[The effect of the ratio of aneurysm sac diameter to patient age on the long-term efficacy of different surgical methods for infrarenal abdominal aortic aneurysm].

Objective: To investigate the effect of the ratio of the maximum diameter of aneurysm sac to age (R) on the long-term efficacy of endovascular aneurysm repair (EVAR) and open surgical repair (OSR) in patients with infrarenal abdominal aortic aneurysm (IAAA). Methods: This is a retrospective cohort study.The clinical data of 317 patients with IAAA who underwent surgical repair in the Department of Vascular Surgery,the Third Affiliated Hospital of Sun Yat-Sen University from January 2016 to October 2022 were retrospectively collected.There were 266 males and 51 females,aged (69.7±8.3) years (range:37 to 87 years).The R value of the patient was calculated and the receiver operating characteristic(ROC) curve was used to establish a model to calculate the optimal cut-off value.The propensity score matching method was used to match the baseline data of patients in the EVAR and OSR group by 3∶1 (the caliper value was 0.05),and the patients were stratified according to the cutoff value of R, and the postoperative efficacy and survival of the patients were analyzed.The primary endpoint was the total mortality rate,and the secondary endpoints included the occurrence of postoperative complications and reintervention.Pearson χ2 or Fisher 's exact test was used for categorical variables, and independent sample t test or Wilcoxon rank sum test was used for continuous variables to compare differences between groups.The survival curves of the two groups were described by Kaplan-Meier method. Results: After propensity score matching,198 cases were in the EVAR group and 66 cases were in the OSR group.The ROC model showed that the best cut-off value of R value was 0.90,and the two groups were divided into two layers:R<0.90 and R≥0.90.Among them,112 patients with R<0.90 (84 cases of EVAR,28 cases of OSR);there were 152 patients with R≥0.90 (114 cases of EVAR and 38 cases of OSR).The follow-up time was (23.6±1.6) months (range:1 to 70 months).In the R≥0.90 stratification,the total mortality (26.3% vs.5.3%,χ2=7.600，P=0.006),complication rate (44.7% vs.26.3%, χ2=4.025，P=0.045), and secondary intervention rate (31.6% vs.13.2%, χ2=4.910，P=0.027) in the EVAR group were higher than those in the OSR group.In the R<0.90 stratification,there was no significant difference in the total mortality rate (13.1% vs.10.7%, χ2=0.109，P=0.741), complication rate (28.6% vs.35.7%, χ2=0.507，P=0.477) and secondary intervention rate (14.3% vs.21.4%, χ2=0.353，P=0.552) between the two groups. Conclusions: When R≥0.90 in IAAA patients,OSR maybe more beneficial to patients in terms of survival rate,postoperative complication rate and secondary intervention rate than EVAR.When R<0.90,there are no significant differences in survival rate,complication rate and secondary intervention rate between the two surgical methods.

[Exploration on risk management of infection prevention and control in COVID-19 makeshift hospitals].

In the current stage of prevention and control of the Omicron variant of the pandemic, makeshift hospitals played a key role in isolating and treating mild and asymptomatic patient, which helped to completely and quickly block the spread of the epidemic in the society. In order to reduce the risk of the spread of COVID-19 in makeshift hospital, prevent occupational exposure and nosocomial infections, it is necessary for all levels to actively identify risk sources, carry the risk assessment, implement comprehensive infection control risk treat, and supervise in a timely manner.

[Construction of IPA decision model for diabetes prevention and control based on economy and importance].

