Modified Procedures for ALPPS Based on a Risk-Reduced Strategy: Paralleled Clinical Evaluation at Multiple Institutions

Purpose@#We compared the clinical outcomes of modified procedures for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) based on a risk-reduced strategy with those of classic ALPPS procedures in treating large liver carcinoma. @*Materials and Methods@#Short-term outcomes, increases in future liver remnant (FLR) and functional FLR (FFLR), and overall survival (OS) were compared between 45 consecutive patients treated with modified ALPPS procedures and 34 patients treated with classic ALPPS procedures. @*Results@#Clinical outcomes after the 1st-stage operation markedly improved with the modified procedures. Although the proportions of liver cirrhosis and hepatocellular carcinoma were higher in the modified group, the mortality and incidence of severe complications did not increase. FLR and FFLR hypertrophy at 1 week after the 1st-stage operation were similar in both groups; however, kinetic growth rates in the modified group were lower. OS rates were similar. @*Conclusion@#Modified ALPPS procedures could be safely applied to provide long-term survival for patients with liver cirrhosis without sufficient FLR.

Clinical Application and Advantages of Sanjiao Theory in Sanren Decoction / 中国实验方剂学杂志

Sanrentang， originally contained in the Regulations on Febrile Diseases written by WU Ju-tong in the Qing dynasty， was composed of eight traditional Chinese herbs to treat damp-warm diseases. It is a treatment method of gradually clearing away damp heat of tri-jiao， with characteristics of separating dispersion and mobilizing discharge. "Separating dispersion" means dispersion in separated ways， with different ways to eliminate dampness to export the dampness， heat， evil and turbid out of the body. "Mobilizing discharge" means discharge to stretch and unblock the Qi， to get rid of dampness and evil. It can be seen， Sanrentang， as a desiccating formula， taking "separating dispersion and mobilizing discharge" as the cubic basis， has a significant effect on both internal and external dampness associated with pathogenic heat syndrome， and its clinical application is quite extensive. After consulting the data of the past 10 years， the authors gave a brief overview on the syndrome theory， clinical application and pharmacological effects of Sanrentang， and elaborated the therapeutic effect and pharmacological effect of Sanrentang in the clinical application of upper， middle and lower Tri-jiao respectively， providing theoretical reference for effective development and utilization of Sanrentang. Coronavirus disease-2019（COVID-19） swept the world in early 2020 and it is a great challenge for the medical community to seek for effective prevention and treatment methods. For COVID-19， although the cause of the disease belongs to the Qi of "pestilence"， many doctors have different opinions on the pathogenic characteristics. However， they all agree with the clinical characteristics of "dampness". COVID-19， which has the attribute of "dampness evil"， is so sticky that it can't be cured at once. In addition to the main symptoms such as fever and cough， it is also characterized by the middle-jiao dampness symptoms such as poor appetite， fullness of abdomen， loose stool and diarrhea. It is worthy to further explore the application prospect of Sanrentang in COVID-19 prevention and treatment.

Modified Procedures for ALPPS Based on a Risk-Reduced Strategy: Paralleled Clinical Evaluation at Multiple Institutions

Purpose@#We compared the clinical outcomes of modified procedures for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) based on a risk-reduced strategy with those of classic ALPPS procedures in treating large liver carcinoma. @*Materials and Methods@#Short-term outcomes, increases in future liver remnant (FLR) and functional FLR (FFLR), and overall survival (OS) were compared between 45 consecutive patients treated with modified ALPPS procedures and 34 patients treated with classic ALPPS procedures. @*Results@#Clinical outcomes after the 1st-stage operation markedly improved with the modified procedures. Although the proportions of liver cirrhosis and hepatocellular carcinoma were higher in the modified group, the mortality and incidence of severe complications did not increase. FLR and FFLR hypertrophy at 1 week after the 1st-stage operation were similar in both groups; however, kinetic growth rates in the modified group were lower. OS rates were similar. @*Conclusion@#Modified ALPPS procedures could be safely applied to provide long-term survival for patients with liver cirrhosis without sufficient FLR.

