Microangiogenesis is an important prognostic factor in various cancers, including hepatocellular carcinoma (HCC). The Vascular Endothelial Growth Factor (VEGF) has been shown to contribute to tumor angiogenesis. Recently, several studies have investigated the regulation of VEGF production by a single gene, with few researchers exploring all genes that affect VEGF production. In this study, we comprehensively analyzed all genes affecting VEGF production in HCC and developed a risk model and gene-based risk score based on VEGF production. Moreover, the model's predictive capacity on prognosis of HCCs was verified using training and validation datasets. The developed model showed good prediction of the overall survival rate. Patients with a higher risk score experienced poor outcomes compared to those with a lower risk score. Furthermore, we identified the immunological causes of the poor prognosis of patients with high-risk scores comparing with those with low-risk scores.

Background: We aimed to evaluate the impact of pain on patients during Hysterosalpingography (HSG). Methods: PubMed, PMC and other journals were searched for randomized controlled trials (RCTS) on HSG. Appropriate articles were selected for inclusion and reasonable exclusion according to keywords. Following a thorough review of the relevant literature, the process of literature screening was conducted in accordance with the aforementioned criteria. The methodological quality of the studies was assessed using the risk of bias assessment tool developed by the Cochrane Collaboration. Meta -analysis was conducted using RevMan 5.4.1 software. Results: Twelve studies were included, including 1530 cases in the experimental group and 1545 cases in the control group. The literature summarizes the basic information of patients during HSG and makes statistics on the differences in visual analog scale (VAS) and pain perception. The findings from the HSG examination revealed a lack of significant association between patients' pain sensation and their age and BMI. However, the duration of pregnancy in patients decreased following HSG treatment (95%CI (-18.84 to -3.58), P=0.004).Compared with conventional testing, HSG could effectively reduce the pregnancy time of patients (95%CI (-18.84, -3.58), P=0.004), reduce the VAS of patients (95%CI (-4.73, -1.51), P=0.0001), and increase the number of patients without pain (95%CI (1.80, 10.43), P=0.001). Conclusion: During the HSG examination, acceptable pain avoidance is generated and can be relieved over time. At present, there is no effective alternative method, so the patient should cooperate with the doctor to complete the examination, to relieve the pain.

Purpose: Magnetic Resonance-High Intensity Focused Ultrasound (MR-HIFU) has revolutionized the treatment of Uterine fibroids. Usually, they are associated with prolonged heavy bleeding during the menstrual period, sacral pain, and increased frequency of UTIs, secondary dysmenorrhea, constipation, and pregnancy-associated problems. It also impacts usual activities, which lead to diminished quality of life and rising healthcare costs. Generally, surgery is the only choice for uterine fibroids; however, MR-HIFU is an entirely non-invasive novel therapy, preferred in pregnancy desiring females. Excluding trials with stringent treatment protocols that are no longer used, the efficacy of Magnetic Resonance-High Intensity Focused Ultrasound (MRHIFU) therapy for uterine fibroids is being re-evaluated. Methods: RCTs, Prospective or Retrospective non-randomized, and cross-over studies that considered clinically symptomatic uterine fibroid treatment were included. The author has searched the data in Cochrane Library, PubMed/MEDLINE, SCOPUS, EMBASE databases. Meta-Analysis was performed using NCSS software, and data were analyzed at a 95% confidence level with a level of precision at 0.05. The NPV%, tSSS change%, and QoL were computed. Meta-Regression was done to evaluate the association between the different parameters. Results: The overall effect of NPV% was 70.24, where the 95% confidence interval ranged from 61.9% to 78.16%. The overall impact of tSSS% change is near 50% after the follow-up of 3 months, 6 months, and 12 months in the included studies. There was a significant improvement in the health-related quality of life (Hr-QoL). Conclusion: The efficacy of MR-HIFU therapy was improved as treatment protocols aimed for total ablation. On the other hand, regulated studies are required to determine the function of MR-HIFU in the treatment of uterine fibroids.

