Objective To investigate the impact of stenting at the origin of vertebral artery (VAO) on cognitive function in patients with first-onset temporal or thalamic infarction. Methods A total of 65 patients with first-onset temporal or thalamic infarction were selected as research subjects, and were diagnosed with new-onset infarction in the medial temporal lobe or thalamus by craniocerebral magnetic resonance imaging (MRI), and severe stenosis of VAO as the responsible vessel for infarction was confirmed by head and neck computed tomography angiography (CTA). A total of 35 patients who received VAO stenting were included in the stenting group, and 30 patients who received drug-based conservative treatment were included in the control group. The Montreal Cognitive Assessment Scale (MoCA), Wechsler Adult Intelligence Scale-Digit Span Test (WAIS-DS), and Fuld Object Memory Evaluation Scale (FOM) scores were compared between the two groups before treatment, 14 days and 3 months after treatment. Results Before treatment, there was no significant difference in the scores of each scale between the two groups (P>0.05). At 14 days and 3 months after treatment, the total MoCA score and the scores of visual space and executive function, delayed recall, and language dimension in the stenting group were higher than those in the control group (P < 0.05). The FOM score in the stenting group was higher than that in the control group at 3 months after treatment (P < 0.05). Conclusion Stenting can significantly improve the cognitive function of patients with temporal lobe and thalamic infarction.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

OBJECTIVE To explore the clinical efficacy and safety of Ruyi jinhuang powder for external application combined with immune checkpoint inhibitors （ICIs） in the treatment of patients with advanced liver cancer complicated with dampness and heat syndrome of liver and gallbladder. METHODS All patients with advanced liver cancer complicated with dampness and heat syndrome of liver and gallbladder were admitted to our hospital from January 2018 to June 2022 and assigned into observation group and control group according to random number table method. Patients in the control group （n＝56） were treated with ICIs （Navulizumab injection/Sintilimab injection/Camrelizumab for injection） 200 mg， ivgtt， 21 days as a treatment cycle. Patients in the observation group （n＝56） were additionally treated with Ruyi jinhuang powder for external application， once a day， on the basis of control group. The therapeutic effects of 2 groups were compared after a treatment cycle. The levels of interleukin-6 （IL- 6）， matrix metalloproteinase-9 （MMP-9）， cyclooxygenase-2 （COX-2）， prostaglandin E2 （PGE2）， carbohydrate antigen 199 （CA199）， alpha-fetoprotein （AFP） and vascular endothelial growth factor （VEGF） in serum were compared between 2 groups before and after treatment. Karnofsky functional status （KPS） score， digital rating scale （NRS） score， total symptom score of traditional Chinese medicine， and the occurrence of adverse reactions were recorded for both groups of patients. RESULTS After treatment， the levels of IL-6， MMP-9， COX-2， PGE2， CA199， AFP， VEGF， NRS score and total symptom score of traditional Chinese medicine in observation group were significantly lower than control group （P＜0.05）， KPS score was significantly higher than the control group （P＜0.05）. The zypp-04） total effective rate and remission rate of the observation group were 64.29% and 80.36%， those of control group were 60.71% and 73.21%. There was no statistical significance between two groups （P＞0.05）. The adverse drug reactions of both groups were mainly nausea and vomiting， liver function injury， fever hlshli@yeah.net and so on； the incidence of adverse reaction in observation group was significantly lower than that of control group （P＜0.05）. CONCLUSIONS In patients with advanced liver cancer complicated with dampness and heat syndrome of liver and gallbladder， the combination of Ruyi jinhuang powder for external application and ICIs can help inhibit the secretion of pain mediators， regulate vascular endothelial function， reduce the inflammatory response， promote the recovery of cardiopulmonary function， improve clinical efficacy and has good safety.

The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.

Objective:To compare the clinical efficacy, prognosis and complications between intravenous chemotherapy (IVC) combined with intra-arterial chemotherapy (IAC) and single IAC in the treatment of children retinoblastoma (RB).Methods:A cohort study was performed.A 4-year follow-up of 300 children (352 eyes) with intraocular RB enrolled in the Children's Hospital Affiliated of Zhengzhou University from June 2015 to June 2019 was conducted.According to the different treatment methods, the children were divided into IAC group (140 cases, 160 eyes) treated with IAC combined with local laser photocoagulation/cryotherapy and IVC+ IAC group (160 cases, 192 eyes) receiving IVC combined with IAC treatment.The clinical efficacy (eye salvage rate), survival and complication incidence of the two groups were compared.The survival analysis was performed by Kaplan-Meier method.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Children's Hospital Affiliated of Zhengzhou University (No.20150503). Written informed consent was obtained from custodians of each child prior to their entering into the cohort.Results:All of the children were followed up for 2-60 months.Within the follow-up, the eye retention rate of the IAC group and IVC+ IAC group was 85.62%(137/160) and 81.21%(154/192) respectively, without statistically significant difference ( P>0.05). The recurrence rate and metastasis rate of IAC group were 18.75%(30/160) and 8.57%(12/140), which were significantly higher than 10.94%(21/192) and 3.13%(5/160) of IVC+ IAC group ( χ2=4.299, P=0.038; χ2=4.143, P=0.042). There was no significant difference in one-year survival rate between the two groups ( χ2=1.766, P=0.184), but the overall survival rate of IVC+ IAC group was 95.00%(152/160), significantly higher than 88.57%(124/140) of IAC group ( χ2=4.193, P=0.041). Kaplan-Meier analysis showed that the overall recurrence-free, metastasis-free and survival rate of IVC+ IAC group were better than those of IAC group, and the differences were statistically significant (all at P<0.05). There was no significant difference in the incidence of eyelid edema and/or ptosis, fundus hemorrhage, enophthalmos and cataract between the two groups (all at P>0.05). The incidence of myelosuppression was 32.14%(45/140) in IAC group, significantly lower than 43.75%(70/160) of IVC+ IAC group ( χ2=4.255, P=0.039). Conclusions:Compared with single IAC treatment, IVC combined with IAC can reduce the metastasis rate, recurrence rate in RB child patient and improve the survival rate, but it is with relatively high incidence of systemic complications.