SNP of AHSA2 gene in three cattle breeds using snapshot technology

Droughtmaster is a tropical breed of beef cattle that can survive in hot climates and easily adapt to torrid environments. These traits are important in livestock breeding. In this study, we genotyped five single-nucleotide polymorphisms (SNPs) of the AHSA2 gene from 190 cattle belonging to three different breeds (Droughtmaster, Angus and Simmental) by using snapshot technology. This work aimed to identify the valuable molecular marker of heat resistance in cattle. Results showed that Droughtmaster exhibited higher expected heterozygosity and polymorphic information content compared with the two other breeds. The AHSA2-1 locus deviated from the Hardy– Weinberg equilibrium in the Droughtmaster breed (P \ 0.05). Two SNPs in Droughtmaster diverged significantly from Angus and Simmental. The SNPs were identified as AHSA2-3 and AHSA2-4, which were closely linked to the three breeds based on pair-wise FST. AHSA2-4 involved a missense mutation. In summary, the GG genotypes in AHSA2-3 and AHSA2-4 may be candidate genotypes associated with heat resistance traits and may serve as valuable genetic markers for breeding of heat-tolerant beef cattle in the future.

Distribution of Microbiota in Fine Particulate Matter Particles in Guangzhou, China / 生物医学与环境科学（英文）

Objective@#High PM concentration is the main feature of increasing haze in developing states, but information on its microbial composition remains very limited. This study aimed to determine the composition of microbiota in PM in Guangzhou, a city located in the tropics in China.@*Methods@#In Guangzhou, from March 5 to 10 , 2016, PM was collected in middle volume air samplers for 23 h daily. The 16S rDNA V4 region of the PM sample extracted DNA was investigated using high-throughput sequence.@*Results@#Among the Guangzhou samples, , , , , and were the dominant microbiota accounting for more than 90% of the total microbiota, and was the dominant gram-negative bacteria, accounting for 21.30%-23.57%. We examined the difference in bacterial distribution of PM between Beijing and Guangzhou at the genus level; was found in both studies, but was only detected in Guangzhou.@*Conclusion@#In conclusion, the diversity and specificity of microbial components in Guangzhou PM were studied, which may provide a basis for future pathogenicity research in the tropics.

Long-term effects of autogenous coronoid grafts on the facial growth of children with unilateral temporomandibular joint ankylosis and reconstructed mandibular condyle / 华西口腔医学杂志

OBJECTIVE@#Mandibular condyle injury usually results in malocclusion and disharmony of facial growth in growing children. This study aimed to evaluate the long-term effects of autogenous coronoid grafts on the facial growth of children with unilateral temporomandibular joint (TMJ) ankylosis who underwent mandibular condyle reconstruction.@*METHODS@#Ten growing patients with unilateral bony TMJ ankylosis admitted in West China Hospital of Stomatology, Sichuan University between January 1st, 2008 and December 31st, 2016 were followed up and evaluated. These patients include three males and seven females with ages ranging from 5 years to 12 years at the time of surgery. Each patient underwent gap arthroplasty, condyle reconstruction with ipsilateral coronoid, and interposition of the pedicled temporalis fascial flap in a single operation. The postoperative follow-up ranged from 3 years to 8 years with an average of 4.9 years. Postoperative panoramic radiographs determined the growth of the mandibular height and length on the affected side and compared it with those of the healthy side.@*RESULTS@#All patients recovered uneventfully after surgery. At the end of follow-up period, the maximal mouth opening ranged from 32 mm to 41 mm with an average of 35.6 mm. Mandibular height and length continued to grow after the successful treatment of ankylosis using autogenous coronoid grafts for condyle reconstruction. However, growth deficit still existed. The final ramus height and mandibular length of the affected side at the end of follow-up increased by 25.3% (P<0.05) and 26.1% (P<0.05), respectively, compared with the initial values measured immediately after surgery. Growth rates of ramus height and mandibular length of the affected side were 47.1% and 27.2% lower (P<0.05) than those of the healthy side, respectively.@*CONCLUSIONS@#Mandibular height and length continued to grow after the successful treatment of ankylosis by using autogenous coronoid grafts for condyle reconstruction. However, growth deficit still existed. The growth rate of the affected mandible was reduced compared with that of the undisturbed side even after treatment of ankylosis.