Objective: To determine the priority of diabetes prevention and control measures in the perspective of the economy and importance, and provide theoretical support for guiding relevant departments to implement measures based on actual economic level. Methods: An online survey was conducted on the importance, feasibility and implementation of major chronic disease prevention and control measures in 488 national demonstration areas for comprehensive chronic disease prevention and control. The content of the survey was divided into individual and group levels, with 10 dimensions and 44 measures, to obtain the scores of the economy and importance. IPA model was used to divide the dimension index of diabetes prevention and control into quadrants. The standardized factor load coefficient of the second-order confirmatory factor analysis was used to determine the priority of dimension index in the same quadrant. The priority of prevention and control measures in each dimension was determined by the discriminant parameter of project response theory. Results: The mean scores of economy and importance were 66.50 and 89.94, respectively, and the matrix was divided into four quadrants. The first quadrant was the "highest priority" with high importance and economy, including medical insurance and family doctors, health education, high-risk detection and intervention, patient management and community action. The second quadrant was characterized as high importance but low economy, which was the priority for improvement, including only one dimension of complication screening. The third quadrant was the lowest priority due to low importance and economy, including personal health service evaluation and follow-up, environmental support, diabetes co-infection prevention and glycemic policy. The last quadrant had low importance but high economy, which was the second improvement level. The priority measures in different quadrants were: (1) the highest priority: blood lipid control, occupational site, prevention and control work plan, blood glucose testing, family doctor contract service; (2) the priority improvement: annual neuropathy screening; (3)the lowest priority: universal access to risk scoring, healthy eating, healthy dining innovations and tuberculosis screening. Conclusion: IPA model can be used to construct a decision-making model for diabetes prevention and control and determine the priority of corresponding measures.

[Advancement in endovascular therapy of aortoiliac occlusive disease].

Aortoiliac occlusive disease (AIOD) refers to the stenosis and occlusion of the distal abdominal aorta and(or) bifurcation of the aortoiliac artery,which is mainly caused by atherosclerosis,leading to pelvic and lower limb ischemia.Open surgery has always been the main treatment for complex AIOD.However,in recent years,with the development of endovascular surgery technologies and medical instruments,its treatment concept has been greatly changed.More and more clinical evidence has proved that the long-term efficacy of endovascular therapy is not inferior to that of traditional open surgery,so minimally invasive endovascular therapy has become the preferred treatment for AIOD.

[The effect of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy on peritoneal carcinomatosis from colorectal cancer].

Objective: To evaluate the safety and efficacy of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS+ HIPEC) in patients with peritoneal carcinomatosis from colorectal carcinoma (CRC PC). Methods: The clinical and follow-up data of 90 consecutive CRC PC patients underwent CRS+ HIPEC in Beijing Shijitan Hospital from January 2015 to June 2018 were collected. Kaplan-Meier method and parallel Log rank test were used for survival analysis. Cox regression model was used for univariate and multivariate analysis. Results: A total of 90 CRC PC patients underwent CRS+ HIPEC, the median age was 53 years (rage: 13 to 81 years), and 51 cases were male, while other 39 were female. The median overall survival (mOS) was 21.9 months (95%CI: 15.7, 28.1). The 1-, 2-, 3-, and 5-year survival rates were 77.8%, 48.6%, 21.1%, and 5.5%, respectively. The incidence rate of serious adverse event (SAE) was 8.9% (8/90). The mortality rate of perioperative period was 2.2% (2/90). Univariate analysis showed the age (P=0.040), primary tumor site (P=0.020), preoperative carbohydrate antigen 125 (CA125) level (P<0.001), peritoneal cancer index (PCI) (P<0.001), completeness of cytoreduction (CC) (P<0.001), ascites (P=0.012) and postoperative adjuvant chemotherapy (P<0.001) were significantly associated with the OS. Multivariate Cox-analysis identified preoperative CA125 level(P=0.033), CC of 0 to 1 (P=0.014), and adjuvant chemotherapy postoperative (P=0.002) were independent prognostic factor for OS. Conclusions: CRS+ HIPEC can improve survival for CRC PC patients with acceptable morbidity and mortality. Stringent patient selection and complete CRS are two key factors for better survival.

[The predictive value of ureteral wall area for impacted ureteral stones].