Objective:To detect the expression level of long non-coding RNA (lncRNA) nuclear receptor subfamily 2 group F member 2-antisense RNA 1 (NR2F2-AS1) and microRNA-129-5p (miR-129-5p) in glioma tissues and to explore its clinical significance.Methods:The glioma tissues of 103 patients with glioma who underwent surgical treatment in the neurosurgery department of Shanxi Provincial People′s Hospital from January 2015 to September 2016 and 50 normal brain tissues removed due to craniocerebral surgery in the same period were selected as the research objects. Real time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression levels of lncRNA NR2F2-AS1 and miR-129-5p in tissue samples. The correlation between the two indexes and the relationship between the expression changes of the two and clinicopathological parameters of glioma patients were analyzed. Kaplan Meier curve was used to analyze the 5-year cumulative survival rate of glioma patients with different expression levels of lncRNA NR2F2-AS1 and miR-129-5p. Cox regression analysis was used to analyze the factors affecting the poor prognosis of glioma patients.Results:Compared with normal brain tissue, the relative expression of lncRNA NR2F2-AS1 in glioma was higher and the relative expression of miR-129-5p was lower (all P<0.05). There was significant negative relationship between the relative expression of lncRNA NR2F2-AS1 and miR-129-5p in glioma ( r=-0.756, P<0.05). The expression of lncRNA NR2F2-AS1 and miR-129-5p in glioma was related to World Health Organization (WHO) grade and tumor length (all P<0.05). The 5-year cumulative survival rate of patients in lncRNA NR2F2-AS1<2.89 group was higher than that in lncRNA NR2F2-AS1≥2.89 group, and the 5-year cumulative survival rate of patients in miR-129-5p<0.55 group was lower than that in miR-129-5p≥0.55 group (all P<0.05). Multivariate analysis showed that high expression of lncRNA NR2F2-AS1, low expression of miR-129-5p, WHO grade Ⅲ-Ⅳ and tumor length were the risk factors affecting the prognosis of patients with glioma (all P<0.05). Conclusions:The increased expression of lncRNA NR2F2-AS1 and the decreased expression of miR-129-5p in glioma tissues are involved in the clinical biological progress of glioma and are closely related to the prognosis of patients.

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

Consensus ; Critical Illness ; Humans ; Serum Albumin ; Serum Albumin, Human

Objective:To investigate the inhibitory effect of adenovirus-mediated recombinant Buthus martensii Karsch chloride toxin artifact (Ad-rBmK CTa) on human glioma U251 cells and its related mechanisms.Methods:Groups of 3 titer gradients of 3.5×10 9, 7.0×10 9 and 3.5×10 10 pfu/ml Ad-rBmK CTa were set up and applied to U251 cells for 24, 48 and 72 h, and a blank control group (no cells and Ad-rBmK CTa were added) and a negative control group (only U251 cells were added) were set up at the same time. The virus infection status was observed by laser confocal fluorescence microscopy. The cell proliferation in each group was detected by methyl thiazolyl tetrazolium (MTT) assay. The cell cycle and apoptosis in each group were detected by flow cytometry. The expressions of apoptosis-related proteins bax, bcl-2 and caspase-3 were detected by Western blot. Results:The infection rate of Ad-rBmK CTa was over 90% after acting on U251 cells for 24 h. As the titer of Ad-rBmK CTa increased, the proliferation inhibition rate of U251 cells treated for the same hours gradually increased (all P <0.01); with the extension of time, the proliferation inhibition rate of U251 cells treated with the same titer of Ad-rBmK CTa also gradually increased (all P < 0.01). After 7.0×10 9 pfu/ml Ad-rBmK CTa acted on U251 cells for 48 h, the proportion of cells in G 0/G 1 phase was (40.7±0.8)%, and cells in S phase and G 2 phase accounted for (35.7±0.6)% and (23.6±1.4)%, and the difference was statistically significant ( F = 225.119, P < 0.01). When 7.0×10 9 pfu/ml Ad-rBmK CTa acted on U251 cells for 24, 48 and 72 h, the apoptosis rates were (7.4±1.4)%, (19.2±1.7)% and (22.3±1.7)% ( F = 49.470, P < 0.01). After 7.0×10 9 pfu/ml Ad-rBmK CTa acted on U251 cells for 48 h, compared with the negative control group, the expressions of bax and caspase-3 proteins increased, and the expressions of bcl-2 decreased. Conclusions:Ad-rBmK CTa may act on the DNA damage-induced G 1/S detection site to arrest the cell cycle in G 0/G 1 phase, thus inhibiting the proliferation of U251 cells in vitro. However, its induction of apoptosis in U251 cells is not obvious. The mechanism may be related to the direct or indirect inhibition of chloride ion channels.