Objective:To explore the feasibility of circulating tumor cell (CTC) dual-antibody enrichment and dual-antibody detection for epithelial-mesenchymal phenotypes in patients with hepatocellular carcinoma (HCC), and investigate the clinical diagnostic value of CTC typing in evaluating postoperative recurrence and prognosis of HCC.Methods:Of 89 HCC patients who underwent surgical treatment in Zhejiang Jinhua Guangfu Tumor Hospital from March 2020 to January 2024 were enrolled into this study, including 73 males and 16 females, aged (64.4±9.5) years old. The peripheral blood samples of patients were collected before operation. Epithelial CTC, mesenchymal CTC and hybrid epithelial-mesenchymal CTC in blood samples of patients with HCC were enriched and detected by EpCAM/CSV double capture antibodies and PanCK/CSV double detection antibodies. Kaplan-Meier analysis was employed to assess recurrence-free survival (RFS) and overall survival (OS) rates. Univariate and multivariate Cox regression were used to analyze the effects of different types of CTC on postoperative RFS and OS.Results:The detection rates of total CTC, epithelial CTC, mesenchymal CTC and hybrid epithelial-mesenchymal CTC were 92.1% (82/89), 64.0% (57/89), 62.9% (56/89) and 55.1% (49/89), respectively. Multivariate Cox regression analysis showed that HCC patients with more mesenchymal CTC ( HR=2.408, 95% CI: 1.580-3.668) and hybrid epithelial-mesenchymal CTC ( HR=1.840, 95% CI: 1.004-3.371) in peripheral blood had higher postoperative recurrence risk (both P<0.05). Univariate Cox regression showed patients with more total CTC ( HR=1.426, 95% CI: 1.040-1.954, P=0.028) was associated with survival. Conclusion:The technique of epithelial-mesenchymal phenotypes analysis of circulating tumor cells based on dual-antibody capture and dual-antibody detection is feasible. The number of mesenchymal CTC and hybrid epithelial-mesenchymal CTC before operation is the influencing factor of postoperative recurrence in patients with hepatocellular carcinoma.

Objective:To investigate the mechanism of dexmetomidine (DEX) in improving lung injury in septic mice.Methods:Male C57BL/6 mice were randomly assigned to the blank group (NC), sham operation group (sham), cecal ligation and puncture group (CLP), and Dex treatment group (CLP+DEX), 36 mice per group. Mice in the CLP group were intraperitoneally injected with 1 mL sterile saline 15 min before CLP, and mice in the CLP + DEX group were intraperitoneally injected with 50 μg/kg DEX 15 min before CLP. The survival rate was recorded within 24 h after CLP. The mice were sacrificed at 0, 3, 6, 12, and 24 h after CLP, and lung tissues were collected. The expression levels of cytokines (IL-6, IL-1β, TNF-α) and lncRNA-HOTAIR in the lung of mice were detected by qPCR. RAW264.7 cell were cultured in vitro, LPS (100 ng/mL) and DEX (1 μ mol/L) were used to establish a cell model for studying the mechanism of Dex, and the expression of cytokines (IL-6, IL-1β, TNF-α) and lncRNA-HOTAIR in RAW264.7 cell model were detected by qPCR. In addition, the effect of lncRNA-HOTAIR on sepsis was explored in vivo and in vitro by knockdown or overexpression of HOTAIR.Results:The survival rate of the CLP+DEX group was higher than that of the CLP group within 24 h after surgery, and the levels of IL-6, IL-1β, and TNF-α in the lungs were significantly lower than those in the CLP group at 6, 12, and 24 h after surgery ( P<0.05). In addition, the level of lncRNA HOTAIR showed that the expression level of lncRNA HOTAIR in the lungs of mice were decreased after Dex treatment, and were decreased 1.1 times ( P<0.05), 4.0 times ( P<0.01) and 3.8 times ( P<0.01) at 6, 12, and 24 h, respectively. Compared with the NC group, knockdown of HOTAIR significantly decreased the levels of IL-1β, IL-6, and TNF-α in septic mice ( P<0.05), and overexpression of HOTAIR significantly increased the levels of IL-1β, IL-6, and TNF-α in septic mice ( P<0.01). Conclusions:DEX can reduce the production of inflammatory factors in the lungs of septic mice and improve the survival rate of septic mice. The mechanism may be related to the inhibition of HOTAIR expression.

