[Current Status and Research Progress in the Clinical Diagnosis and Treatment of Colorectal Juvenile Polyps].

Juvenile polyps(JP),also known as retention polyps,are the most common type of colorectal polyps and the main cause of lower gastrointestinal bleeding in children,with rare incidence in adults.In recent years,with the development and application of electronic colonoscopy,the detection rate of colorectal JP has gradually increased.It is generally accepted that JP is a benign hamartomatous lesion of the intestine,while it can cause complications such as massive hemorrhage of the lower digestive tract,anemia,intussusception,and intestinal obstruction.Moreover,there are reports about the canceration of JP.Therefore,it is necessary to improve the understanding and achieve early diagnosis and treatment of this disease.This article reviews the research progress in the epidemiological characteristics,pathogenesis,clinical manifestations,diagnosis and treatment methods,and canceration risk of JP.

Peroral endoscopic myotomy for esophageal motility disorders.

BACKGROUND: Esophageal motility disorders which include achalasia, esophagogastric junction outflow obstruction (EGJ outflow obstruction), jackhammer esophagus (JE), distal esophageal spasm (DES), etc. are rare disease of unknown causes. The diagnosis is based on endoscopy, barium meal, and high-resolution manometry (HRM). With the development of endoscopy, peroral endoscopic myotomy (POEM) has emerged as a standard method for the treatment of achalasia. PURPOSE: The purpose of this article is to enable gastroenterologists to have a more comprehensive understanding of the application status, technical characteristics, clinical efficacy and future prospect of POEM in the treatment of esophageal motility disorders. METHODS: Through a large number of reading literature, combined with clinical practice, summary and analysis of the indications, procedure, efficacy, complications, and controversies of POEM in the treatment of esophageal motility disorders, as well as the current and future perspectives of POEM were studied. RESULTS: POEM is safe and effective in the treatment of esophageal motility disorders, but the GERD reflux rate is higher. CONCLUSIONS: POEM can be a new option for the treatment of esophageal movement disorders, but large sample, multi-center, long-term study reports are needed, and it promotes the development of NOTES technology.

A Case Report of Primary Neonatal Hypocholinesterase Caused by Homozygous Frameshift Mutation of the utyrylcholinesterase (BCHE) Gene and Review of Literature.

BACKGROUND: Primary neonatal hypocholinesterase is rare; its genetic pattern and mutation still need to be further studied. METHODS: The patient and his parents are studied using next-generation sequencing technology. RESULTS: A boy one day after birth is admitted to the Neonatal Intensive Care Unit at our hospital after experiencing intermittent vomiting for 12 hours. The patient's serum cholinesterase level (113 - 283 U/L) is lower than normal value (4,000 - 12,600 U/L). Many factors of low serum cholinesterase are excluded. We highly suspect that it may be related to congenital factors. Molecular genetic test results show that the patient carried the BCHE gene (NM_000055.2) and has homozygous frameshift mutations at exon 2 c.401dupA (p.Asn134fs) of chromosome 3q26. It is a pathogenicity mutation. This locus mutation belongs to a novel pathogenic mutation. As a result of this mutation, the 134th amino acid Asn began to frameshift and the translation is terminated early. It can cause the Encoding of protein to truncate and lose its normal function. His parents' serum cholinesterase levels (father: 5,135 U/L; mother: 4,367 U/L) are in the normal value range, but his parents carried a heterozygous BCHE gene. CONCLUSIONS: This study suggests that gene sequence detection should be carried out early in hypocholinesterase of nknown cause in neonates. This study can not only improve understanding of the etiology and pathological mechanism of hypocholinesterase, but also it can enlarge the hypocholinesterase gene mutation spectrum.

Effect of Hypokalemia on Functional Outcome at 3 Months Post-Stroke Among First-Ever Acute Ischemic Stroke Patients.