Objective: To investigate the clinical indicators for preoperative prediction of impacted ureteral stones and analyze the predictive value of ureteral wall area(UWA). Methods: A total of 197 patients who underwent ureteroscopic lithotripsy due to ureteral stones at our institution from January to December 2020 were retrospectively analyzed. Preoperative patient age, gender, body mass index (BMI), history of hypertension, diabetes mellitus, side of stone, location of stone, maximum diameter of stone, CT value of stone, C-reactive protein (CRP), creatinine, renal pelvis diameter, ureteral wall thickness and UWA were collected. Patients were divided into impacted and non-impacted groups according to whether the stones were impacted intraoperatively. Univariate analysis was used to compare the differences in each clinical indicator between the two groups, and multivariate logistic regression was performed to analyze the independent predictors of impacted stones for those with differences. The receiver operating characteristic (ROC) curve was used to analyze the predictive power of each independent predictor, and the Delong test was used to analyze whether the difference in the area under the curve (AUC) of each independent predictor was statistically significant. Results: All 197 patients successfully completed the operation, aged 51 (36, 56) years; 137 males and 60 females. According to the results of ureteroscopy, they were divided into 82 cases of impacted ureteral stones and 115 cases of non-impacted ureteral stones. Univariate analysis showed that there were significant differences in maximum stone diameter, stone CT value, renal pelvis diameter, ureteral wall thickness and ureteral wall area between the two groups (P<0.05); There was no significant difference in age, gender, BMI, history of hypertension, diabetes, stone side, location of stone, CRP and creatinine (P>0.05). Multivariate logistic regression analysis showed that stone CT value (P<0.01), ureteral wall thickness (P<0.001) and ureteral wall area were independent predictors of impacted ureteral stones (P<0.001). The ROC curve was used to compare the predictive efficacy of independent predictors of stone CT value, ureteral wall thickness and ureteral wall area. The area under the ureteral wall area curve was the largest (AUC = 0.901, 95%CI: 0.859-0.943, P<0.001), followed by ureteral wall thickness (AUC = 0.799, 95%CI: 0.736-0.862, P<0.001) and stone CT value (AUC = 0.700, 95%CI: 0.626-0.775, P<0.001). By Delong test, there were significant differences in AUC between ureteral wall area and stone CT value (Z=4.527, P<0.001) and ureteral wall thickness (Z=3.407, P<0.001). The best predictive value of ureteral wall area was 79.6 mm2. The sensitivity and specificity of this critical value for predicting ureteral incarcerated calculi were 80.1% and 89.5%. Conclusions: The UWA, ureteral wall thickness as well as the CT value of stones were all independent predictors of impacted ureteral stones, and UWA had a better predictive value.

[Consumption of sugar-sweetened beverages and artificially sweetened beverages and risk of cardiovascular disease: a meta-analysis].

Objective: Using Meta-analysis to evaluate the relation of sugar-sweetened beverages (SSBs) intakes and artificially sweetened beverages (ASBs) intakes with risk of incident cardiovascular disease. Methods: "Sugar-sweetened beverages"(SSBs),"artificially sweetened beverages"(ASBs),"coronary heart disease"(CHD),"stroke","cardiovascular disease"(CVD), and related terms (both in English and in Chinese) were searched in Pubmed, EMBASE, Web of Science, Cochrane library, ProQuest, China National Knowledge Infrastructure (CNKI), Wanfang databases, and VIP Chinese Science and Technology Journal. Besides, it searched for additional references in websites including Clinical Tirals.gov and International Clinical Trials Registry Platform. The time was up to May 31st 2020. Stata 13 software was used to calculate pooled RR, perform heterogeneity test, and assess publication bias. Results: A total of 14 articles were included from the 40 804 articles retrieved, including 12 articles from European and American countries and 2 articles from Asian countries. The baseline mean age of the participants ranged from 52 to 69 years, and the mean follow-up time was from 6 to 26 years. Meta-analysis showed that compared with those in the lowest group, the RR (95%CI) for those in the highest group of SSBs consumption was 1.11 (1.04-1.08) for CHD, 1.10 (1.01-1.19) for stroke, and 1.09 (0.96-1.24) for CVD events. The corresponding RR (95%CI) comparing extreme groups of ASBs consumption was 1.10 (0.98-1.23) for CHD, 1.19 (1.09-1.29) for stroke, and 1.32 (1.15-1.52) for CVD events. Further analysis for subtypes of stroke showed that compared with the lowest group, the RR (95%CI) for those in the highest groups of SSBs consumption was 1.10 (0.99-1.22) for ischemic stroke and 0.86 (0.71-1.04) for hemorrhagic stroke. The corresponding RR (95%CI) comparing extreme consumption of ASBs was 1.23 (1.04-1.46) for ischemic stroke and 1.33 (1.03-1.72) for hemorrhagic stroke. Conclusion: Higher consumption of SSBs or ASBs may lead to increased risk of incident CHD and stroke (particularly ischemic stroke).