ObjectiveTo screen the risk factors of osteoporosis in perimenopausal women， and to provide direction for timely prevention and treatment. MethodsUsing multilevel stratified random sampling method， the perimenopausal women were investigated by questionnaire survey， and the determination of bone mineral density （BMD） and the levels of several important hormones. ResultsA total of 720 valid questionnaires were received. Among 720 perimenopausal women， 173 had osteoporosis and 547 had no osteoporosis. Univariate analysis of the influencing factors of osteoporosis showed that the levels of parathyroid hormone （PTH）， Estradiol （E₂）， body mass index （BMI）， age， time of last period and age of menopause were significantly different among perimenopausal women in the prevalence of osteoporosis（χ²=4.23， 4.86， 16.06， 21.04， 10.52， 13.02； P<0.05）.Logistic regression analysis showed that the increase of PTH （OR=2.70， P<0.05）and menopause （OR=1.76， P<0.05） were the risk factors of osteoporosis . Higher BMI（OR=0.65， P<0.05）， higher personal monthly income（OR=0.72， P<0.05）， longer sunshine time（OR=0.69， P<0.05）， were the protective factors against osteoporosis. ConclusionThe increase of PTH levels and menopause are the risk factors for osteoporosis in women. Perimenopausal women should be monitored for bone mineral density and appropriate intervention. Necessary treatment measures should be taken for the patients with osteopenia and osteoporosis.

Objective:To explore diagnostic value of tumor necrosis factor-α (TNF-α) in patients with pulmonary infection after liver transplantation.Methods:The clinical data of 80 patients with pulmonary infection after liver transplantation in the the First Affiliated Hospital of Xinjiang Medical University from January 2016 to May 2019 were retrospectively analyzed. According to different pathogens, they were divided into bacteria infection group ( n=35) and non-bacteria infection group ( n=45). The general data, levels of serum TNF-α, C-reactive protein (CRP) and procalcitonin (PCT) were compared between the two groups. Logistic regression was performed to explore risk factors for pulmonary infection after liver transplantation. Receiver operating characteristic (ROC) curves were performed to analyze diagnostic value of TNF-α, CRP and PCT. Results:The levels of serum TNF-α, CRP and PCT in bacteria infection group were significantly higher than those in non-bacteria infection group ( P<0.05). Multivariate analysis showed that high TNF-α, CRP, and PCT levels were independent risk factors for bacterial pneumonia after liver transplantation. ROC analysis showed that sensitivity, specificity and areas under ROC curves (AUC) of TNF-α, CRP and PCT for diagnosis of bacterial pulmonary infection after liver transplantation were (80.12%, 72.12%, 80.18%), (83.45%, 73.46%, 83.38%) and (0.802, 0.751, 0.803), respectively. The AUC, sensitivity, and specificity between TNF-α and PCT for diagnosis of bacterial pulmonary infection after liver transplantation were similar ( P>0.05). The AUC, sensitivity and specificity of TNF-α for diagnosis of bacterial pulmonary infection after liver transplantation were better than those of CRP ( P<0.05). Conclusions:The diagnostic value of TNF-α for pulmonary infection after liver transplantation is similar to that of PCT, and is superior to CRP. It can be applied as a reliable index for identifying bacterial pneumonia and non-bacterial pneumonia.

Objective To explore the spatial-temporal characteristics and changing regularities of Schistosoma japonicum in-fections among human from 2004 to 2011. Methods The township level spatial databases of schistosomiasis in Hunan Province from 2004 to 2011 were established,and the related spatial analysis was performed by SPSS 17.0,ArcGIS 10.1 and SaTScan 7.03. Results The schistosome infection rate among human in Hunan Province sharply decreased from 3.0％in 2004 to 0.8％in 2011. However,the rate among residents in parts of some townships in 2011 was still hovering at a higher level (P90=2.12％),and the higher rate was distributed along the Oncomelania hupensis snail ridden areas outside embankment. The auto-correlation analysis showed that the global Moran's I for schistosome infection rate among human was 0.34 to 0.53 from 2004 to 2011,and was higher than the expected value(Z>8.71,P<0.05). The local G statistics indicated that the positive hotspot high-high clustering areas were mainly near the coast of Dongting Lake from 2004 to 2011,and the number of townships with schistosomiasis endemic in the clustering areas reached 30 to 70. The spatial scan analysis showed that the number of townships in the clustering areas ran up to 145 to 183 from 2004 to 2011. Conclusions The schistosome infection rate among human de-creased significantly in Hunan Province from 2004 to 2011. However,the rate in parts of some townships still remains at a com-paratively high level,and there are positive spatial correlation and spatial agglomerations in the schistosome infection rate among human,suggesting that the prevention and control work on schistosomiasis in these areas should be strengthened in the fu-ture.

s] Objective To evaluate the effect of comprehensive schistosomiasis control measures with focus on total removal of cattle and sheep in Junshan District,Yueyang City. Methods The retrospective review and field survey were implemented in the pilot villages in Junshan District. The data of Schistosoma japonicum infection status of human,cattle,sheep and Oncome-lania hupensis snails,and density of snails were gathered and modeled in the period of 2006 to 2016. Results The prevalence of schistosome infection in residents in the pilot villages decreased from 3.44％ in 2006 to 0.59％ in 2012(F = 14.501,P =0.013). After removal of all the cattle and sheep in 2013,the prevalence of schistosome infection in the residents decreased to zero in 2016(F=14.148,P=0.033). The density of living snails decreased from 0.8833/0.1 m2 in 2006 to 0.3088/0.1 m2 in 2012(F=76.250,P=0.005). Conclusion The comprehensive schistosomiasis control strategy with focus on cattle and sheep removal is remarkably effective.

