[Endovascular abdominal aortic aneurysm repair with a new stent graft:early results from a multicenter study].

Objective: To examine the safety and effectiveness of a new stent graft system for endovascular repair of abdominal aortic aneurysm(AAA). Methods: This is a prospective,multi-center,single-arm clinical trial. The patients with AAA treated with a new stent graft system were enrolled at 21 centers from September 2018 to September 2019 in China. Follow-up was performed before discharge, and at 30, 180, 360 days after operation, respectively. The primary safety endpoint was the incidence of major adverse events(MAE) within 30 days. The primary efficacy endpoint was the success rate of AAA treatment at 360 days. Secondary safety endpoints were the incidence of perioperative access complications and acute lower limb ischemia,all-cause mortality, AAA related mortality and incidence of serious adverse events (SAE) at 180 and 360 days. Secondary efficacy endpoints were the incidence of type Ⅰ or Ⅲ endoleak,stent displacement,and conversion to open surgery or re-intervention at 180 and 360 days. Results: One hundred and fifty-six patients were enrolled,including 137 males and 19 females. The age was (68.9±6.9) years (range:48.2 to 84.6 years).Maximum aneurysm diameter was (50.8±11.2) mm (range:25.0 to 85.0 mm),diameter of proximal landing zone was (21.2±2.5) mm (range:17.0 to 29.5 mm),and length of proximal landing zone was (31.4±13.0) mm (range:11.0 to 75.0 mm).The incidence of MAE was 1.3% (2/156) at 30 days,both were all-cause death cases. The success rate of AAA treatment was 88.5% (138/156) at 360 days. No perioperative access complication and acute lower limb ischemia occurred. All-cause mortality was 2.0% (3/154) at 180 days and 2.6% (4/153) at 360 days,and there was no AAA related death. The incidence of SAE was 23.0%(35/152) at 180 days and 30.5%(46/151) at 360 days, and no device-related SAE occurred. The incidence of type Ⅰor Ⅲ endoleak was 3.4% (5/147) at 180 days and 3.5% (5/144) at 360 days. Conclusion: The new stent graft system is easy to operate,and early-term safety and effectiveness results are expected.

Risk of complications with retromandibular transparotid vs. anteroparotid approach for condylar fractures: a systematic review and meta-analysis.

OBJECTIVE: Retromandibular approaches have been known to reduce the risk of facial nerve palsy and improve the management of condylar fractures. As such, it is necessary to identify the best approach with the least complications. This review was conducted to obtain a comprehensive estimate for the risk of complications following both the transparotid and the anteroparotid approach for patients with mandibular condylar fractures. MATERIALS AND METHODS: A comprehensive search was conducted using PubMed Central, EMBASE, MEDLINE, and Cochrane library, ScienceDirect and Google Scholar from January 1964 until October 2021. The Newcastle Ottawa scale and Cochrane risk of bias tool were used to assess the quality of the included studies. A meta-analysis was carried out using a random-effects model and reported pooled incidence with 95% confidence intervals (CIs). A funnel plot was used to assess possible publication biases. RESULTS: In total, 40 studies with 2,096 participants were assessed and the majority of the included studies (29 out of 40 studies) had a high risk of bias. The pooled incidence of facial nerve palsy following the transparotid approach was 13% (95% CI: 10%-17%; I2=66.8%), and 2% (95% CI: 1%-5%; I2=57.8%) following the anteroparotid approach. The pooled incidence of sialocele following the transparotid approach was 2% (95% CI: 0%-4%; I2=45.8%), and 2% (95% CI: 1%-5%; I2=67.2%) following the anteroparotid approach. The pooled incidence of postoperative infection following the transparotid approach was 1% (95% CI: 0%-4%; I2=63.1%), and 1% (95% CI: 0%-3%; I2=0%) following the anteroparotid approach. CONCLUSIONS: The incidence of facial nerve palsy was higher among patients undergoing the transparotid approach when compared to patients undergoing the anteroparotid approach. Further trials comparing both of these approaches are required to identify the best methodology with the lowest complication rate.

[In situ semiconductor laser fenestration of type A aortic dissection during thoracic endovascular aortic repair].