[Drug-coated balloons versus bare metal stent for treatment of femoropopliteal lesions:36 month follow-up results of single center].

Objective: To examine the therapeutic effects of drug-coated balloon (DCB) and bare metal stent (BMS) on primary femoropopliteal disease (FPAD) in the real world. Methods: This was a retrospective analysis of single-center follow-up results at 12,24,and 36 months of patients with FPAD lesions that were treated with DCB and BMS at Department of Aortic and Vascular Surgery, Fu Wai Hospital.One-to-one propensity score matching(PSM) was performed to balance the covariance between DCB group (137 cases) and BMS group (100 cases). Freedom from clinically driven target lesion reintervention rate(fCD-TLR) was determined by Kaplan-Meier curve.Log-rank test was used to compare the rates of fCD-TLR between DCB and BMS groups at 12,24,36 months post-operation. Results: After PSM, there were both 71 patients in each group,aged (68.0±9.6) years(range: 46 to 90 years) and (68.8±7.3) years(range: 48 to 87 years),lesion lengths were (119.6±14.2)mm(range:40 to 380 mm) and (110.8±13.1)mm(range:40 to 400 mm). The median follow-up period were 24.3 months (range:5.8 to 55.1 months).There was no death,amputation or reintervention within the 30 days after operation.The rates of fCD-TLR for DCB group at 12,24 and 36 months were 97.2%,85.9%,69.1%, and 95.8%,83.1%,59.2% for BMS group.There was no statistical difference between the two groups by Log-rank test (P=0.551). Conclusion: DCB and BMS can both maintain favorable clinical effects in FPAD patients at 12,24,36 months post-operation.

[The application of energy adjustment models in nutritional epidemiology].

The energy adjustment models in nutritional epidemiological studies could substantially reduce the confounding effect of total energy intake from the intake of dietary components, and it could explore the real relationship between the intake of dietary component and research outcomes. Four energy adjustment models were introduced in this article, including the standard multivariate model, multivariate nutrient residual model, energy partition model, and multivariate nutrient density model. The four energy adjustment models were applied to analyze the association between the intake of saturated fatty acids and the risk of all-cause mortality based on the data of the US National Health and Nutrition Examination Survey. The consistent results of different energy adjustment models could indicate that the four models could better control the confounding effect of total energy intake.

[Surgical treatment of total subclavian artery occlusion: a single center experience of 67 cases].

Objective: To examine the outcomes of surgical repair for patients with total subclavian artery occlusion. Methods: A retrospective analysis was performed on 67 patients with subclavian artery occlusion disease admitted at Ward 1 of Aortic and Vascular Surgery Center, Fuwai Hospital from January 2016 to July 2019. The age was, and There were 51 male patients and 16 females with an age of (61.7±8.2) years (range: 37 to 79 years). The t-test, Mann-Whitney U-test, χ(2) test, and Fisher's exact test were used to analyze the factors related to the technique success. The Kaplan-Meier curve was used to calculate the cumulative patency rate and plot the corresponding survival curves, and the Log-rank test was used for comparison. The length from the subclavian artery ostial to the occlusion area was used as a variable to plot the receiver operating characteristic curve, and the optimal cut-off value was determined by the Youden index. Results: Eighteen patients received open surgery. Forty-nine patients with subclavian artery occlusion accepted endovascular repair, of which 38 patients succeeded (31 cases on left side and 3 cases on right side). Fifteen patients failed with endovascular therapy, of which 10 cases received elective surgery and 5 cases received conservative therapy. The success rate of endovascular repair was 69.4%(34/49). Among them, the success rate of left subclavian artery occlusion was 81.6%(31/38), while the right side was 3/11. Patients with the length from the subclavian artery ostial to the occlusion area ≥6 mm were more likely to get success (23/34 vs. 4/15, χ(2)=5.506, P=0.019). In the endo-group, one patient had hemorrhage in the left chest. In the open-group, one patient had lymphatic leakage. Follow-up period ranged from 3 to 46 months with a median of 22 months. The patency of endovascular repair group and the open surgery group was 92.6% and 90.8% at 12-month, while 82.9% and 84.3% at 24-month, respectively. The cumulative patency rates of smoking patients and non-smoking patients after endovascular treatment were 70.2% vs. 100% (P=0.048) at 24-month. No independent prognosis factors were identified through the Cox proportional risk model which significantly affected postoperative patency rates for patients with subclavian artery occlusion. Conclusions: Part of patients with subclavian artery occlusion can be treated by endovascular therapy. The success rate of left subclavian artery occlusions is higher than right sides. The length from the subclavian artery ostial to the occlusion area affected the success rate of repair.