Evidence displays that circular RNAs (circRNAs) are considerable mediators of numerous processes in cancer development. Given that many circRNAs are not functionally characterized, our aim was to explore the function and mechanisms of circ_0051428 in thyroid cancer (TC). The analysis of circ_0051428, miR-1248 and FN1 mRNA expression was conducted using real-time quantitative polymerase chain reaction. Cell growth was observed using CCK-8 and colony formation assays. Cell migration was investigated using wound healing assay. Cell apoptosis was identified by the expression of apoptosis-related proteins (Bax and Bcl-2) using Western blotting. Animal models were established to testify the role of circ_0051428 in vivo. The assumed binding between miR-1248 and circ_0051428 or FN1 was identified using dual-luciferase reporter or RIP assay. circ_0051428 exhibits an abnormally elevated expression in TC. circ_0051428 deficiency caused inhibition of TC cell proliferation, migration, clonogenic capacity, and inhibition of tumor growth in vivo. circ_0051428 directly targeted miR-1248, and FN1 was a target downstream of circ_0051428/miR-1248 axis. circ_0051428 could sponge miR-1248 to upregulate FN1. Furthermore, miR-1248 downregulation recovered circ_0051428 deficiency-suppressed cancer cell proliferation, survival and migration. Besides, the repressive effects of FN1 knockdown on cancer cell growth, survival and migration were also partly abolished by miR-1248 downregulation. circ_0051428 targeted miR-1248 to modulate FN1 expression, thereby facilitating the malignant progression of TC, which contributed to the understanding of the molecular mechanism of TC development.

目的 探讨多层螺旋CT(MSCT)对慢性肾衰竭(CRF)持续性血液透析患者肺部感染的诊断价值.方法 回顾性分析2019年1月-2020年12月在武汉市第三医院接受诊治的60例确诊为CRF持续性血液透析合并肺部感染患者的临床资料,比较患者胸部CT征象及分布特征.结果 CRF持续性血液透析患者肺部感染中混合感染发生率最高(35％),其次为细菌感染(25％).MSCT影像图像的结节征象显示率明显高于常规CT和高分辨率CT(P<0.05),其他征象3种CT技术均显示差异无统计学意义(P>0.05).结论 MSCT有助于显示CRF持续性血液透析患者肺部感染所致肺部实质、气管、血管改变,并能准确显示病灶的范围及特征,对于提高肺部感染的综合诊断具有重要意义.

INTRODUCTION:Magnetic resonance-high intensity focused ultrasound (MR-HIFU) has revolutionized the treatment of Uterine fibroids. Usually, they are associated with prolonged heavy bleeding during the menstrual period, sacral pain, and increased frequency of UTIs, secondary dysmenorrhea, constipation, and pregnancy-associated problems. It also impacts usual activities, which lead to diminished quality of life and rising healthcare costs. Generally, surgery is the only choice for uterine fibroids; however, MR-HIFU is an entirely non-invasive novel therapy, preferred in pregnancy desiring females. AIM:To re-evaluate the efficacy of magnetic resonance-high intensity focused ultrasound (MRHIFU) therapy for uterine fibroids. MATERIAL AND METHODS:Randomized clinical trials (RCTs), prospective or retrospective non-randomized, and cross-over studies that considered clinically symptomatic uterine fibroid treatment were included. Meta-analysis was performed using NCSS software, and data were analyzed at a 95% confidence level with a significance level of 0.05. In addition, the non-perfused volume percentage (NPV%), transformed Symptom Severity Score percentage change (tSSS change%), and health-related quality of life (HR-QoL) were computed. RESULTS:The overall effect of NPV% was 67.60%, where the 95% confidence interval ranged from 55.58% to 79.62%. The overall impact of tSSS% change was approximately 50% (0.54) with 95% CI of 0.41-0.66 of 3 months, 6 months, and 12 months in the included studies. There was a significant improvement in the health-related quality of life (HR-QoL). CONCLUSIONS:The efficacy of MR-HIFU therapy was improved as treatment protocols aimed for total ablation.

