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To observe the effects and safety of Tongyan Spray (通咽喷雾剂) on the range and time of hyoid motion in patients with ischemic post-stroke dysphagia. Seventy-two patients with ischemic post-stroke dysphagia were selected and randomly assigned to a treatment group (36 cases) and a control group (36 cases) by a random number table from January 2013 to October 2014. All patients swallowed 4 kinds of barium meals with different traits respectively, and each patient underwent video fluoroscopy (VF) examination twice. In the treatment group, Tongyan Spray was sprayed to the pharynx on both sides and the middle part once respectively. The spray was applied 30 min before the second examination. Purified water at room temperature was used as placebo in the control group. The changes in the range and time of hyoid motion in both groups were observed before and after treatment. Six patients dropped out in each group, and 60 patients completed the study and were included in the final analysis. Significant improvement was observed in the range of superior hyoid excursion distance and the time of hyoid motion in the treatment group compared with the control group (P

Hepatocellular carcinoma (HCC) was the third most common cause of cancer-associated mortality in China in 2015. Early detection of HCC and hepatic cirrhosis (HC) can serve a crucial role in the prevention and therapeutic intervention of these diseases. Current early detection methods rely on less sensitive imaging modalities compared with the pathological examination. In the present study, a total of 64 patients with HCC, 44 patients with HC and 298 individuals with no evidence of disease (NED) were recruited, and the ability of methylated septin 9 (mSEPT9) in diagnosing HCC and HC was investigated. The overall detection sensitivity of mSEPT9 for HCC and HC was 76.7 and 34.1%, respectively, with a 95.9% specificity (HCC vs. NED). The sensitivity of mSEPT9 for HCC was significantly higher than that of α-fetoprotein (AFP; χ2 test; 56.7%; P50 years of age exhibited higher sensitivity compared with those

Objective To explore the relationship between MRI types and epilepsy control following tumor removal of dysembryoplastic neuroepithelial tumor (DNT). Methods The clinical and follow ⁃ up data of DNT cases were retrospectively collected from January 2012 to July 2019, and the data were further analyzed with respect to prognostic factors. Results Epilepsy occurred in all cases. According to MRI⁃based classification, 8 patients belonged to type Ⅰ, 4 patients were type Ⅱ, and the other 2 patients were type Ⅲ. Tumor total removal was performed in all cases. Postoperative pathological HE staining confirmed each tumor simple contained specific neuronal components in all cases, and in 13 cases, synaptin (Syn), oligodendrocyte transcription factor 2 (Olig ⁃ 2) and neuronal nuclear antigen (NeuN) were positive in routine immunohistochemical staining. In the postoperative follow ⁃up period from 6-84 months, Engel Ⅰ outcome was achieved in all type Ⅰ cases and 2 type Ⅱ cases, Engel Ⅲ was in 2 type Ⅱ cases, Engel Ⅱ was in 2 type Ⅲ cases. Conclusions Postoperative seizure control in PNT may be closely associated with the MRI types, and type Ⅰ may have a better prognosis in seizure control following tumor removal than type Ⅱ and type Ⅲ. DOI：10.3969/j.issn.1672⁃6731.2020.03.014

Chemoembolization for hepatocellular carcinoma (HCC) is often suboptimal due to multiple involved signaling and lack of effective drugs. Arsenic trioxide (ATO) is a potent chemotherapeutic agent, which can target multiple signaling and have substantial efficacy on HCC. However, its usage is limited due to systemic toxicity. Using ATO-eluting beads/microspheres for chemoembolization can have locoregional drug delivery and avoid systemic exposure but will require high drug load, which has not been achieved due to low solubility of ATO. Through an innovative approach, we generated the transiently formed ATO microcrystals via micronization and stabilized these microcrystals by solvent exchange. By encapsulating ATO microcrystals, but not individual molecules, with poly(lactide-co-glycolic acid) (PLGA), we developed microspheres cored with extremely high dense ATO. The molar ratio between ATO and PLGA was 157.4:1 and drug load was 40.1%, which is 4–20 fold higher than that of reported ATO nano/microparticles. These microspheres sustainably induced reactive oxygen species, apoptosis, and cytotoxicity on HCC cells and reduced tumor growth by 80% via locoregional delivery. Chemoembolization on mice model showed that ATO-microcrystal loaded microspheres, but not ATO, inhibited HCC growth by 60–75%, which indicates ATO within these microspheres gains the chemoembolizing function via our innovative approach.

Background: The presence of significant liver fibrosis is a key determinant of long-term prognosis in non-alcoholic fatty liver disease (NAFLD). We aimed to develop a novel machine learning algorithm (MLA) to predict fibrosis severity in NAFLD and compared it with the most widely used non-invasive fibrosis biomarkers. Methods: We used a cohort of 553 adults with biopsy-proven NAFLD, who were randomly divided into a training cohort (n = 278) for the development of both logistic regression model (LRM) and MLA, and a validation cohort (n = 275). Significant fibrosis was defined as fibrosis stage F ≥ 2. MLA and LRM were derived from variables that were selected using a least absolute shrinkage and selection operator (LASSO) logistic regression algorithm. Results: In the training cohort, the variables selected by LASSO algorithm were body mass index, pro-collagen type III, collagen type IV, aspartate aminotransferase and albumin-to-globulin ratio. The diagnostic accuracy of MLA showed the highest values of area under the receiver operator characteristic curve (AUROC: 0.902, 95% CI 0.869-0.904) for identifying fibrosis F ≥ 2. The LRM AUROC was 0.764, 95% CI 0.710-0.816 and significantly better than the AST-to-Platelet ratio (AUROC 0.684, 95% CI 0.605-0.762), FIB-4 score (AUROC 0.594, 95% CI 0.503-0.685) and NAFLD Fibrosis Score (AUROC 0.557, 95% CI 0.470-0.644). In the validation cohort, MLA also showed the highest AUROC (0.893, 95% CI 0.864-0.901). The diagnostic accuracy of MLA outperformed that of LRM in all subgroups considered. Conclusions: Our newly developed MLA algorithm has excellent diagnostic performance for predicting fibrosis F ≥ 2 in patients with biopsy-confirmed NAFLD.

