Endoscopic features of esophageal high-grade intraepithelial neoplasia dominated by cytological atypia

Little is known about esophageal high-grade intraepithelial neoplasia dominated by cytological atypia (HGINc). We aimed to elucidate the endoscopic features of HGINc compared with esophageal high-grade intraepithelial neoplasia dominated by architectural atypia (HGINa). All patients pathologically diagnosed as esophageal high-grade intraepithelial neoplasia after endoscopic submucosal dissection at our center between January 2018 and December 2019 were included in this study. According to the pathological diagnosis, the patients were divided into two groups: HGINa group and HGINc group. Basic characteristics and endoscopic information were collected in detail. Data were analyzed statistically. Binary logistic regression was performed and a predictive model for HGINc was established. Then we evaluated its predictive value and built a nomogram for clinical application. A total of 175 patients were included in this study (126 with HGINa and 49 with HGINc). Among 228 lesions found in all patients, there were 148 HGINa and 80 HGINc. The independent relevant factors for HGINc were tobacco and alcohol usage, color, and gross type. To predict risk of HGINc, a three-factor model (TFM) was established with a highest area under curve (AUC) as 0.869 (95% CI, 0.852, 0.939). When the cut-off value was set as 0.3569184, the diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for HGINc was 81.14%, 88.75%, 77.03%, 67.62%, and 92.68%, respectively. HGINc differs greatly in endoscopic features from HGINa in our study. It’s important to reduce misdiagnosis that our model was established with good predictive value for clinical application.     

他克莫司对小鼠毛囊生长周期的影响

目的探讨他克莫司对小鼠毛囊生长周期的影响及其作用机制。方法应用苏木素-伊红（HE）染色及RT-PCR法研究他克莫司对小鼠毛囊生长周期影响。结果脱毛后第5天他克莫司组及米诺地尔组小鼠背部毛囊呈生长期Ⅴ状态,而凡士林组毛囊呈生长期Ⅲ状态。在脱毛后第5天他克莫司组及米诺地尔组小鼠背部皮肤检测到血管内皮细胞生长因子及肝细胞生长因子表达,而凡士林组未能检测到。结论他克莫司可通过促进毛囊提前进入生长期Ⅴ而达到促进毛发生长的作用,这种促进作用可能与血管内皮细胞生长因子及肝细胞生长因子作用有关。     

An association of elevated serum prolactin with phthalate exposure in adult men

Objective To investigate the associations of hormone circulation with phthalate exposure in adult men. Methods Semen and serum samples were collected from 118 men who were suspected of infertility. Phthalate diesters including dibutyl phthalate (DBP) and diethylhexyl phthalate (DEHP) in both semen and serum samples were measured, along with serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), estradiol (E 2 ) and prolactin (PRL). Results Serum PRL was positively as...     

运动负荷试验预测高血压的意义及运动触发高血压生化因子的变化

对４０例２２～３５岁血压正常的原发性高血压病患者子女以及２０例无高血压病者子女进行运动负荷试验。结果：前者１４例出现运动触发性高血压（≥３０．０／１２．７ｋＰａ），运动触发高血压者肾素活性、血管紧张素Ａ_２、血浆５－羟色胺浓度运动后均较正常血压者升高（Ｐ＜０．０５）；内源性洋地黄因子静息状态显著升高（Ｐ＜０．００１），而运动后降低；血小板５－羟色胺静息时无显著变化，运动后降低。高血压患者子女运动后心钠素较无高血压者子女升高（Ｐ＜０．０５），其中运动触发高血压者升高的较显著。前列环素、血栓素Ａ_２运动后较运动前升高，但差异无显著意义。     

A new model to predict acute kidney injury after cardiac surgery in patients with renal insufficiency

ObjectiveTo establish a simple model for predicting postoperative acute kidney injury (AKI) requiring renal replacement therapy (RRT) in patients with renal insufficiency (CKD stages 3–4) who underwent cardiac surgery.MethodsA total of 330 patients were enrolled. Among them, 226 were randomly selected for the development group and the remaining 104 for the validation group. The primary outcome was AKI requiring RRT. A nomogram was constructed based on the multivariate analysis with variables selected by the application of the least absolute shrinkage and selection operator. Meanwhile, the discrimination, calibration, and clinical power of the new model were assessed and compared with those of the Cleveland Clinic score and Simplified Renal Index (SRI) score in the validation group. Results: The rate of RRT in the development group was 10.6% (n = 24), while the rate in the validation group was 14.4% (n = 15). The new model included four variables such as postoperative creatinine, aortic cross‐clamping time, emergency, and preoperative cystatin C, with a C-index of 0.851 (95% CI, 0.779–0.924). In the validation group, the areas under the receiver operating characteristic curves for the new model, SRI score, and Cleveland Clinic score were 0.813, 0.791, and 0.786, respectively. Furthermore, the new model demonstrated greater clinical net benefits compared with the Cleveland Clinic score or SRI score.ConclusionsWe developed and validated a powerful predictive model for predicting severe AKI after cardiac surgery in patients with renal insufficiency, which would be helpful to assess the risk for severe AKI requiring RRT.     