Objective: To investigate the feasibility, efficacy and safety of semiconductor laser in situ fenestration of type A aortic dissection during thoracic endovascular aortic repair. Methods: The clinical data of 68 patients with type A aortic dissection treated by semiconductor laser in situ fenestration from June 2016 to January 2020 in Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University were analyzed retrospectively. Of the patients, 45 were male, 23 were female, the mean age was (52±14) years. The technical success rate and complication rates were assessed. Results: The technical success rate of 68 patients was 92.6% (63/68), only 5 patients failed due to the complex aortic arch type, 3 patients underwent chimney stent implantation, 2 patients underwent artificial vessel bypass. During the perioperative period, 1 patient died due to severe pulmonary infection, 4 patients developed neurological symptoms such as cerebral infarction after surgery, and the remaining patients had no related complications. Postoperative CTA follow-up indicated that the primary intercalation rupture was completely closed, and the main and branch stents were patency, 8 (8.8%) type Ⅰ leakage were occurred. Conclusion: It showed that in situ semiconductor laser fenestration is a feasible, effective and safe method to treat type A aortic dissection.

[Significance of prostate central gland/total gland volume ratio combined with PSA in the diagnosis of prostate cancer patients].

Objective: To explore the significance of prostate central gland/total gland volume (PVc/PV) ratio combined with PSA in the diagnosis of PSA 4-20 ng/ml prostate cancer patients. Methods: Data of patients undergoing prostate puncture in Minghang Branch, Zhongshan Hospital from July 2015 to December 2018 were retrospectively analyzed. The anteroposterior, transverse and axial diameters of the prostate and the central prostate gland were measured by magnetic resonance imaging (MRI). The differences of tPSA, f/tPSA, PSAD and PVc/PV between the prostate cancer group and non-prostate cancer group were compared. Receiver operating characteristic (ROC) curves of prostate cancer diagnosis were plotted according to tPSA, f/tPSA, PSAD, PVc/PV alone and PVc/PV combined with tPSA, respectively, and the area under the curve (AUC) was calculated and compared using tPSA as the reference. Results: There was no significant difference in tPSA between the two groups (P>0.05). However, significant differences were observed in f/tPSA, PSAD and PVc/PV between the two groups (P<0.05). The AUC value of PVc/PV combined with tPSA, PVc/PV and PSAD was 0.901 2,0.866 7 and 0.848 1,respectively, which were statistically different from that of tPSA (P<0.05). The AUC value of f/tPSA was 0.716, which was not statistically different from that of tPSA (P>0.05). Conclusion: The PVc/PV ratio combined with tPSA can be used as an important reference index for the diagnosis of prostate cancer in PSA 4-20 ng/ml patients.

[The application of retroperitoneal laparoscopic nephron-sparing surgery in stage T(1b) renal cell carcinoma].

Objective: To investigate the safety and feasibility of retroperitoneal laparoscopic nephron-sparing surgery (NSS) in stage T(1b) renal cell carcinoma (RCC) patients . Methods: Between March 2014 and June 2017, 52 stage T(1b) RCC cases (36 males, 16 females) treated with retroperitoneal laparoscopic NSS in Zhongshan Hospital and Central Hospital of Minhang District were enrolled and retrospectively analyzed, with a tumor size range of 4.0 to 6.8 cm, and a mean size of(4.7±0.45)cm.The anatomic characteristics of tumors, operative time, intra-operative blood loss, warm ischemia time, intra- and post-operative complications, length of hospital stay, and oncological outcomes were reviewed. Results: Only 2 cases converted to open surgery due to uncontrollable bleeding in operation. The rest 50 cases successfully underwent retroperitoneal laparoscopic NSS, with mean operative time of (122±20.86) min (range: 100-220 min), mean blood loss of (140±128.85)ml (range: 50-800 ml), mean warm ischemia time of (30±3.52)min (range: 25-42 min), pre-operative mean serum creatinine of (100±23.54)µmol/L (range: 65-148 µmol/L), mean serum creatinine three monthsafter operation of (104±30.84)µmol/L (range: 72-224 µmol/L), mean drainage of (180±82.33)ml (range: 80-550 ml), mean length of hospital stay after operation of (8±1.56)d (range: 5-15 d). There was no significant difference in renal function between pre- and post-operation (P=0.056). One patient suffered pulmonary embolism was cured conservatively. Fifty patients were followed up, among which 47 cases with malignant pathology were followed up for 3-29 months, and two of them suffered from pulmonary metastasis. Conclusions: After pre-operative comprehensive assessment of tumors, stage T(1b) renal cell carcinoma could be treated with retroperitoneal laparoscopic NSS safely.