BACKGROUND Hypokalemia has been confirmed to be a predictor of adverse cardiovascular and renal outcomes. There is a paucity of studies focusing on the potential connection between the serum K+ level and the outcome after acute ischemic stroke (AIS). This study investigated whether hypokalemia in the acute stroke stage contributes to worse functional outcome in AIS patients. MATERIAL AND METHODS This retrospective cohort study included consecutive patients with first-ever AIS admitted between June 2015 and March 2016. Patients were divided into 2 groups: hypokalemia (K+ <3.5 mmol/L) and normokalemia (3.5 mmol/L ≤K+ ≤5.5 mmol/L). Primary outcome measure was poor outcome at 3 months (modified Rankin scale >2). Univariate and multivariate logistic regression analyses were used to assess the association between hypokalemia and poor outcome. Receiver operating curve (ROC) analysis was performed to determine the optimal cutoff point of serum K+ level for predicting poor outcome. RESULTS The percent of patients with poor outcome at 3 months was higher in the hypokalemic group (62.9%) than in the normokalemic group (45.5%). Hypokalemic patients tended to have lower fasting glucose at admission, lower Glasgow coma scale score, and longer time from symptom onset to treatment compared with normokalemic patients. Hypokalemia was associated with poor outcome at 3 months after adjusting for potential confounders (odds ratio=2.42, 95% confidence interval=1.21-4.86, P=0.013). ROC analysis showed that the optimal threshold for serum K+ level was 3.7 mmol/L. CONCLUSIONS Hypokalemia at the initial admission is associated with poor prognosis at 3 months in first-ever AIS patients.

Therapeutic plasma exchange versus double plasma molecular absorption system in hepatitis B virus-infected acute-on-chronic liver failure treated by entercavir: A prospective study.

BACKGROUND: Therapeutic plasma exchange (TPE) and double plasma molecular absorption system (DPMAS) were two extracorporeal liver support systems. Few studies compared their efficacy profile. OBJECTIVE: This study was to compare the efficacy of TPE and DPMAS on acute-on-chronic liver failure (ACLF) caused by hepatitis B virus (HBV-ACLF). METHODS: 60 HBV-ACLF patients were enrolled and prospectively studied. All patients received entecavir therapy, and were assigned to TPE group (n = 33) and DPMAS group (n = 27). Primary end-points were the effects of TPE and DPMAS on liver function and serum inflammatory markers. RESULTS: Serum procalcitonin, interleukin (IL)-6, and high sensitive C-reactive protein (hsCRP) were significantly elevated in patients with HBV-ACLF. TPE achieved significantly higher removal rates of total bilirubin (TBIL, P = .002), direct bilirubin (DBIL, P = .006), and hsCRP (P = .010) than DPMAS, but DPMAS displayed lower loss rate of albumin (P = .000). TPE and DPMAS resulted in similarly increased serum IL-6 levels and comparable 12-week survivals (P > .05). Multivariate analysis showed that hospital stay (Relative Risk [RR]: 1.062, 95% Confidence Interval [CI]: 1.011-1.115, P = .016), prothrombin time (RR: 1.346, 95% CI: 1.077-1.726, P = .010), and international normalized ratio (RR: 0.013, 95% CI: 0.006-0.788, P = .041) were independent predictors for 12-week survival. Both TPE and DPMAS treatments were well-tolerated. CONCLUSION: Compared to DPMAS, TPE was more efficient in eliminating TBIL, DBIL, and hsCRP, but it was associated with higher loss rate of albumin. TPE and DPMAS were similar in improving 12-week survivals in HBV-ACLF.

Implementation of Tunneled Peripherally Inserted Central Catheters Placement in Cancer Patients: A Randomized Multicenter Study.

This study sought to evaluate the impact of the subcutaneous tunneling technique on peripherally inserted central catheter (PICC) placement. We randomized 694 patients who needed PICC placement to either the tunneled PICCs (experimental group) or the non-tunneled PICCs (control group) from August to December 2021. The cumulative frequency of complications was assessed as the primary outcome. Secondary outcomes comprised of the amount of bleeding, catheter insertion time, self-reported pain score, and one-puncture success rate. After 6 months of follow-up, the tunneled PICCs group showed a significant decrease in the frequency of total complications, especially in infection (3.0% vs. 7.1%, p = .021) and catheter-related thrombosis (3.3% vs. 8.3%, p = .008), although approximately 0.5 ml bleeding and 3.5 min time were increased. This randomized multicenter study supports the efficacy of subcutaneous tunneling technology in reducing PICC-related complications, enhancing patient comfort, and encouraging using subcutaneous tunneling technology for PICC placement.