MicroRNA-144在结肠癌中的表达水平及临床意义

目的探讨microRNA-144在结肠癌中的表达水平及其与临床病理特征的相关性。方法提取38例结肠癌及其正常结肠黏膜组织标本的总RNA,采用逆转录实时荧光定量聚合酶链反应(RT-qPCR)方法检测microRNA-144的表达量,并分析其与临床分期、分化程度、淋巴结转移等临床病理特征的关系。结果癌与癌旁正常结肠黏膜组织比较,microRNA-144在癌组织中高表达,相对表达量的中位数是2.30。其表达与TNM分期(P<0.05)、分化程度(P<0.05)相关,受试者工作特征(ROC)曲线分析显示,以相对表达量1.70为临界点时,microRNA-144作为评价结肠癌细胞分化程度,敏感性为88%,特异性为61.5%。结论 microRNA-144在结肠癌中的异常表达可能与结肠癌的发生、发展有关。     

Radiofrequency Ablation of Hepatic Metastases: Factors Influencing Local Tumor Progression

Background

Although radiofrequency ablation (RFA) of nonresectable hepatic metastases has gained wide acceptance by showing survival benefit in selected patients, scattered reports are available regarding risk factors of local control of percutaneous RFA. The purpose of this study was to prospectively evaluate the factors influencing local tumor progression after percutaneous RFA of hepatic metastases.

Methods

Sixty-nine hepatic metastatic lesions in 54 patients were treated by percutaneous RFA. Efficacy was evaluated by contrast-enhanced computed tomography or magnetic resonance imaging at 1 month after ablation, then at 3-month intervals for the first year and biannually thereafter.

Results

The results of the log-rank test showed that tumor size of <3 cm (p = 0.024) and the absence of tumor contiguous with large vessels (p = 0.002) significantly correlated with local control for hepatic metastases. Cox regression analysis showed that the tumor size <3 cm and the absence of tumor contiguous with large vessels were independent factors (p = 0.055 and 0.009, respectively). The results of the log-rank test showed that neither the threshold post-ablation margin of 1.8 cm (p = 0.064) nor the presence of a tumor with subcapsular location (p = 0.134) correlated with the success of local control.

Conclusions

Percutaneous RFA is more effective in achieving local control in patients with hepatic metastases when the tumor size is <3 cm and not contiguous with large vessels.     

Metabolic Risk Factors Are Associated with the Disease Severity and Prognosis of Hepatitis B Virus-Related Acute on Chronic Liver Failure

Background/AimsMetabolic risk factors could accelerate hepatitis B virus (HBV)-related mortality; however, their impacts on disease severity in HBV-related acute on chronic liver failure (HBV-ACLF) patients remain unexplored. In this study, we assessed the effects of metabolic risk factors on the outcome of HBV-ACLF patients.MethodsThis study retrospectively enrolled antiviral therapy naïve HBV-ACLF patients from a single center in China. Patients were evaluated according to Child-Turcotte-Pugh score, Model for End-Stage Liver Disease (MELD) score, 30-day, 90-day mortality and survival rate to estimate the prognosis of HBV-ACLF. The impacts of different metabolic risk factors were further analyzed.ResultsA total of 233 patients, including 158 (67.8%) with metabolic risk factors and 75 (32.2%) without metabolic risk factors, were finally analyzed. Patients with metabolic risk factors had significantly higher MELD score (22.6±6.1 vs 19.8±3.8, p<0.001), 90-day mortality rate (56.3% vs 38.7%, p=0.017), and shorter median survival time (58 days vs 75 days hazard ratio, 1.553; 95% confidence interval, 1.061 to 2.274; p=0.036) than patients without them. Moreover, metabolic risk factors were independently associated with patients’ 90-day mortality (hazard ratio, 1.621; 95% confidence interval, 1.016 to 2.585; p=0.043). Prediabetes/diabetes and hypertension were related to higher rates of infection and worse renal function in HBV-ACLF patients.ConclusionsHBV-ACLF patients with metabolic risk factors, especially prediabetes/diabetes or hypertension, could have more severe disease and lower survival rates. In addition, the existence of metabolic disorder is an independent risk factor for HBV-ACLF patients’ 90-day mortality.     

Aldosterone biosynthesis in extraadrenal tissues

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