Objective To systematically review the efficacy of different artificial liver support systems in the treatment of acute-on-chronic liver failure (ACLF) using a network Meta-analysis. Methods PubMed, Embase, the Cochrane library, Clinical Trial, CNKI, SinoMed, and Wanfang Data were searched for randomized controlled trials (RCTs) on different artificial liver support systems in the treatment of ACLF. Literature screening, data extraction, and method ological quality assessment were performed according to inclusion and exclusion criteria, and Stata15.1 software and R4.1.0 software were used to perform a network Meta-analysis. Results A total of 14 RCTs were included, with 1141 patients in total. The network meta-analysis showed different intervention methods had no significant difference in reducing mortality rate based on cross comparison (all P > 0.05). The probability ranking diagram showed that plasma exchange (PE) showed the best effect in reducing 30-day mortality rate, followed by extracorporeal liver assist device (ELAD), fractionated plasma separation and adsorption with Prometheus system, molecular adsorbent recirculating system (MARS), Biologic-DT liver dialysis device, and PE+MARS. PE showed the best effect in reducing 90-day mortality rate, followed by Prometheus, ELAD, and MARS. Biologic-DT showed the best effect in improving hepatic encephalopathy, followed by MARS, PE+MARS, and ELAD. Patients undergoing ELAD had the lowest risk of bleeding, and compared with standard medical treatment, Biologic-DT might increase the risk of bleeding [risk ratio=1.9×10 8 , 95% confidence interval: (4.6-6.2)×10 27 ]. Conclusion PE might be the best option for reducing 30- and 90-day mortality rates in ACLF patients. Biologic-DT has a better effect in improving hepatic encephalopathy, but it may increase the risk of bleeding.

Thoracic aortic disease, which involves some of the arch vessels, is challenging to treat because of its complex anatomical structure and variation. With the progress and development of endovascular repair technology, in situ fenestration and pre-fenestration have become important measures for the treatment of thoracic aortic diseases. In recent years, there have been a series of reports on the application of in situ fenestration or pre-fenestration in a few centers, and the preliminary results are satisfactory. However, there are some problems such as single operation and small sample size. In order to further compare and analyze the safety and efficacy between the two operations, meta-analysis was conducted by searching Pubmed, Embase, Cochrane, Web of Science, China National Knowledge Infrastructure, Wanfang data, VIP data and China Biology Medicine disc. There was no significant difference in technical success rate, 30-day mortality, endoleak rate and reintervention rate between the two methods. The application of surgical methods can be determined according to the patient's condition and the surgeon's clinical experience.

Objective:To investigate the clinicopathological features of fumarate hydratase (FH) deficiency uterine leiomyoma.Methods:The data of 38 patients with FH deficiency uterine leiomyoma were screened and analyzed. The expressions of FH, S-(2-succino)-cysteine (2SC), desmin, p16, p53, CD 10 and cell proliferation associated nuclear antigen (Ki-67) proteins were detected by immunohistochemistry, and their clinicopathological features were analyzed retrospectively. Results:(1) Clinical features: the median age of the patients was (42.5±7.4) years old. Twenty-one cases (55%) of them were myomas found in physical examination, and the median maximum diameter of the tumor was 6.0 cm (range: 5.0-7.5 cm); myomectomy was performed in 23 cases (61%), total hysterectomy with or without bilateral appendages in 15 cases (39%); laparoscopic surgery in 27 cases (71%), open surgery in 11 cases (29%); none of the patients had renal cell carcinoma. (2) Histological features: atypical nuclear cells were distributed locally or diffusely, eosinophilic nucleoli and intranuclear inclusion bodies could be seen, glass like globules could be seen in the cytoplasm, nuclear division was 0-4/10 high power field (HPF), and antler like blood vessels and pulmonary edema-like changes could be seen in the stroma. Among 38 patients with FH deficiency uterine leiomyoma, FH was negative in 37 cases (97%), and positive in 1 case (3%); 2SC, desmin, p16, p53, CD 10 and Ki-67 showed focal positive expression in 38 cases (100%), including 35 cases (92%) with Ki-67 index<10% and 3 cases (8%) with Ki-67 index ≥10%. (3) Follow-up: 4 cases (11%) recurred, and there was no death. There were significant differences in age, family history, distribution of atypical nuclei and mitosis number between recurrent group and non-recurrent group (all P<0.05). Conclusions:FH deficiency uterine leiomyoma is a rare tumor, which needs pathological examination,immunohistochemical examination and clinical history. Patients younger than 43 years old, with family history, histologically atypical diffuse nuclear distribution and mitotic number ≥3/10 HPF should be alert to the risk of recurrence.

