model group (11 rats) and sham group (6 rats). Motor cortex ischemia was induced by injection of endothelin-1 in SD rats. The number of pasta grabed by the injured forelimb and the location in matrix were evaluated daily 7 days after surgery. The infarct volume was measured by Nissl staining at the 7 days, 14 days, and 28 days after stroke. Results: The number of pasta obtained by rats was reduced from (33.43±1.02) to (20.57±0.57) at 7 days post stroke in model group, and then increased to (26.85±0.98) at 28 days post stroke, although there was a significant difference between sham group(32.33±1.45) and ischemic group (t=3.198, P<0.05). The frequency of retrieval from each slot of the pasta matrix represented that sham group demonstrated a significant gain in performance in the antero quadrant of the matrix compared to ischemic rats by the fourth week after stroke.The stroke volume was decreased from (37.82±1.17)mm³ at 7 days post-stroke to (24.35±0.38)mm³ at 28 days post-stroke, indicating brain recovery from ischemic injury. Conclusion The pasta matrix reaching task can function as a versatile and sensitive behavioral assay that permits experimenters to collect accurate outcome data and manipulate limb use to mimic human clinical phenomena including compensatory strategies and focused rehabilitative training after stroke.