MiR-17-5p modulates mitochondrial function of the genioglossus muscle satellite cells through targeting Mfn2 in hypoxia.

The root cause of obstructive sleep apnea-hypopnea syndrome (OSAHS) is repeated hypoxia during sleep. The genioglossus is one of the most important upper airway dilatation muscles and is important for maintaining normal oxygen supply during sleep. Hypoxia can directly affect the energy metabolism level of the genioglossus muscle, thereby weakening muscle function. MicroRNAs (miRNAs) can regulate mitochondrial function at the post-transcriptional level and achieve recovery or even enhancement of genioglossus function, but the specific mechanism is still unclear. In this study, an intermittent hypoxic cell model was established to detect the effects of hypoxia on the proliferation and apoptosis of Genioglossus muscle satellite cells (GG MuSCs), and the damage to the mitochondrial structure and function was assessed by transmission electron microscopy and mitochondrial membrane potential. Then, miR-17-5p was upregulated and downregulated by miRNA mimics and inhibitors, respectively, and bioinformatics analysis was used to predict and validate the target genes of miR-17-5p. The results showed that the hypoxic environment affected the proliferation of GG MuSCs and mitochondrial membrane potential, which promoted the occurrence of apoptosis and mitochondrial edema. After upregulation of miR-17-5p, cell proliferative capacity and mitochondrial function were restored. Bioinformatics prediction and gene and protein level analyses found that Mfn2 may be a target gene of miR-17-5p. .

[Biomechanical changes of sheep cervical spine after unilateral hemilaminectomy and different degrees of facetectomy].

OBJECTIVE: To establish animal models and investigate the impact of unilateral hemilaminectomy (ULHL) and different degrees of facetectomy (FT) on the cervical spinal biomechanics. METHODS: Twenty sheep were randomly and evenly divided into 4 groups. No operation was performed for group A, right C4-C6 ULHL was performed for group B, right C4-C6 ULHL and 50% ipsilateral C4-C5 FT was performed for group C, right C4-C6 ULHL and 100% ipsilateral C4-C5 FT was performed for group D. Animals of group A, B, C and D were sacrificed 24 weeks after operating and fresh cervical spine specimens were acquired, biomechanically tested and these data were compared to determine whether ULHL and different degrees of FT led to long-term differences in range of motion. RESULTS: (1) Changes of the total range of motion of cervical spine 24 weeks after surgery: the total range of motion of group D (60.2°±8.6°) was significantly greater than group A (40.7°±6.4°) and group B (41.2°±13.1°) under flexion-extension station, the total range of motion of group D (81.5°±15.7°) was significantly greater than that of group A (56.7°±12.2°) and group B (57.7°±12.8°) under lateral bending station, and the total range of motion of group D (38.5°±17.5°) had no obvious increase compared with group A (26.4°±9.9°) and group B (27.1°±10.9°) under axial rotation station. The total range of motion of group C had no obvious increase compared with group A and group B under flexion-extension station (44.1°±11.7°), lateral bending station (73.6°±11.4°) and axial rotation station (31.3°±11.5°). (2) Changes of the intersegmental motion 24 weeks after surgery: the intersegmental motion of group D (20.3°±4.6°) at C4-C5 was significantly greater than that of group A (11.7°±3.4°) and group B (11.9°±2.1°) under flexion-extension station, the intersegmental motion of group D (26.8°±3.5°) at C4-C5 was significantly greater than that of group A (15.2°±3.1°) and group B (16.2°±3.2°) under lateral bending station, the intersegmental motion of group D (15.2°±3.5°) at C4-C5 was significantly greater than that of group A (6.6°±2.3°) and group B (7.1°±1.9°) under axial rotation station. The intersegmental motion of group C (21.2°±4.1°) at C4-C5 was significantly greater than that of group A and group B under lateral bending station, the intersegmental motion of group C at C4-C5 had no obvious increase compared with group A and group B under flexion-extension station (15.7°±3.7°) and axial rotation station (10.3°±3.1°). CONCLUSION: ULHL does not affect cervical stability, ULHL and 50% ipsilateral FT does not affect the long-term cervical stability, ULHL and 100% ipsilateral FT can lead to long-term instability under lateral bending and flexion-extension station.