Efficacy of ScopeGuide-Assisted Training in Enhancing Colonoscopy Competence and Reducing Patient Discomfort.

OBJECTIVE: In this study, we aimed to evaluate the efficacy of the Magnetic Scope Guide Assist (ScopeGuide) in enhancing the procedural competence of endoscopists and reducing patient discomfort during colonoscopy. METHODS: This was a retrospective study with 88 trainee participants. The study participants were trained on patients who underwent colonoscopy without anesthesia. Both ScopeGuide-assisted training and conventional training (without ScopeGuide) were utilized for colonoscopy instruction. The outcomes of training were compared, with a particular emphasis on the competency of looping resolution. RESULTS: ScopeGuide-assisted training was superior to conventional training in multiple aspects, including looping resolution ( Z =-3.681, P <0.001), pain scores ( Z =-4.211, P <0.001), time to reach the cecum ( Z =-4.06, P <0.001), willingness to undergo repeat colonoscopy ( Z =-4.748, P <0.001), competence of positional changes ( Z =-4.079, P <0.001), and the effectiveness of assisted compression ( Z =-3.001, P =0.003). Further stratified analysis revealed that the ScopeGuide-assisted training mode was more beneficial for junior endoscopists ( P <0.05 in all parameters) but not for intermediate endoscopists ( P >0.05) and partially beneficial for senior endoscopists ( P <0.05 for all parameters except looping resolution). CONCLUSION: ScopeGuide-assisted training can significantly facilitate endoscopists in resolving loops and reducing patient pain, thereby enhancing their colonoscopy abilities.

Understanding the Relationship Between Vascular Smooth Muscle Cell Function and the Efficacy of Acupuncture in Treating Cerebral Ischemic Stroke: A Preclinical Meta-Analysis and Systematic Review.

Background: Cerebral blood flow and vascular structures serve as the fundamental components of brain metabolism and circulation. Acupuncture, an alternative and complementary medical approach, has demonstrated efficacy in treating cerebral ischemic stroke (CIS). Nevertheless, the mechanisms underlying the impact of acupuncture on vascular smooth muscle cell (VSMC) function remain uncertain. The objective of this systematic review and meta-analysis is to assess the alterations in VSMC function following acupuncture stimulation in CIS models. Methods: The databases PubMed, Web of Science, SCOPUS, and EMBASE were queried until November 2022 using a predetermined search strategy. The FORMAT BY SYRCLE guidelines were adhered to, and the risk of bias of the included studies was evaluated using the Risk of Bias tool developed by the Systematic Review Centre for Laboratory Animal Experimentation. The random-effects model was employed to estimate the standardized mean difference (SMD). Results: Eighteen articles are included in this review. Acupuncture showed significant positive effects on the region cerebral blood flow (SMD=8.15 [95% CI, 4.52 to 11.78]) and neurological deficiency (SMD=-3.75 [95% CI, -5.54 to -1.97]). Descriptive analysis showed a probable mechanism of acupuncture stimulation in CIS rats related to VSMC function. Limitations and publication bias were presented in the studies. Conclusion: In this systematic review and meta-analysis, our findings indicate that acupuncture stimulation has the potential to improve regional cerebral blood flow and alleviate neurological deficits, possibly by regulating VSMC function. However, it is important to exercise caution when interpreting these results due to the limitations of animal experimental design and methodological quality.

[Analysis of a consanguineous pedigree featuring hereditary coagulation factor â ¤ deficiency].