Objective: To investigate the clinical efficacy of polydocartanol foam sclerotherapy and conventional surgery in the treatment of varicose veins in lower extremities.Methods: 112 cases of VVLE patients hospitalized in the vascular surgery department of our hospital from September 2017 to August 2019 were included and divided into experimental group and control group according to different surgical methods, with 56 cases in each group. Both groups of VVLE patients received routine preoperative surgical examination and epidural anesthesia, in which the control group received conventional surgical treatment (high ligation and stripping of the great saphenous vein), and the experimental group received polydocartanol foam sclerosis. The operative time, length of hospital stay, intraoperative blood loss, subjective feeling improvement, postoperative pain (whether there is local pain, whether to take painkillers), and incidence of symptoms were observed and analyzed in each group.Results: Compared with the control group and experimental group, the operative time, hospital stay, and intraoperative blood loss were significantly reduced (P<0.05). Compared with the control group, there was no statistically significant difference in the subjective feelings of VVLE patients in the experimental group (P>0.05). Of the 56 VVLE patients in the experimental group (101 affected limbs), 32 (31.68%) had local pain, and 6 (10.71%) needed to take painkillers. Among the 56 patients with VVLE in the control group (105 affected limbs), 69 (65.71%) had local tenderness, and 21 (37.50%) needed a painkiller. The difference in the local pain rate and the painkiller rate between the two groups was statistically significant compared with the control group (P<0.05). In the experimental group, 3 (5.36%) cases of thrombophlebitis, 4 (7.14%) cases of skin pigmentation, and 3 (5.36%) cases of varicose vein residue occurred in VVLE patients, with a total incidence of 17.86%. In the control group, there were 6 (10.71%) cases of thrombophlebitis, 6 (10.71%) cases of skin pigmentation, 4 (7.14%) cases of varicose vein residue, and 7 (12.50%) cases of skin paresthesia, for a total of 41.07%. The difference in the postoperative complication rate between the two groups of VVLE patients was statistically significant (P<0.05).Conclusion: Polydocaryl foam sclerotherapy can effectively promote the recovery of VVLE patients and relieve their pain with higher safety and reliability. Compared with traditional surgical treatment, polydocaryl foam sclerotherapy has significant advantages, strong practicability, and is expected to be a new treatment method to replace traditional surgery.

目的 探讨介入性输卵管臭氧再通术(FTRO)联合微弹簧圈用于输卵管积水介入栓堵的治疗效果.方法 随机选取因输卵管积水进行介入栓堵的病例 80 例,其中,观察组40 例采用 FTRO 联合微弹簧圈栓堵,对照组 40 例以传统方法栓堵.随访栓堵后超声复查情况、子宫输卵管造影情况、月经改善情况、胚胎移植及宫内妊娠情况.结果 观察组超声复查积水明显改善,82.5％患者月经改善,与对照组相比有显著性差异(P＜0.05);胚胎移植成功率及宫内妊娠率较对照组也有所提高.结论 FTRO 联合微弹簧圈用于输卵管积水介入栓堵,临床效果明显优于传统栓堵法,技术简单,值得推广.

BACKGROUND:This study aimed to investigate the image quality and adverse events (AEs) of ethiodized poppyseed oil (EPO) compared with ioversol as contrast agents in hysterosalpingography (HSG). METHODS:Two hundred twenty-eight patients underwent HSG were consecutively recruited in this prospective cohort study, and were accordingly divided into EPO group (N = 165) and ioversol group (N = 63). The quality of image was assessed according to the European Guidelines on quality criteria for diagnostic radiographic images. AEs during, within 2 h and at 1-month post-HSG were recorded. RESULTS:EPO displayed elevated image quality compared with ioversol including the total image quality score (P < 0.001), the cervical canal display score (P < 0.001), shape and outline of uterus score (P < 0.01), cervical mucosa or folds score (P < 0.001), oviduct isthmus score (P < 0.001), ampulla and fimbriae of oviduct score (P < 0.001) and celiac diffuse image score (P < 0.001). Multivariate linear regression displayed that EPO (P < 0.001) was an independent predictive factor for increased total image quality score. AEs were similar between EPO group and ioversol group during and within 2 h post-HSG (all P > 0.05). However, at 1-month post-HSG, the number of patients had unchanged and faded menstrual blood color decreased but the proportion of patients with deepened menstrual color increased in EPO group compared with ioversol group (P = 0.007). In addition, the number of patients had iodine residue in uterine cavity was elevated in EPO group compared with ioversol group (P < 0.001). CONCLUSION:EPO is more efficient in image quality and equally tolerant compared to ioversol as contrast agents in HSG.