[Quantitative evaluation of image quality of megavoltage computed tomography for guiding helical tomotherapy].

OBJECTIVE: To quantitatively analyze image quality of two sets of phantom (CatPhan504 and Cheese) Megavoltage computed tomography (MVCT) images acquired by Helical Tomotherapy with three scanning modes (Fine, Normal and Coarse), and to explore and validate a semi-automatic quality assurance procedure for MVCT images of Helical Tomotherapy. METHODS: On Helical Tomotherapy, CatPan504 and Cheese phantoms were scanned with three pitch levels (Fine, Normal, Coarse: 4 mm, 8 mm, 12 mm/circle) respectively. Pylinac, Matlab and Eclipse were used to calculate and compare spatial resolution, noise level and low contrast resolution of images obtained under three scanning modes respectively. The spatial resolution can be evaluated by the blurring of line-pair CT value in the images of CatPhan504's CTP528 module. The noise level can be evaluated by the integral non-uniformity in the images of Cheese's uniformity module. the low contrast resolution can be evaluated by contrast-to-noise ratio of both phantoms' plug-in module, or visibility of the region of interest (Supra-Slice) in the images of CatPhan504's CTP515 module. RESULTS: Analyses on CatPhan504's line pair module(CTP528 module) showed that the first three line pairs(the gap size are 0.500 cm, 0.250 cm and 0.167 cm respectively) could be clearly observed but blurring began to occur from the fourth line pair(the gap size is 0.125 cm) under Coarse mode. Meanwhile, the first four line pairs were all observable under the Normal and Fine modes. Integral non-integrity index(the value negatively correlated with the noise level) were 0.155 7, 0.136 8 and 0.122 9 for Coarse, Normal and Fine modes respectively. None of the Supra-Slice in CatPhan504's CTP515 module could be observed under three imaging modes. Low contrast contrast-to-noise ratio of Cheese phantom was similar under three modes and the insert visibility exhibited nearly linear growth with the increasing difference between CT average value of the insert material and background. CONCLUSION: Superiority and inferiority of three image modes in terms of the three image quality index was not consistent. Evaluation results above could provide reference for more rational decision on scanning modes selection of helical tomotherapy, which was based on image visualization demands in clinical practice. The proposed method could also provide guidance for similar image quality assessment and periodic quality assurance.

[Application of diffusion tensor imaging combined with virtual reality three-dimensional reconstruction in the operation of gliomas involved eloquent regions].