OBJECTIVE: To screen potential mutation and explore the underlying mechanism for a consanguineous pedigree featuring hereditary coagulation factor Ⅴ (FⅤ) deficiency. METHODS: Clinical diagnosis was validated by coagulant parameter assays of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), FⅤ procoagulant activity (FⅤ:C) and FⅤ antigen (FⅤ:Ag). Potential mutations of the F5 gene in the proband and his family members were analyzed by direct DNA sequencing of PCR products of all exons, exon-intron boundaries and 3', 5' untranslated regions. Suspected mutation was confirmed by reverse sequencing. RESULTS: The PT and APTT in the proband were significantly prolonged, which measured 23.5 s (reference range 11.8-14.8 s) and 50.5 s (reference range 27.0-41.0 s), respectively. FⅤ activity and FⅤ antigen of the proband were significantly reduced to 8% and <1%, respectively. PT and APTT in the younger sister of the proband were also significantly prolonged (24.1 s and 62.4 s, respectively). Her FⅤ activity and FⅤ antigen were also significantly decreased (7% and <1%, respectively). PT and APTT of other family members were within the normal range. The homozygous missence mutation causing T→C transition at position 29170 in exon 5 of F5 gene has resulted in a Phe190Ser substitution in the proband. His younger sister was also homozygous for Phe190Ser. Heterozygosity for Phe190Ser was confirmed in his elder brother, elder sister, two daughters and niece, and their FⅤ activity were slightly decreased (57%, 73%, 72%, 66% and 75%, respectively). A normal wild type was observed in two younger brothers of the proband, and their FⅤ activity and FⅤ antigen were in the normal range. CONCLUSION: Homozygous missence mutation of Phe190Ser has been found in above family featuring hereditary FⅤ deficiency. The homozygous missence mutation was inherited from the parents by consanguineous marriage. Phe190Ser probably underlies may underlie the pathogenesis of hereditary FⅤ deficiency in this pedigree.

[Triterpene compounds of Ainsliaea yunnanensis].

The compounds of Ainsliaea yunnanensis were isolated and purified by various kinds of column chromatography methods and their structures were determined by spectroscopic data analysis. Twelve compounds were obtained from the petroleum ether of ethanolic extract of A. yunnanensis and elucidated as bauerenyl acetate (1), bauerenol (2), alpha-amyrin (3), psi-taraxasterol (4), beta-amyrin (5), echinocystic acid (6), multiflorenol (7), 3beta-hydroxy-olean-18-ene germanicol (8), 3beta-hexadecanoyl-12-oleanen-11-one (9), fernenol (10), fern-7-en-3beta-ol (11), and lupeol (12). All compounds were isolated from this genus for the first time except compound 1, 3, 5 and 10, and they were all isolated from this plant for the first time.

Molecular characterization of three heat shock protein 70 genes and their expression profiles under thermal stress in the citrus red mite.

Three heat shock protein 70 family transcripts, named PcHsp70-1, PcHsp70-2 and PcHsp70-3, were isolated from the citrus red mite, Panonychus citri. PcHsp70-1, PcHsp70-2, and PcHsp70-3 contained an open reading frame of 1977, 1968, and 2028 nucleotides that encoded 658, 655 and 675 amino acid residues, respectively. Comparison of deduced amino acid sequences of PcHsp70-1 and PcHsp70-2 showed 86.34% identity, while the amino acid sequence of PcHsp70-3 was only 57.39 and 58.75% identical to that of PcHsp70-1 and PcHsp70-2, respectively. Sequences and phylogenetic analyses suggested that PcHsp70-1 and PcHsp70-2 were cytosolic Hsps, whereas PcHsp70-3 was located in ER (endoplasmic reticulum). To accurately validate mRNA expression profiles of the three Hsp70s under thermal stress conditions, seven housekeeping genes were evaluated. Alpha-tubulin and RpII were selected as optimal endogenous references for cold shock and heat shock conditions, respectively. Real-time quantitative RT-PCR revealed that only the mRNA expression of PcHsp70-2 was up-regulated under heat shocks, and all of the three Hsp70s were constitutively expressed under cold shocks. The results suggest that the three Hsp70s were more critical to coping with heat than cold shocks.

Evaluation of suitable reference genes for quantitative RT-PCR during development and abiotic stress in Panonychus citri (McGregor) (Acari: Tetranychidae).