[The effect of extending proximal landing zone in thoracic endovascular aortic repair on the prognosis of Stanford type B aortic dissection].

With the continuous development of endovascular surgery, thoracic endovascular aortic repair (TEVAR) has gradually replaced traditional open surgery and has become the preferred treatment strategy for Stanford type B aortic dissection. However, the disadvantage of the short proximal landing zone greatly limited the indication of TEVAR surgery and affected the prognosis. In recent years, many strategies such as hybrid surgery, in vitro fenestrated and branched aortic endo-graft, chimney technique, in-situ fenestration technique, etc., have been developed, which greatly broadens the TEVAR indication and improved the prognosis.

Increased expression of long noncoding RNA LINC00961 suppresses glioma metastasis and correlates with favorable prognosis.

OBJECTIVE: Long non-coding RNA LINC00961 (LINC00961) has been reported to play an important role in tumor development and metastasis of lung cancer. However, the expression and role of LINC00961 in glioma remains unclear. The present study aimed to investigate the expression of LINC00961 in patients with glioma and to investigate its effect on glioma cells. PATIENTS AND METHODS: Quantitative Real-Time PCR (qRT-PCR) was performed to detect the expression of LINC00961 in glioma tissues and cell lines. Then, the association between LINC00961 expression and clinical pathological parameters and prognosis of glioma patients were further evaluated. Gain of function studies were performed to determine the effects of LINC00961 on proliferation and metastasis of glioma cells. Western blotting assay was used to explore the regulation mechanism. RESULTS: We found that LINC00961 was significantly downregulated in glioma tissues and cell lines compared with that of adjacent normal brain tissues and normal human astrocytes. Low expression of LINC00961 was significantly correlated with WHO grade and KPS score. Clinical analysis indicated that patients with low LINC00961 expression had a shorter overall survival than those with high expression. Univariate and multivariable Cox regression analyses further identified that down-regulated LINC00961 might act as an independent prognostic factor for glioma patients. Functionally, overexpression of LINC00961 significantly suppressed glioma cells proliferation, migration, and invasion. Mechanistically, we found that overexpression of LINC00961 inhibited glioma cell EMT. CONCLUSIONS: LINC00961 might be considered as a novel molecule involved in glioma development, which provides an independent prognostic indicator and a potential therapeutic target for glioma patients.

Effect of side-stream phosphorus recovery on biological phosphorus removal performance investigated by chemical and microbial analyses in a novel BNR-IC process.

The aim of this study was to assess the effect of side-stream ratio (SSR) on performance of phosphorus (P) removal and recovery in a novel process linking biological nutrients removal (BNR) and induced crystallization (IC). Results showed that P removal efficiency was significantly enhanced when given an appropriate SSR, resulting in effluent P concentrations decreasing from 0.75 to 0.39 mg/L with an increase of SSR from 0 to 35%, where a maximum of 7.19 mg/L P recovery amount was obtained at 35% of SSR. Increasing the SSR can favor the P recovery, while an excessively high SSR (more than 35%) would have a negative effect on the subsequent biological P removal in the BNR-IC system. Polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) analysis showed that in total, 11 DGGE bands of highest species richness were visually detected and significant changes in microbial community structure were found, with SSR variations ranging from 0 to 55%. Moreover, an increase in SSR can cause an increase in microbial community biodiversity; where microbial populations correspond to the 11 bands, they were generally classified into five different phyla or classes (Beta-, Gamma-, and Deltaproteobacteria, as well as Clostridia and Flavobacteria) based on the evolutionary tree analysis.

Summary report of action research on occupational rehabilitation and community re-integration of migrant workers with work injuries in Mainland China.

This article is a summary of an action research exploring the strategies to initiate the occupational rehabilitation and community re-integration of migrant workers with work injuries in Guangdong Province, China. Using two cases of rehabilitation intervention for workers with work injury, a case management model of occupational rehabilitation and community re-integration was illustrated, in the different phases of rehabilitation. Finally, some key elements in supporting occupational rehabilitation and community re-integration for migrant workers with work injury in China were highlighted.

Suppressive effects of leflunomide on leptin-induced collagen I production involved in hepatic stellate cell proliferation.