目的 观察介入治疗糖尿病患者下肢血管病变的临床疗效,并探讨其临床价值.方法 收集并分析42例行介入治疗的糖尿病下肢血管病变患者作为观察组,38例行常规保守治疗的糖尿病下肢血管病变患者作为对照组,对比两组患者治疗后血清TC,TG,LDL,HDL及D-二聚体的表达情况,评估两组患者的临床疗效,并进行对比分析.结果 两组患者在年龄、性别、吸烟史、病程及Fontaine分期中均未见显著差异,提示具有可比性.两组患者在静息疼痛、足面溃烂、四肢发冷及间歇跛行中存在显著差异,在其他症状中未见显著异常,在血清TC,TG,LDL,HDL及D-二聚体中存在显著差异.术后疗效对比结果显示:两组患者治愈率、无效率及总有效率比较差异具有统计学意义,有效率比较差异无统计学意义.结论 介入治疗能够有效缓解糖尿病患者下肢血管病变的临床症状,降低血清TC,TG,LDL和D-二聚体水平,升高HDL水平,提高总体有效率,具有良好的临床疗效.

目的 基于影像学分析骨髓水肿与股骨头坏死的关系.方法 选择股骨头坏死患者125例221髋,髋关节骨髓水肿分级0级73髋、Ⅰ级32髋、Ⅱ级61髋、Ⅲ级55髋.所有患者行X线、CT、MRI检查,记录硬化带、塌陷、关节腔积液及坏死区方位情况.评价这些影像学指标与骨髓水肿的关系.结果 股骨头坏死区塌陷、髋关节积液、股骨头坏死方位与骨髓水肿分级有关(P<0.05),表现为股骨头坏死区出现塌陷及股骨头坏死位于股骨头上方、前上方承重区时出现骨髓水肿的概率更高,并且随着髋关节积液增多,骨髓水肿逐渐加重.股骨头坏死区硬化带与骨髓水肿分级无关(P>0.05).结论 骨髓水肿与股骨头坏死区塌陷、髋关节积液及股骨头坏死方位有关,可提示病情进展,临床应予重视.

目的 运用磁共振血氧水平依赖功能磁共振成像技术(Bold-fMRI)、弥散加权成像(DWI)及弥散张量成像(DTI)成像技术,探讨严重烧伤早期脑组织损伤的神经机制.方法 研究采用前瞻性实验设计,35只健康雄性新西兰大白兔随机分成对照组及烧伤组(烧伤后1h、2h、3h、4h、5h、6h).采用体表烫伤法制作兔严重烧伤模型.运用磁共振Bold-fMRI、DWI及DTI成像技术采集相关磁共振图像,最后计算各组的表观弥散系数(ADC值)、各向异性分数值(FA值)、烧伤前后全脑肯德尔系数(ReHo值)以及脑含水量的变化情况.分析烧伤后脑含水量与ADC值、FA值、ReHo值的相关性.结果 与对照组相比,烧伤后4～6h兔脑所测感兴趣区(ROI)范围内ADC值出现显著降低,两者间差异有统计学意义(P＜0.05);而烧伤后各时间节点的FA值未见明显变化,差异无统计学意义(P＞0.05).和正常对照组相比,烧伤后兔脑主要表现为双侧额叶、岛叶及左侧丘脑间的ReHo值显著上升;而在右侧楔前叶、海马旁回及双侧颞叶ReHo值显著下降.与正常对照组相比,烧伤后兔脑含水量明显增加,且在1～6h内呈缓慢升高的趋势,尤以烧伤后3h为著.进一步与影像学资料进行相关性分析后发现:烧伤后脑含水量与ADC值呈负相关(r=-0.867,P＜0.01),与FA值无明确相关性(r=0.147,P=0.524),而与ReHo值呈正相关(r=0.734,P＜0.01).结论 重度烧伤后出现神经功能损害的神经机制可能是由于细胞毒性脑水肿引起,为烧伤患者治疗方案的选择奠定了可靠地理论基础.