Is Long-term Ambient Air Pollutant Exposure a Risk Factor for Irritable Bowel Syndrome in Children? A 12-year Longitudinal Cohort Study

BACKGROUND/AIMS: Recent studies suggest that air pollution may play a role in gastrointestinal disorders. However, the effect of long-term exposure to air pollution on childhood irritable bowel syndrome (IBS) is unclear. Hence, we conducted a nationwide cohort study to investigate the association between long-term air pollution exposure and the incidence and risk of IBS in Taiwanese children during 2000–2012. METHODS: We collected data from the Taiwan National Health Insurance Research Database, linked to the Taiwan Air Quality-Monitoring Database according to the insurant living area and the air quality-monitoring station locations. Children < 18 years old, identified from January 1st, 2000, were followed-up until IBS diagnosis or December 31st, 2012. The daily average air pollutant concentrations were categorized into 4 quartile-based groups (Q1–Q4). We measured the incidence rate, hazard ratios (HRs), and 95% confidence intervals for IBS stratified by the quartiles of air pollutant concentration. RESULTS: A total of 3537 children (1.39%) were diagnosed with IBS within the cohort during the follow-up period. The incidence rate for IBS increased from 0.84 to 1.76, from 0.73 to 1.68, from 0.85 to 1.98, and from 0.52 to 3.22 per 1000 person-years, with increase in the carbon monoxide, nitrogen dioxide, non-methane hydrocarbon, and methane quartile (from Q1 to Q4) exposure concentration, respectively. The adjusted HR for IBS increased with elevated carbon monoxide, nitrogen dioxide, non-methane hydrocarbon, and methane exposure in Q4 to 1.98, 2.14, 2.19, and 5.87, respectively, compared with Q1. CONCLUSION: Long-term ambient air pollutant exposure is an environmental risk factor for childhood IBS.

Application of colonoscopic tattooing with India ink for localization of colorectal lesions in laparoscopic surgery / 中国内镜杂志

Objective?To investigate the use of submucosal injection of India ink for localization of colorectal lesions in laparoscopic surgery, and to evaluate its efficiency and safety.?Methods?A retrospective study of 146 patients with colorectal lesions from January 2015 to November 2017, who underwent preoperative colonoscopic marking with India ink and subsequently received laparoscopic colectomy was conducted. 1.0 ml of physiologic saline solution was first injected into the submucosa to produce an artificial submucosal elevation, and then 0.2 ml of 1 : 10 diluted India ink followed with another 1ml of physiologic saline solution was injected. Operation time, success rate, complications, location efficiency, and postoperative pathology were evaluated.?Results?The India ink tattooing was easily applied for all patients without complication. At laparoscopic surgery, all lesions could be clearly visualized. No ink diffusion, leakage, and local inflammatory responses were observed. The surgical margins of all samples were tumor negative.?Conclusion?Preoperative submucosal tattooing with India ink is recommended as an easy, safe and economical procedure.

Synergistic induction of apoptosis by combination treatment of sinomenine with cisplatin in human fibrosarcoma HT-1080 cells / 中国病理生理杂志

AIM: To investigate the synergistic antitumor effect of sinomenine(SIN)and cisplatin(DDP) against human fibrosarcoma HT-1080 cells and its possible mechanism.METHODS:CCK-8 assay was used to detect the cytotoxic effect of SIN and DDP in HT-1080 cells,and the combination index(CI)of SIN and DDP was analyzed by Chou-Talalay method.The apoptosis was analyzed by flow cytometry.The protein levels of copper transporter 1(CTR1),gluta-thione S-transferase-π(GST-π),Bcl-2 and Bax were determined by Western blot.RESULTS: At 48 h after treatment with SIN or DDP at various concentrations,the cell viability was remarkably reduced(P<0.05), and the IC50values of DDP and SIN were 6.50 μmol/L and 1.06 mmol/L, respectively.When the inhibition rate of HT-1080 cells exceeded 25%, SIN in combination with DDP produced a synergistic effect(CI<1).Combination treatment of SIN with DDP signi-ficantly induced apoptosis of HT-1080 cells.SIN up-regulated the protein levels of CTR1 and Bax,and down-regulated the protein levels of GST-πand Bcl-2(P<0.05).CONCLUSION:SIN synergistic induces apoptosis with DDP in human fi-brosarcoma HT-1080 cells by up-regulating the protein levels of CTR1 and Bax, and down-regulating the protein levels of GST-πand Bcl-2.