It is well known that the quality of life (QoL) of patients with chronic hepatitis C (HCV) is lower than that of the general population and that therapy with direct-acting antivirals (DAA) for HCV is safe and effective. However, data on the QoL of patients are scanty. The purpose of this study was to assess the effect of DAA drugs on patients' QoL.The literature included in this meta-analysis was due in March 2021. The random effect model of heterogeneous data and the fixed effect model of homogeneous data were used to analyze the data. QoL had to be evaluated using the Short Form Health Survey (SF-36) questionnaire with at least one measure at baseline (T0) and one measure at 12 weeks (T12) or 24 weeks (T24) after the end of therapy. The meta-analysis included eight studies, which involved 1,619 patients.At T12, the meta-analysis showed all items of the SF-36 questionnaire improved from the pretreatment to post-treatment period and reached statistical significance (p 0.05) except for the bodily pain (mean difference: 1.16, 95%CI -0.43-2.74) and role limitations-emotional (mean difference: 4.10, 95%CI -1.32-9.52). However, after subgroup analysis (whether ribavirin was being used or not), the bodily pain domain (mean difference: 3.34, 95%CI 1.03-5.65) became statistically significant again. At T24, the results indicated that all items of the SF-36 questionnaire improved from the pretreatment to the post-treatment period and reached statistical significance (p 0.05) except for the role limitations-emotional domain (mean difference: 4.50, 95%CI -2.66-11.66).There is evidence indicating that DAA therapy is accompanied by an improvement in QoL. Patients receiving DAA medication have a clinically relevant improvement in most domains of the SF-36 questionnaire at T12 or T24, except for a few aspects including role limitations-emotional.

Objective: Intraoperative rupture of an aneurysm is a known risk in the surgical management of intracranial aneurysms. The aim of the present study is to determine the risk factors for IPR.Methods: This study retrospectively examined 2302 patients with intracranial aneurysms treated surgically between December 1996 and July 2019. These patients were categorized into two groups according to whether they exhibited IPR or not: i) The non-IPR group; and ii) the IPR group. Multiple factors, including sex, age, history of SAH, Hunt-Hess grade, Fisher score, operation timing, surgical approach, GOS, size, side, site, number, orientation, morphology and adhesion to surrounding tissue, were analyzed to identify factors associated with IPR.Results: The overall rupture rate was 14.8%. Overall, the number of SAHs (1, ≥2) and aneurysm location (supraclinoid ICA and PICA) were found to be independent risk factors for IPR. This analysis revealed that in the MCA aneurysm database the risk for IPR decreased in patients aged >40 years. Furthermore, the present study identified a progressive increase in the risk of IPR with increasing H-H grade. Finally, in the ACOA aneurysm database the left pterional and coronal craniotomy approach increased the risk for IPR up to 1.99- and 15.153-fold, respectively, compared with the right pterional approach.Conclusions: The number of SAHs (1, ≥2) and aneurysms site (supraclinoid ICA and PICA), age ≤40 years, higher H-H grade and surgical approach (left pterional and coronal craniotomy) seem to be important factors affecting the incidence of IPR.

HLH is a catastrophic and likely underdiagnosed pathology with multiple triggers including infection. PVB19 can cause persistent marrow infection leading to HLH despite negative acute serologic markers making timely diagnosis difficult. Increased awareness of PVB19‐HLH is warranted given its potentially lethal nature and the careful interpretation required with serologic markers.

DJ-1 (also called PARK7) is a multifunctional redox-sensitive protein that is protective against oxidative stress-induced cell death. TAR DNA-binding protein 43 (TDP-43) is a major protein component of pathological inclusions in amyotrophic lateral sclerosis and frontotemporal dementia. Reducing aberrant aggregation of TDP-43 is a potential approach to prevent cell death. To investigate whether DJ-1 might inhibit TDP-43 aggregation to exert a protective effect in oxidative stress-induced injury, we tested the protein level and subcellular localization of TDP-43 and DJ-1 in SH-SY5Y cells transfected with wild-type DJ-1, DJ-1 mutant (L166P) cDNA, or DJ-1 siRNA. We show that oxidative stress induced by paraquat leads to the formation of cytosolic TDP-43 aggregation in SH-SY5Y cells. DJ-1 overexpression decreases paraquat-induced cytoplasmic accumulation of TDP-43 in SH-SY5Y cells and protects against paraquat-induced cell death. Transfection of DJ-1 L166P mutant or DJ-1 siRNA leads to increased cytosolic aggregation of TDP-43 in paraquat-treated SH-SY5Y cells and promotes cell death. These data suggest that DJ-1 may protect against oxidative stress-induced cell death through the suppression of cytoplasmic TDP-43 aggregation.