Objective:To investigate the infection rate in close contacts of COVID-19 patients before and after the last negative nucleic acid test, evaluate the effect of dynamic nucleic acid test in determining the infectivity of COVID-19 patients.Methods:Dynamic nucleic acid test results of COVID-19 cases were collected in a retrospective cohort study. COVID-19 cases with negative nucleic acid test results before their first positive nucleic acid tests were selected as study subjects. Close contacts of the index cases and the secondary close contacts were kept isolation for medical observation to assess their risk of infection.Results:This study included 89 confirmed cases from two local COVID-19 epidemics in Ningbo. A total of 5 609 close contacts were surveyed, the overall infection rate was 0.20%. No close contacts of the COVID-19 cases before the last negative nucleic acid test were infected, and the infection rate in the close contacts of the COVID-19 cases after the last negative nucleic acid test was 1.33%, all of these close contacts lived together with the index cases. No secondary close contacts were infected.Conclusion:COVID-19 patient becomes infectious after the last nucleic acid is negative, and has no infectivity before the last nucleic acid negative.

To evaluate the value of ultrasonography in diagnosing peripheral intraneural vascular anomalies . Methods The ultrasonographic images of 10 patients with peripheral intraneural vascular anomalies confirmed by surgery or pathology were retrospectively analyzed . T he ultrasonographic features were summarized . Results T he ultrasonographic images could not only clearly show the location , involvement and blood supply of peripheral intraneural vascular anomalies , but also determined the classification of them . Ultrasonography showed enlarging nerves ,within w hich tubular structures could be observed ,and the boundary between the vascular malformations and the perineurium was not clear . Abundant arteriovenous blood flow ( arteriovenous malformation) or low velocity venous blood flow ( venous malformation) within the vascular anomalies could be detected by color Doppler examination . Conclusions Ultrasonography is the preferred imaging method for diagnosis of peripheral intraneural vascular anomalies .

Objective To investigate the expressiorn of microRNA-622(miR-622) and dual specificity tyrosine phosphorylation-regulated kinase 2 (DYRK2) in colon cancer tissues and cell lines and explore the effect of miR-622 on SW11l6 cells migration and invasion.Methods Eighty-two colon cancer tissues and paired para-tumor tissue specimens were collected.C.olon cancer cell line SW1116,SW480 and normal human colon epithelial cell line NCM460 were cultured.MiR-622 was detected by using Real time PCR,DYRK2 expression was measured by using immunohistochemistry,Real time PCR anid Western blot in tissue level and cell level,respectively.The relation of miR-622 and DYRK2 was analyzed by Pearson correlation analysis.miR-622 mimics transfection was conducted to up-regulate miR-622,while negative control,NC group were transfected with control sequence.Expression of DYRK2 was evaluated by using Real time PCR and Western blot,while Transwell chamber assays were used to assess the migration ability changes.Results Real time PCR and Western blot results showed that miR-622 mRNA was highly expressed in colorectal cancer tissue and colon cancer cell SW1116,whereas DYRK2 mRNA and protein were lowly expressed when compared with paracancerous tissue and normal colonic epithelial cell line NCM460.An obvious negative correlation was showed between miR-622 and DYRK2(r=0.916,P＜0.01).Compared to NC group,DYRK2 mRNA and protein expression were down-regulated after transfection of miR-622 mimics,which was observerd through Real time PCR and Western blot(P＜0.01).Correspondingly,compared to NC group,the migration ability of SW116 was remarkably enhanced after transfection of miR-622 mimics(P＜0.01).Conclusion The expression of miR-622 is high and DYRK2 is low in colon cancer.Up-regulation of miR-622 could negatively regulate DYRK2 expression and promote SW1116 cells migration.