Quantitative real time reverse transcriptase polymerase chain reaction (RT-qPCR) is preferred for gene expression analysis in living organisms. Currently, it is a valuable tool for biological and ecological studies as it provides a relatively straightforward way to assess the relevance of transcriptional regulation under developmental and stress tolerance conditions. However, studies have shown that some commonly used reference genes varied among different experimental treatments, thus, systematic evaluation of reference genes is critical for gene expression profiling, which is often neglected in gene expression studies of arthropods. The aim of this study is to identify the suitable reference genes for RT-qPCR experiments involving various developmental stages and/or under abiotic stresses in citrus red mite Panonychus citri, a key pest in citrus orchards worldwide. GeNorm, NormFinder, and Bestkeeper software analysis indicates that elongation factor-1 alpha (ELF1A), RNA polymerase II largest subunit, alpha tublin, and glyceraldhyde-3-phosphate dehydrogenase (GAPDH) are the most stable reference genes in various developmental stages, meanwhile, ELF1A and GAPDH were the most stable reference genes under various abiotic stresses. Furthermore, this study will serve as a resource to screen reference genes for gene expression studies in any other spider mite species.

[Analysis of an hereditary protein C deficiency pedigree with compound heterozygous gene mutations].

OBJECTIVE: To analyze genetic mutations and explore its molecular pathogenesis for an hereditary protein C (PC) deficiency pedigree. METHODS: The pedigree has included 15 individuals from 4 generations. Plasma levels of PC activity (PC:A), PC antigen (PC:Ag) and other coagulant parameters were determined for members of the family. The 9 exons and intron-exon boundaries of protein C gene (PROC) of the proband were amplified with PCR and analyzed with direct sequencing. Detected mutations were confirmed with reverse sequencing. Corresponding PCR fragments from the family members were also directly sequenced. RESULTS: Plasma PC:A and PC:Ag for the proband was 26% and 18.60%, respectively, both being lower than normal references. Seven members from the pedigree also had lower PC:A, six had lower PC:Ag. A compound heterozygous missense mutation, including a T to G transition at position 6128 of exon 7, which results in Phe139Val, and a G to C transition at position 8478 in exon 9, which results in Asp255His, were identified in the proband. The paternal grandma, father and two aunts were heterozygous for g.6128 T to G, whilst the mother, the second uncle, sister and son were heterozygous for g.8478 G to C. There were lower PC:A in family members with g.8478 G to C. CONCLUSION: The proband had inherited two independent mutations of the PROC gene including g.6128 T to G in exon 7 and g.8478 G to C in exon 9 from her father and mother, respectively. The resulting compound heterozygous mutation has caused a serious hereditary protein C deficiency.

Simultaneous determination of purity and potency of the components of gentamycin using high-performance liquid chromatography.

The quality of some earlier developed antibiotics is usually ensured by the combination of HPLC purity and microbiological potency measurement in the pharmacopoeias of various countries because the relationship between their purity and potency is not clearly quantified. Due to potency is assessed using certain units of measurement, it can not be directly traced to the international system of units (SI unit). This has become a hotspot in the study of the quantitative relationship between purity and potency of antibiotics. It would be quite an achievement to simultaneously determine both purity and potency using HPLC methods during quality control. This study evaluated a multicomponent antibiotic product, gentamycin, as a test sample. First, pure samples of the C components of gentamycin: C1a, C2, C2a and C1 were prepared, separately. Second, quantitative relationship (theoretical potency) between the purity and potency of each C component of gentamycin were determined using 1H NMR, HPLC-ELSD and microbiological assay method. One milligram of gentamycin C1a, C2, C2a and C1 was equal to 1 286.98, 1 095.74, 1 079.52 and 739.61 gentamycin units, respectively. Finally, a method for the determination of gentamycin potency was established based on the proportion and content of C components of gentamycin. The unification of purity and potency for gentamycin was achieved using only HPLC-ELSD. It is also demonstrated that C components of gentamycin and micronomicin produce the same responses under ELSD, which means that it is not necessary to prepare separate reference standards for each C component of gentamycin and that quantitative testing can be performed accurately using only one micronomicin reference standard. This study simplified the previous method for the determination of the content of C components of gentamycin using HPLC-ELSD. The developed method is suitable for regular use as a part of quality control and can simplify the rigmarole quality control procedures provided in current pharmacopeias.

[Changes of choroidal thickness in central serous chorioretinopathy].