Objective To understand the spatial distribution characteristics of wild feces in schistosomiasis endemic areas of Jiangling County,Hubei Province and further explore the source of infection efficiently,so as to provide the evidence for the development of corresponding monitoring and response technology. Methods In 2011,the fresh wild feces were investigated every two months in the selected 15 villages by the severity of historical endemic in Jiangling County. The schistosome miracidi-um hatching method was used to test the schistosome infection of the wild feces. The descriptive analysis and spatial analysis were used for the description of the spatial distribution of the wild feces. Results Totally 701 wild feces samples were collected with the average density of 0.0556/100 m2,and the positive rate of the wild feces was 11.70%(82/701). The results of the re-gression analysis showed a positive spatial correlation between the positive rate of wild feces and the rate of human infection,the area with infected Oncomelania hupensis and the number of fenced cattle,and the corrected R2 of the model was 0.58. Conclu-sion The infection rate of wild feces is positively correlated with the rate of human infection,area with infected O. hupensis and number of fenced cattle in space in Jiangling County,so the prevention and control measures could be conducted according to the spatial distribution of the positive wild feces.

Objective To investigate the temporal and spatial distribution of Schistosoma infection of population and its risk factors in Eastern Dongting Lake area in 2012 and 2014,so as to provide the reference for formulating effective intervention mea-sures. Methods Junshan District was selected as a study field in Eastern Dongting Lake area. The method of spatial autocorre-lation analysis was applied to analyze the change of spatial distribution of Schistosoma infection in Junshan District in 2012 and 2014. The spatial regression model was fitted to detect the risk factors for human infection. Results The livestock infection rate in 2013 was lower than that in 2011. The average infection rate of schistosome was reduced to 0.55%in 2014. The spatial auto-correlation existed on the distribution of schistosomiasis in Junshan District in both 2012 and 2014 and 4 high incidence villages were identified. The results of the spatial error model showed that the prevalence of human infection was positively correlated with the infection rate of the livestock and the area of the susceptible environment in 2012. The spatial lag model showed that the prevalence of human schistosomiasis was positively correlated with the area of the susceptible environment ,but not with the in-fection rate of livestock. Conclusion The measures involving grazing prohibition and phasing out cattle and sheep are remark-ably effective and should continue on the basis of the current spatial distribution of schistosomiasis in this area.

Objective To observe the clinical efficacy of bipolar hemi arthroplasty and PFNA internal fixation for elderly patients with unstable intertrochanteric fracture.Methods The data of 79 elderly patients with unstable intertrochanteric fracture in our hospital from Au-gust 2013 to August 2014 were analyzed retrospectively.According to different surgical methods,79 cases were divided into observation group (n =40)and control group(n =39).The observation group were treated by artificially double-acting avascular replacement,and the control group received PFNA internal fixation.The operation time,intraoperatve blood soss,bedridden time,clinical effecacy and complications were recorded and observed.Results The operative time and bed time of observation group were significantly shorter than those of control group, the difference was statistically significant(P <0.05).The total postoperative complication rate of observation group was 20.00%,which was higher than 20.51% of control group,the difference was statistically significant (P <0.05).The Harris scores in observation group 3 months and 6 months after surgery were significantly higher than those in control group,the differences were statistically significant(P <0.05).Con-clusion Both artificially double-acting avascular replacement and PFNA internal fixation have a good effect on elderly patients with unstable intertrochanteric fracture.The artificially double-acting avascular replacement has the advantages of less blood loss,faster recovery and less postoperative complications,which is conducive to improving the quality of life of patients.

Objective To investigate the tempo?spatial patterns of schistosomiasis in Jiangling County,Hubei Province,so as to identify the risk areas and provide the scientific evidence in following intervention plans for marshland epidemic areas in the stage of transmission control. Methods The schistosomiasis epidemiological data in Jiangling County from 2009 to 2013 to?gether with the related geographical information were collected and analyzed. The tempo?spatial distribution patterns were ana?lyzed by the spatial autocorrelation analysis and spatial clustering analysis. Results The human infection rate was decreased from 2.15%in 2009 to 0.63%in 2013,which was the historically low level. The results of tempo?spatial analysis showed that there were spatial clustering effects in human schistosomiasis infection for each of the years. The values of spatial autocorrelation index Moran’s I were statistically significant. Eighteen and thirty?five clusters were detected by using SatScan and FlexScan soft?ware,respectively. Conclusions From 2009 to 2013,the schistosomiasis endemic situation in Jiangling County presented a decline trend and reached the historical low level. The identified spatial clustering areas should be targeted as the prioritized ar?eas for schistosomiasis control.