Objective To evaluate the value of ultrasonography in diagnosing intraneural ganglion cysts . Methods The ultrasonographic images of 12 patients with intraneural ganglion cysts confirmed by surgery and pathology were retrospectively analyzed . The ultrasonographic features were summarized . Results The ultrasonographic images showed the location ,number ,size ,shape ,boundary ,internal echo , involvement extent and blood supply in intraneural ganglion cysts clearly . Intraneural ganglion cysts showed cystic masses within peripheral nerve ,boundary clear ,irregular-shaped ,ill-acoustic transmissibility ,and separations are common ,color Doppler examination showed no blood flow inside the cysts . Conclusions High frequency sonography is the preferred imaging method for diagnosis of intraneural ganglion cysts .

Objective To evaluate the value of color Doppler ultrasonography in diagnosing cystic adventitial disease of the popliteal artery . Methods The ultrasonographic images of 12 patients with cystic adventitial disease of the popliteal artery confirmed by surgery and pathology were retrospectivly analyzed . The ultrasonographic features were summarized . Results The ultrasonographic images showed the location ,number ,size and the compression of popliteal artery . Cystic adventitial disease of the popliteal artery showed cystic masses within popliteal artery wall . The tunica media and tunica externa were separated . Slender separations could be found in some cysts . Color Doppler ultrasonography showed no blood flow inside the cysts . When the popliteal artery was compressed ,the velocity of blood flow increased significantly . The affected popliteal artery diameter was less than that of the contralateral side [ ( 2 .858 ± 1 .256)mm vs (5 .500 ± 0 .095)mm , t ＝7 .531 , P ＜0 .01] ,the peak flow velocity of the affected popliteal artery was higher than that of the contralateral side[(213.750±119.464)cm/svs(57.417±4.209)cm/s, t ＝4 .465 , P ＜0 .01] ,the peak flow velocity of the affected posterior tibial artery was lower than that of the contralateralside[(32.417±14.569)cm/svs(47.250±4.115)cm/s,t ＝4.318,P ＜0.01] .Conclusions Color Doppler ultrasonography is the preferred imaging method for diagnosis of cystic adventitial disease of the popliteal artery .

Objective To explore the effect of different levels of iodine excess on morphological changes of mouse thyroid follicle and pancreatic acinar cells.Methods Sixty female mice (BALB/c) were selected and their body weight were 18-22 g.The mice were divided into 6 groups according to body weight via the random number table method,10 mice in each group.Potassium iodate was added to drinking water in exposure groups with iodine contents of 300,600,1 200,2 400,and 4 800 μg/L,while normal group (control) was given normal levels of iodine (5 μg/L) tap water.After feeding for one month,the thyroid and pancreas of the mice were harvested,and the morphology of thyroid follicle and pancreatic acinar cells were observed through light microscope and ultrastructural changes of pancreas were observed through electron microscope.Results After one month of feeding,mice in the high iodine drinking water groups,starting from the 1 200 μg/L group,thyroid follicular cavity gradually enlarged and cells became flat;swollen and vacuolar-like deformation were observed in the mouse pancreas acinar cells under light microscope.Under the electron microscope,the ultrastructure of pancreatic acinar cells changed significantly starting from the 600 μg/L group,the number of zymogens decreased,organelle degeneration and necrosis,and endoplasmic reticulum expanded.Conclusion Iodine excess can cause damage to pancreatic acinar cells in mice.

Objective To establish a HPLC method for simultaneously determining the content of dexamethasone ace-tate ,camphor and phenol in compound cream .Methods The separation was performed on a SHIADZU-GL Inertsil? ODS-3 RP C18 analytical column with the mobile phase consisting of methanol-water (60:40) .The flow rate was 1 .0 ml/min .The detection wave length was 285 nm and the column temperature was 40 ℃ .Results Dexamethasone acetate ,camphor and phe-nol showed good linearity (r> 0 .9995 , n= 7) within the concentration range of 4 .024-40 .24 ,101 .7-2033 and 10 .38-425 .2 μg/ml ,respectively . The average recovery of dexamethasone acetate ,camphor and phenol was 101 .2％ (RSD was 0.56％ ) ,99 .89％ (RSD was 0 .72％ ) ,100 .2％ (RSD was 0 .97％ ) ,respectively .Moreover ,the RSDs were less than 1 .5％ in the repeated tests .Conclusion The method was simple ,quick and accurate .It is suitable for the quality control of dexametha-sone acetate camphor and phenol cream .