Hepatic epithelioid hemangioendothelioma (HEHE) is a rare tumor of vascular origin. Whether HEHE in Chinese patients exhibits similar characteristics compared with Western patients is not well known. The aim of the present study was to summarize the characteristics of HEHE in Chinese patients and identify its prognostic factors. In total, six patients diagnosed with HEHE at the Beijing Friendship Hospital between 2000 and 2012 were combined with 44 previously reported cases in China, retrieved from the literature between 1989 and mid-2012. These 50 cases from China were compared with 402 patients from Western populations. Prognostic factors were identified by the χ2 test and Cox regression analysis. The male to female ratio of the Chinese patients was 1:2.1 with the mean age of 44.2 years (range, 22–86 years). The percentage of asymptomatic Chinese patients was significantly higher than in the Western patients (40.0 vs. 24.8%; P=0.026), and that of extrahepatic metastasis (16.0 vs. 36.6%; P=0.005) was significantly lower in Chinese patients. On imaging study, capsular retraction (59.5%) and calcification (26.0%), as well as positivity of CD34 (93.5%) and CD31 (80.6%), were more frequently found in the Chinese patients. Management for the Chinese patients included liver resection (LRx; 45.7%), liver transplantation (LTx; 5.7%), trans-catheter arterial chemoembolization (14.3%) and palliative treatment (34.3%). Chinese patients with larger-sized tumor nodules [relative risk (RR), 1.58; 95% confidence interval (CI), 1.032–2.422; P=0.035) and diffuse type (RR, 12.17; 95% CI, 1.595–92.979; P=0.016) exhibited unfavorable outcomes. In contrast to Western patients with HEHE, a larger number of Chinese patients were asymptomatic with less extrahepatic metastasis. In China, LRx is widely adopted rather than LTx. Chinese patients with large tumor size or diffuse type may encounter a poorer prognosis.
Noise exposure is central to hearing impairment, especially for adolescents. Chinese youth frequently and consciously expose themselves to loud noise, often for many hours. Hence, a Chinese-adapted evaluative scale to measure youth's attitude toward noise could rigorously evaluate data validity and reliability. After authenticating the youth attitude to noise scale (YANS) originally developed by Olsen and Erlandsson, we purposively sampled and surveyed 642 freshmen at Capital Medical University in Beijing, China. To establish validity, we conducted confirmatory factor analysis according to Olsen's classification. To establish reliability, we calculated Cronbach's alpha coefficient and split-half coefficient. We used Bland-Altman analysis to calculate the agreement limits between test and retest. Among 642 students, 550 (85.67%) participated in statistical analysis (399 females [72.55%] vs. 151 males [27.45%]). Confirmatory factorial analysis sorted 19 items into four main subcategories (F1-F4) in terms of factor load, yielding a correlation coefficient between factors <0.40. The Cronbach's alpha coefficient (0.70) was within the desirable range, confirming the reliability of Chinese-adapted YANS. The split-half coefficient was 0.53. Furthermore, the paired t-test reported a mean difference of 0.002 (P = 0.9601). Notably, the mean overall YANS score (3.46) was similar to YANS testing in Belgium (3.10), but higher than Sweden (2.10) and Brazil (2.80). The Chinese version of the YANS questionnaire is valid, reliable, and adaptable to Chinese adolescents. Analysis of the adapted YANS showed that a significant number of Chinese youth display a poor attitude and behavior toward noise. Therefore, Chinese YANS can play a pivotal role in programs that focus on increasing youth awareness of noise and hearing health.
Background/AimDiffraction enhanced imaging (DEI) is a synchrotron radiation X-ray phase-contrast imaging technique that can better reveal the microstructure of biological soft tissues than conventional X-rays. The aim of this study is to investigate the angio-architectural changes of the liver during fibrosis, cirrhosis and its subsequent regression by applying synchrotron radiation based DEI.MethodsDEI experiments were performed at the 4W1A station of Beijing Synchrotron Radiation Facility. Twenty-four Sprague-Dawley rats were induced with liver fibrosis by carbon tetrachloride (CCl4) for up to 10 weeks, after which spontaneous regression started and continued until week 30. Quantitative analysis of the DEI images yielded the mean vascular density and intercapillary distance, which was then re-confirmed by immunohistochemical analysis of CD34.ResultsBased on the DEI results, the mean vascular density was 1.4-fold higher in fibrotic rats (at week 6) and 2-fold higher in cirrhotic rats (at week 10) compared with the control (p<0.05). Accordingly, the intercapillary distance decreased to 563.89±243.35 µm in fibrotic rats and 392.90±92.68 µm in cirrhotic rats compared with 673.85±214.16µm in the control (p<0.05). During fibrosis regression at week 30, vascular density was 0.7-fold lower and intercapillary distance increased to 548.60±210.94 µm as compared with cirrhotic rats (p<0.05).In parallel to the DEI results, immunohistochemical analysis of CD34 showed similar changes.ConclusionSynchrotron-based DEI can conduct radiological as well as pathological analysis. Our results are consistent with previous reports indicating that angiogenesis is directly proportional to fibrosis progression. Furthermore, by clarifying the vascular characteristics of liver diseases, DEI reveals that cirrhosis cannot fully reverse during fibrosis regression.
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