Retroperitoeal malignant peripheral nerve sheath tumors: a clinicopathologic study of 13 cases / 临床与实验病理学杂志

Purpose To investigate the clinicopathology and the expression of H3K27me3 in retroperitoeal malignant pe-ripheral nerve sheath tumors (MPNST). Methods The clini-copathology and prognosis of 13 cases MPNST were analyzed. Immunohistochemical analysis was used to detect H3K27me3 in MPNST, synovial sarcoma, dedifferentiated liposarcoma and leiomyosarcoma. Results 13 cases of MPNST were high-grade. The mean diameter of tumors was 20 cm. 2-year survival rate of MPNST was about 60% . 5-year survival rate of MPNST was a-bout 30% . Compared to NF-1 associated and sporadic MPNST (P＜0. 05), the RT-induced MPNST had a poor prognosis. Re-currence and distant metastasis patient had a poor prognosis( P＜0. 05). Age had no significant effect on patient survival. In addition, immunohistochemical staining showed that the expres-sion of H3k27me3 was absent in 11 of 13 cases of MPNST. And compared with the expression of H3K27me3 in synovial sarco-ma, dedifferentiated liposarcoma and leiomyosarcoma, it had statistical significance of that expression in MPNST (P＜0. 05). Conclusion Retroperitoeal MPNST is common at high-grade. Tumor volume is relatively large and prognosis is poor. RT-in-duced, recurrence and distant metastasis play an important role in survival rate of MPNST. H3K27me3 which is more common absence in high-grade could be an effective marker of MPNST.

Statin and the Risk of Ischemic Stroke or Transient Ischemic Attack in Head and Neck Cancer Patients with Radiotherapy / 대한뇌졸중학회지

No abstract available.

Structural improvement and analysis of a novel endoscopic succession closing device / 医用生物力学

Objective By developing a novel endoscopic succession closing device to overcome the shortcomings of existing devices that cannot deploy several clips at one time,to perform structural analysis on different clamp structures and to validate their performances in tissue closure through finite element analysis.Metbods Comparative analyses of 3 clamp structures,namely,the aligning tooth structure (original,clamp A),the staggered tooth structure (clamp B),a combination structure with page break angle and staggered tooth (clamp C),were performed to analyze pressure and its distribution on tissues when clamping the stomach wall.Displacement of 7.5 mm was then applied on the clamps to simulate the effect from operating procedures of the device and tissue kick-back.Results The maximum stresses of the clamp A and B were located on the first pair of teeth which was closest to the rotating shaft,with the stress of 10.39 kPa and 10.11 kPa,respectively.The maximum stress (11.35 kPa) of the clamp C was located on the second pair of teeth.For clamp A and B,the longer the distance to shaft,the larger pressure on stomach tissues.While for clamp C,the pressure on device-tissue interface showed little change along the path.Under tensile displacement,clamp A and B slipped off from the tissue when displacements reached to 5.0 mm and 6.5 mm,respectively,while clamp C did not slip off.Conclusions Clamp with page break angle and staggered tooth can exert the uniform maximum pressure to tissues and provide a larger contact area away from the rotating shaft,thus improving the anti-slippage and performance of the novel endoscopic closing device.

Effects of strut numbers on biomechanical properties of Z-shaped stent-grafts / 医用生物力学

Objective To analyze the influence from strut numbers on biomechanical properties of Z-shaped stentgrafts,especially on their radial support performance and flexibility,so as to provide theoretical support for the design and clinical selection of Z-shaped stent-grafts.Methods Z-shaped stent-grafts with 5,8,10,12 struts were established by finite element method to simulate the process of compression and bending behavior.Radial displacements were applied on surface of the stent-graft and opposite rotations were applied around the z-axis,until a bending angle of 40° was reached.Then parameters such as stent stress,radial support force,strains in graft,cross-section deflection,bending torque were extracted to evaluate the performance of different stentgrafts.Results Compared with stent-grafts with more strut numbers,5-strut stent-graft showed a better radial support performance with the maximum radial force during compression,and it also generated the smallest 68 N · mm torque and 67.5％ cross-section deflection.The tensile strain in graft of 5-strut stent-graft during the process of bending was relatively smaller.Conclusions The strut number of Z-shaped stent-grafts has a significant influence on biomechanical properties of the stent-grafts.Especially the Z-shaped stent-graft with relatively fewer strut numbers shows an advantage in evaluating radial support performance and flexibility such as the bending torque and the cross-section deflection,and is more suitable to be anchored and fit to the tortuous blood vessel,which will play a positive role in decreasing the complication such as endoleaks and thrombosis.The research findings can guide structure design of Z-shaped stent-grafts and optimal selection for surgery.