OBJECTIVE: To investigate the values of diffusion tensor imaging (DTI) and virtual reality (VR) techniques in design surgery program of gliomas near eloquent regions. METHODS: In this study, 35 cases were retrospectively analyzed with gliomas involved language areas or rolandic regions operated in Department of Neurosurgery, Peking University Third Hospital from January 2015 to January 2019. Surgery programs were performed by Dextroscope virtual reality system. The pre-operative data, such as the magnetic resonance imaging (MRI), magnetic resonance arteriography (MRA) and DTI was transferred into the VR computer for restitution,Tumors, neural fiber tracts and blood vessels were reconstructed to simulate operation and design individual surgical plan. Neurological function was evaluated 1 week, 1 month and 3 months after operation. RESULTS: Virtual reality three-dimensional images of the 35 cases were successfully achieved, including neural fiber tracts,blood vessels and the lesions. The displacement and destruction of fiber tracts, the anatomic relationship between tumor and important fiber bundle, artery and vein could be shown clearly. Surgical simulation and surgery program of VR of the 35 patients were successfully performed. The 3D images obtained from virtual reality near to the real surgery. Ten of the 35 cases were defined as rolandic regions tumors, 14 of the 35 cases were defined as language areas tumors and 11 of the 35 cases involved both language areas and rolandic regions. Complete resection of enhancing tumor (CRET) was achieved in 30 cases (85.7%), subtotal resection in 5 cases (14.3%), neurological function improved in 34 cases (97.1%) after operation,and 1 case had no improvement compared with that before(2.9%). Thirteen cases without neurological deficit pre-operation, showed transient neurological deficit ,which were recovered about 10 days post-operation, 12 of 22 cases with pre-operative neurologic deficit, improved one week postoperation, 9 of 22 cases with pre-operative neurologic deficit improved one month after operation, the rest 1 case was recurrent with glioblastoma with aggravated hemiplegia symptom after operation, who died of cerebral hernia 2 months later. CONCLUSION: Dextroscope virtual reality system can clearly expose and quantify the 3D anatomic relationship of tumors, neural fiber tracts and blood vessels surrounding gliomas near eloquent regions, which is helpful to design the best individualized surgery program, to improve surgical effect.

[Related factors of frailty in the elderly male patients with chronic kidney disease].

Objective: To investigate the characteristics of frailty in the elderly male patients with chronic kidney disease (CKD) and the effects of renal function on the incidence of frailty. Methods: A total of 105 non-dialysis CKD patients aged ≥65 years who were admitted to the Chinese PLA General Hospital between October 1, 2018 and January 30, 2019 were included in this study. Their clinical data and laboratory indicators were collected. Frailty was defined according to Fried frailty criteria. According to the frailty scores, the participants were categorized as non-frail (n=37), intermediately frail (n=37) and frail (n=31). The association of frailty and the level of estimated glomerular filtration rate (eGFR) in the patients was analyzed using the model of multivariate Logistic regression. Results: Among the 105 patients, the mean age was 74 (68, 77) years old. The incidence of frail and intermediate frail was 35.2% (37/105) and 29.5% (31/105), respectively. Multivariate logistic analysis showed statistically significant associations of frailty with age (OR=1.14, 95%CI:1.08-1.20, P<0.001), body mass index (OR=0.87, 95%CI:0.79-0.95, P=0.001) and the level of eGFR (OR=0.98, 95%CI:0.96-0.99, P=0.003) in those patients. The incidence of frail in patients with eGFR<45 ml·min(-1)·(1.73 m(2))(-1) and 45-59 ml·min(-1)·(1.73 m(2))(-1) was 1.02 (OR=2.02, 95%CI: 1.06~3.87) and 0.84 (OR=1.84, 95%CI: 1.05-3.22) times higher than that of eGFR≥60 ml·min(-1)·(1.73 m(2))(-1), respectively. Conclusion: The incidence of frailty in the elderly patients with CKD is affected by many factors, such as age, body mass index and renal function, and increases with decreased renal function.

[Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy to treat peritoneal carcinomatosis from gastric cancer: a clinical study of 110 patients].

Objective: To evaluate the safety and efficacy of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS+ HIPEC) in patients with peritoneal carcinomatosis from gastric cancer (GCPC). Methods: The clinical data and follow-up results of GCPC patients treated with CRS+ HIPEC were collected for a retrospective analysis. The primary endpoint was survival rate and the secondary endpoint was safety. Results: A total of 110 GCPC patients accepted CRS+ HIPEC, with a median overall survival (OS) of 13.1 months, and with 1-, 2-, 3-, and 5-year survival rates of 56.4%, 24.9%, 11.2%, and 7.8%, respectively. The perioperative mortality was 0.9%, and the morbidity of serious adverse events was 8.2%. Univariate analysis showed that gender, tumor marker before surgery, PC type, length of surgery, postoperative adjuvant chemotherapy, peritoneal cancer index (PCI), completeness of cytoreduction, HIPEC temperature, and ascites had a significant impact on OS. Multivariate Cox-analysis showed that completeness of cytoreduction, ascites, and postoperative adjuvant chemotherapy were independent factors of OS. Conclusion: CRS+ HIPEC improves survival for GCPC patients with normal preoperative tumor markers, low PCI, no ascites and synchronous PC. Stringent patient selection and complete CRS are two key factors for better survival.