OBJECTIVE: To determine the quantitative changes of choroidal thickness in central serous chorioretinopathy. METHODS: Cross-sectional study. Twenty-three patients with unilateral central serous chorioretinopathy (CSC) in acute and chronic stages were diagnosed after fluorescein angiography, indocyanine angiography and enhanced depth imaging optical coherence tomography (EDI OCT). EDI OCT scan across the fovea was performed in each eye and the result was compared with that from an age-, sex-matched and spherical equivalent-matched control subject. Subfoveal thickness of choroid was calculated by a onboard software in HRA2. RESULTS: Choroidal thickness in the CSC eyes and the fellow eyes was (464.43 ± 97.15) µm and (399.91 ± 124.01) µm, respectively. No significant difference between the two groups (t = 4.653, P < 0.05). Choroidal thickness was (313.09 ± 70.67) µm in the control group. There was statistically significant difference in thickness between the CSC group and the control group (t = 5.077, -2.085; P < 0.05). Choroidal thickness in the fellow eyes with choroidal vascular hyperpermeability was (506.44 ± 75.66) µm, which was differed significantly (t = 4.749, P < 0.05)from the non-hypermeability eyes (331.43 ± 97.94) µm. CONCLUSIONS: Subfoveal choroid thickness in the symptomatic eye and the fellow eyes in CSC group is thicker than that of the control group. The subfoveal choroidal thickness of eyes with hypermeability is thicker than that in the non-hypermeability eyes. EDI-OCT is a noninvasive procedure which can be used to evaluate the choroidal hypermeability in CSC.

[Clinicopathological observation of solitary fibrous tumor of the orbit].

OBJECTIVE: To study the clinicopathological characteristics of orbital solitary fibrous tumor. METHODS: It was a retrospective case series study. The clinical and pathological characteristics of 8 cases of orbital solitary fibrous tumor that were treated in Tianjin Eye Hospital from January 2003 to December 2011 were reviewed and analyzed. Immunohistochemical staining was performed, investigating the expression of CD34, vimentin, S-100 and SMA. RESULTS: In the 8 cases, 5 cases were male and 3 cases were female; 6 cases involved the right orbit and 2 cases involved the left orbit. Patients' ages ranged from 30 to 60 years, and the mean age was 41 years; duration of symptoms ranged from 2 months to 5 years. The locations of the tumor were in the superior or superotemporal orbit (5 cases), lacrimal sac and medial orbit (2 cases), or inferior orbit (1 case). The clinical features mainly included the swelling of the upper lid, unilateral painless orbital or lacrimal sac mass, proptosis and diplopia. CT scan usually revealed a moderately or intensely enhanced mass that was well-circumscribed. Complete tumor removal was performed in all cases. The tumor sizes ranged from 1.2 - 3.1 cm and appeared as a round or irregular oval mass with a thin fibrous capsule; incomplete capsule was found in 3 tumors. Microscopic observation revealed that the tumor was composed mainly of spindle or oval cells in a fascicular, storiform, hemangiopericytoma-like or a "patternless" pattern, with numerous thick bands of collagen that showed diffuse positive staining for CD34 and vimentin. Five cases had been followed-up from 6 to 86 months postoperatively, no evidence of local recurrence had been found in these patients. CONCLUSIONS: Orbital solitary fibrous tumor is a spindle cell tumor with diffuse positive staining for CD34 and vimentin. This tumor usually is well circumscribed and encapsulated. Complete excision is the preferred treatment. The tumor should be distinguished from other spindle cell tumors in the orbit.

[An inherited coagulation factor VII deficiency pedigree caused by homozygous mutation of His348Gln].

OBJECTIVE: To investigate the gene mutation and the molecular pathogenesis of an inherited coagulation factor VII (F VII) deficiency pedigree with consanguineous marriage. METHODS: The diagnosis was validated by coagulant parameter assay on the prothrombin time (PT), activated partial thromboplastin time, fibrinogen and coagulation factor activity. F VII gene mutations were analyzed in the proband and other family members by direct DNA sequencing of the PCR products of all exons, exon-intron boundaries and 5'and 3' untranslated sequences. The mutations were confirmed by reverse sequencing. RESULTS: The values of PT and F VII activity in the proband were significantly abnormal, they were 30.9 s and 3% respectively. The PT of her daughter, father and mother was slightly extended to 21.2 s, 16.3 s and 16.1 s respectively, and the F VII activity was reduced to 22%, 25% and 35% respectively. The coagulant parameters of her younger brother were within normal range. Homozygous T-->G transition at position 11482 in exon 8 was identified in the proband resulting in His348Gln, and heterozygosity for His348Gln was confirmed in her daughter and her parents, and the normal wild-type was observed in her younger brother. CONCLUSION: Homozygous missense mutation of His348Gln was found in a pedigree of hereditary F VII deficiency. The mutation was inherited from her heterozygote parents.