Hand reconstruction by transplanting the fostered residual finger and second toe which share the same blood supply system / 中华显微外科杂志

Objective To investigate the methods and results of hand reconstruction by transplanting the fostered residual finger and the second toe,which share the same blood supply system.Methods From January,2014 to January,2016,3 cases with destructive hand injuries in our hospital;and debridement was performed in one session during the early stage of trauma,with skin grafting to cover the wrist stump and foster the residual finger to a branch of the dorsalis pedis artery.The first dorsal metatarsal artery around the toe web was identified and then gradually isolated proximally with dissection of the branches of the dorsalis pedis artery supplying the fostered finger until the convergence of the two blood vessels.Then,reconstructed hand by residual finger and combined second toe transplantation.Results After a follow-up period of 3 months to 2 years,the reconstructed hand had a good appearance and was able to complete basic mundane actions.The function of the limb was restored to a large extent andthe patient was satisfied with the reconstructed hand.Conclusion Transfer of a fostered residual finger and combined second toe which have the same blood supply system for hand reconstruction as a new method need to anastomose only one set of arteries,and it is feasible with the good appearance and function of the reconstructed hand.

Structural improvement and analysis of a novel endoscopic succession closing device / 医用生物力学

Objective By developing a novel endoscopic succession closing device to overcome the shortcomings of existing devices that cannot deploy several clips at one time,to perform structural analysis on different clamp structures and to validate their performances in tissue closure through finite element analysis.Metbods Comparative analyses of 3 clamp structures,namely,the aligning tooth structure (original,clamp A),the staggered tooth structure (clamp B),a combination structure with page break angle and staggered tooth (clamp C),were performed to analyze pressure and its distribution on tissues when clamping the stomach wall.Displacement of 7.5 mm was then applied on the clamps to simulate the effect from operating procedures of the device and tissue kick-back.Results The maximum stresses of the clamp A and B were located on the first pair of teeth which was closest to the rotating shaft,with the stress of 10.39 kPa and 10.11 kPa,respectively.The maximum stress (11.35 kPa) of the clamp C was located on the second pair of teeth.For clamp A and B,the longer the distance to shaft,the larger pressure on stomach tissues.While for clamp C,the pressure on device-tissue interface showed little change along the path.Under tensile displacement,clamp A and B slipped off from the tissue when displacements reached to 5.0 mm and 6.5 mm,respectively,while clamp C did not slip off.Conclusions Clamp with page break angle and staggered tooth can exert the uniform maximum pressure to tissues and provide a larger contact area away from the rotating shaft,thus improving the anti-slippage and performance of the novel endoscopic closing device.

Effects of strut numbers on biomechanical properties of Z-shaped stent-grafts / 医用生物力学

Objective To analyze the influence from strut numbers on biomechanical properties of Z-shaped stentgrafts,especially on their radial support performance and flexibility,so as to provide theoretical support for the design and clinical selection of Z-shaped stent-grafts.Methods Z-shaped stent-grafts with 5,8,10,12 struts were established by finite element method to simulate the process of compression and bending behavior.Radial displacements were applied on surface of the stent-graft and opposite rotations were applied around the z-axis,until a bending angle of 40° was reached.Then parameters such as stent stress,radial support force,strains in graft,cross-section deflection,bending torque were extracted to evaluate the performance of different stentgrafts.Results Compared with stent-grafts with more strut numbers,5-strut stent-graft showed a better radial support performance with the maximum radial force during compression,and it also generated the smallest 68 N · mm torque and 67.5％ cross-section deflection.The tensile strain in graft of 5-strut stent-graft during the process of bending was relatively smaller.Conclusions The strut number of Z-shaped stent-grafts has a significant influence on biomechanical properties of the stent-grafts.Especially the Z-shaped stent-graft with relatively fewer strut numbers shows an advantage in evaluating radial support performance and flexibility such as the bending torque and the cross-section deflection,and is more suitable to be anchored and fit to the tortuous blood vessel,which will play a positive role in decreasing the complication such as endoleaks and thrombosis.The research findings can guide structure design of Z-shaped stent-grafts and optimal selection for surgery.

Finite element modeling and analysis on end-to-end anastomosis of the large intestine / 医用生物力学

Objective To analyze the relationship of closed staple height with tissue damage and compression pressure, so as to provide theoretical references and guidance for the surgeon to choose the appropriate staple cartridge and height, as well as improve the safety of operation. Methods The finite element model of stapled colorectal end-to-end anastomosis was established based on analysis of staple-tissue interaction. Large intestine tissues with different wall thicknesses (1.0-1.5 mm) were compressed by closed staples with 4 different height to compare changes in stress distributions and average radial pressure. Results When the tissues were compressed by closed staple with height of 1.0, 1.1, 1.2 and 1.5 mm, respectively, the average radial stress of compressed tissues with wall thicknesses of 1.2, 1.3, 1.4, and 1.5 mm were 56.0, 58.6, 59.7 and 57.3 kPa, respectively, which was close to the optimal compression pressure. Stress concentrations were found in contact area of the staple and tissues，with the maximum stress being 2 783, 1 750, 1940 and 2 030 kPa, respectively. Conclusions Tissue damage cannot be completely avoided in anastomotic surgery, and stress concentration is generally located near contact region of the staple and tissues. The optimal closed staple height ranges in 50%-60% of the uncompressed tissue height.