[Meta analysis of surgical treatment for old Monteggia fracture in children].

Objective: To analysis the treatment effect of the ulnar osteotomy and ring-shaped ligament reconstruction for the treatment of old Monteggia fracture in children by using Meta analyze, and the difference of clinical curative effect was compared in order to provide the basis for the selection of clinical treatment options for old Monteggia fractures in children. Methods: We searched databases such as CNKI, Wanfang database, Medline, PubMed, Embase and Science through computer, at the same time, the references of relevant documents were retrieved manually, and the data processing was carried out by the RevMan5.3 statistical software provided by the Cochrane cooperation network by incorporating the exclusion criteria. The results were obtained and analyzed. Results: A total of 17 standard literature, 438 cases, 224 cases of ulnar osteotomy, 214 cases with ring ligament repair and reconstruction were obtained. The operation scheme, which was mainly based on the lengthening of ulna osteotomy, was superior to the reconstruction of ring ligament reconstruction. The complications and second operation rates of the former was less than that of the latter. Conclusion: The surgical methods for the reconstruction of the ulna osteotomy and the ring-shaped ligament have advantages and disadvantages. The choice of the operative plan for the old Monteggia fracture should be based on the following factors: the time of the old Monteggia fracture formation, the degree of the ulnar and radial deformity and the familiarity of the operative method.

[Sampling Survey of the Relationship Between Acute Mountain Sickness and Mental Health of Officers and soldiers].

Objective: To sample survey the relationship between acute mountain sickness and mental health of officers and soldiers, so as to provide theoretical direction for the psychological prevent and counsel of them. Methods: In May 2017, 61 officers and soldiers were selectedas subject investigated, and divided to AMS group included 35 persons and non-AMS group included 26 persons according to the finding of theAMS symptom division point table, then used symptom self-testing tableto test and evaluate the mental health of them. Results: The AMS group showed significantly higher scores on the psychological parameters such as omatization, interpersonal sensitivity, depression, anxiety, phobicanxiety, parnoid ideation and so on (105.20±13.82, 1.37±0.26, 1.14±0.21, 1.16±0.19, 1.16±0.18, 1.06±0.11, 1.10±0.17, 1.22±0.19, P<0.05) . Conclusion: The mental factors of omatization, interpersonal sensitivity, depression, anxiety, phobic anxiety, parnoid ideation and so on had great influence on AMS, we should pay attention to these factors and carry on mental intervention, and enhance anti-stress ability of individual, to ensure the successful completion of plateau military mission.

A method to characterize the roughness of 2-D line features: recrystallization boundaries.

A method is presented, which allows quantification of the roughness of nonplanar boundaries of objects for which the neutral plane is not known. The method provides quantitative descriptions of both the local and global characteristics. How the method can be used to estimate the sizes of rough features and local curvatures is also presented. The potential of the method is illustrated by quantification of the roughness of two recrystallization boundaries in a pure Al specimen characterized by scanning electron microscopy.

miR-367 promotes uveal melanoma cell proliferation and migration by regulating PTEN.

We aimed to investigate the biological role of miR-367 in uveal melanoma cell growth and migration, and the underlying mechanism responsible. Quantitative real-time polymerase chain reaction was performed to evaluate miR-367 expression in uveal melanoma tissue samples and cell lines. A miR-367 mimic, miR-367 inhibitor, and negative control oligonucleotide were transfected into these cells to investigate the function of this microRNA. In addition, the role of PTEN in miR-367-mediated uveal melanoma cell growth and migration was evaluated. miR-367 was significantly upregulated in uveal melanoma cells and tissue samples (both P < 0.01). Its inhibition suppressed the proliferation, cell cycle transition, and migration of such cells, and increased levels had the opposite effect. PTEN was confirmed to be a target gene of miR-367. More importantly, co-transfection with a PTEN construct lacking the 3'-untranslated region mitigated miR-367 mimic-induced promotion of uveal melanoma cell proliferation and migration. In summary, miR-367 was found to be upregulated in this malignancy, and may promote uveal melanoma cell proliferation and migration, at least in part by regulating PTEN.