In this manuscript, we showed that following a fibrogenic stimulus of leptin, hepatic stellate cells (HSCs) underwent a complex activation process characterized by increased proliferation and excessive deposition of type I collagen. Studies with special chemical inhibitors demonstrated that this process involved Janus protein tyrosine kinase (JAK)/signal transducer and activator of transcription (STAT), mitogen-activated protein kinases (MAPK), and phosphatidylinositol 3-linase (PI3K)/Protein kinase B (AKT) signal pathways. Leflunomide pretreatment significantly inhibited the deposition of type I collagen in HSCs and the proliferation of primary HSC by interrupting the three proliferative signal transduction pathways in vitro, which was indicated by [(3)H]thymidine incorporation and cell cycle analysis. Furthermore, leptin-induced cyclin D1 protein expression, which correlates well with HSC proliferation, was also significantly inhibited by leflunomide. On the other hand, leflunomide also prevented leptin-induced Kupffer cell (KC) activation and HSC collagen synthesis induced by KC-conditioned medium (KCCM). Collectively, these results provided a novel insight into the mechanisms by which leflunomide may exert in liver fibrosis.

Meta-analysis of the clinical effectiveness of venous arterialization for salvage of critically ischaemic limbs.

OBJECTIVE: The aim of this study is to assess the clinical effectiveness of venous arterialization in patients with critical limb ischaemia not reconstructable by conventional bypass. DESIGN: Meta-analysis of observational studies. MATERIALS: Eligible studies concerning treatment by venous arterialization for chronic critical leg ischaemia were identified from electronic database, cross-reference search and pertinent articles. There was no language restriction. METHODS: All relevant studies were systematically reviewed and data extracted by two independent reviewers. Study endpoints were foot preservation, secondary graft patency, postoperative clinical improvement and complications. RESULTS: A total of 56 studies were selected for comprehensive review. No RCTs were identified. Seven patient series, comprising 228 patients, matched the selection criteria. Overall 1-year foot preservation was 71% (95% CI: 64-77%) and 1-year secondary patency was 46% (95% CI: 39-53%). The large majority of patients in whom major amputation was avoided experienced successful wound healing, disappearance of rest pain and absence of serious complications. CONCLUSION: On the basis of limited evidence, venous arterialization may be considered as a viable alternative before major amputation is undertaken in patients with 'inoperable' chronic critical leg ischaemia.

[Cloning of human B lymphocyte activation-related novel gene].

OBJECTIVE: To clone the novel activation-related gene of B lymphocyte. METHODS: The differential display reversal transcription PCR (DDRT-PCR) technique was applied to analyse the expression difference of mRNA between resting and activated B lymphocyte from human tonsil. The positive differential display cDNA fragment identified by Northern-blotting was chosen as probe to filtrate human activated B lymphocyte cDNA library. RESULTS: Sixty two differential display cDNA fragments (expressed sequence tag, EST) were obtained. Thirty-two of them were mainly expressed in resting B lymphocyte and thirty were expressed in activated cells. Twenty-five were positive ones after identification by Northern blot analysis. A novel cDNA clone was obtained after using EST30 as a probe to filtrate the human activated B cell cDNA library. The whole cDNA clone was 2,048 bp in length and contains a 630 bp open reading frame. The N end of the deduced amino acid sequence was homologous with KAR3 protein which is a member of kinesins superfamily in yeast. CONCLUSIONS: A novel possible activation-related gene in human B lymphocyte was obtained.

[Effect of beta-endorphin on plasma sialic acid level in rats and the relationship with the immune function].

With the use of beta-EP microinjection into the central nervous system, spectrophotometrical analysis and immunochemical method we studied the effect of beta-Endorphin (beta-EP) on plasma sialic acid (SA) level. The results indicate: (1) The plasma SA level was significantly decreased after microinjection of beta-EP into the lateral ventricle (LV); (2) When beta-EP was microinjection into nucleus arcuatus (ARC), the plasma SA level was significantly decreased (P < 0.05). This effect can be blocked by i.v. atropine or vagotomy; (3) Microinjection of beta-EP into ARC can cause the increase of CD3, CD4 and CD4/CD8, while CD8 was decreased. The above results suggest that the possible mechanism underlying the decrease of plasma SA level is mediated by cholinergic muscarinic receptor, and the cellular immune function is enhanced.