[Clinical application of the transjugular intrahepatic portosystemic stent-shunt in the emergency treatment of esophagogastric varices bleeding due to cirrhosis].

OBJECTIVE: To investigate the effects of transjugular intrahepatic portosystemic stent-shunt (TIPS) in emergency treatment of esophagogastric varices bleeding for the cirrhosis patients. METHODS: 39 cases with esophageal and gastric varices bleeding due to liver cirrhosis received TIPS and were followed-up for 1 to 12 months, the short-term effects including 24 hours haemostasis rates post TIPS, pressure gradient between portal vein and systemic circulation, average pressure of portal vein were observed. The levels of albumin, cholinesterase, total bilirubin and prothrombin time post TIPS were also evaluated were observed and evaluated. RESULTS: 37 cases received TIPS successfully among the 39 patients, with a total effective rate of 94.87% (37/39) and the rate of hemostasis in 24 hours was 100%. PSG dropped from (30.44+/-7.68) cm H2O to (18.78+/-4.71) cm H2O, mean portal pressure declined from (38.22+/-7.40) cm H2O to (27.00+/-5.38) cm H2O (P is less than 0.01). No significant differences existed at the level of albumin(A) and cholinesterase (CHE) before and after operation (P is more than 0.05). The relapse rate of frame stenosis was 5.71% (2/35). The incidence rate of hepatic encephalopathy was 13.51% (5/37). The relapse rate of rehaemorrhagia was 2.86% (1/35). The incidence rate of hepatic failure was 2.70% (1/37). The death rate was 5.71% (2/35). CONCLUSION: The effect of TIPS in treating portal hypertension caused by liver cirrhosis is prominent and safe, and is worthy of clinical application.

[The research progress in treating astigmatism at the time of cataract surgery].

With the increasing progress of cataract surgery, the postoperative residual astigmatism has become one of the factors that influences the desirable refractive outcome for patient. Correction of astigmatism has become an important aspect of refractive cataract surgery. There are several options for correcting astigmatism at the time of cataract surgery, which include using the cataract incision or astigmatic keratotomy to counteract pre-existing astigmatism, or using a toric intraocular lens (Toric IOL). All of these choices have their operational indications, inherent advantages and disadvantages. The central concern of astigmatism surgery lies in the preoperative measurement and subsequent surgical planning for its correction. And the correction effect will be influenced by various factors. This paper reviews the recent progress in treating astigmatism at the time of cataract surgery based on the above points.

The Influence of Sliding Speed on the Friction Behavior of Silica Surface.

Studies have shown that the relative sliding speed of the silicon-based material surface has an effect on its friction behavior. In this study, the molecular dynamics method was used to simulate the sliding of the SiO2 surface at different speeds. This is to explore the internal mechanism between SiO2 surface friction behavior and the relative sliding speed. First of all, this study constructed a 3D model of the SiO2 friction surface and simulated the sliding process under two different environments of absolute dryness and full wetness. Then, the sliding of the SiO2 surface at different speeds in dry and wet environments is simulated and verified the rationality of the simulation through experiments. The final results show that the lattice distortion and tribochemical reactions that occur on the SiO2 surface of the material have varying degrees of influence on the friction behavior of the material surface. In the dry environment, the coefficient of friction of the SiO2 surface increases with the speed. On the contrary, in the humid environment, the SiO2 surface decreases as the speed increases. The analysis results found that the speed has varying degrees of influence on the lattice distortion and tribochemical reaction of the SiO2 surface. Eventually, this study quantifies the effect of speed on SiO2 surface tribochemical reactions and lattice distortion in two different environments.