Structural improvement and analysis of a novel endoscopic succession closing device / 医用生物力学

By developing a novel endoscopic succession closing device to overcome the shortcomings of existing devices that cannot deploy several clips at a time, to perform structural analysis on different clamp structures and to validate their performances in tissue closure through finite element analysis. Methods Comparative analyses of three clamp structures, namely, the aligning tooth structure (original, clamp A), the staggered tooth structure (clamp B), a combination structure with page break angle and staggered tooth (clamp C), were performed to analyze pressure and its distribution on tissues when clamping the stomach wall. Displacement of 7.5 mm was then applied on the clamps to simulate the effect of the operating procedures of the device and tissue kick-back. Results The maximum stresses of the clamp A and B were located on the first pair of teeth which was closest to the rotating shaft, with the stress being 10.39 kPa and 10.11 kPa, respectively. The maximum stress (11.35 kPa) of the clamp C was located on the second pair of teeth. For clamp A and B, the longer the distance to shaft, the larger pressure on stomach tissues. While for clamp C, the pressure on device-tissue interface showed little change along the path. Under tensile displacement, clamp A and B slipped off from the tissue when displacements reached to 5 mm and 6.5 mm, respectively, while clamp C did not. Conclusions　Clamp with page break angle and staggered tooth can exert the uniform max pressure to tissues and provide a larger contact area away from the rotating shaft, thus improving anti-slippage and performance of the novel endoscopic closing device.

Effects of strut numbers on biomechanical properties of Z-shaped stent-grafts / 医用生物力学

Objective To analyze the influence from strut numbers on biomechanical properties of Z-shaped stent-grafts, especially on their radial support performance and flexibility, so as to provide theoretical support for the design and clinical selection of Z-shaped stent-grafts. Methods Z-shaped stent-grafts with 5, 8, 10, 12 struts were established by finite element method to simulate the process of compression and bending behavior. Radial displacements were applied on surface of the stent-graft and opposite rotations were applied around the z-axis, until a bending angle of 40°was reached. Then parameters such as stent stress, radial support force, strains in graft, cross-section deflection, bending torque were extracted to evaluate the performance of different stent-grafts. Results Compared with stent-grafts with more strut numbers, 5-strut stent-graft showed a better radial support performance with the maximum radial force during compression, and it also generated the smallest 68 N•mm torque and 67.5% cross-section deflection. The tensile strain in graft of 5-strut stent-graft during the process of bending was relatively smaller. Conclusions The struts number of Z-shaped stent-grafts has a significant influence on biomechanical properties of the stent-grafts. Especially the Z-shaped stent-graft with relatively fewer strut numbers shows an advantage in evaluating radial support performance and flexibility such as the bending torque and the cross-section deflection, and is more suitable to be anchored and fit to the tortuous blood vessel, which will play a positive role in decreasing the complication such as endoleaks and thrombosis. The research findings can guide structure design of Z-shaped stent-grafts and the operation to make an optimal selection.

Parkinson’s disease and risk of colorectal cancer: A population-based case-control study in Taiwan

Objective: The aim of this study was to evaluate whether there is an association between Parkinson’s disease (PD) and colorectal cancer in Taiwan. Methods: This was a case-control study using claim data of the Taiwan National Health Insurance Program. There were 64,619 subjects aged 20-84 with newly diagnosed colorectal cancer as cases and 64,619 randomly selected subjects without colorectal cancer as controls from 2005 to 2011. Both cases and controls were matched by sex, age, comorbidities, and index year of diagnosing colorectal cancer. Subjects who were diagnosed with PD within 5 years of diagnosing colorectal cancer were excluded. The multivariable logistic regression model was used to estimate the adjusted odds ratio (OR) and 95% confidence interval (95% CI) for risk of colorectal cancer associated with PD. Results: After adjusting for confounding factors, the multivariable logistic regression analysis revealed that the adjusted OR of colorectal cancer was 0.69 for subjects with PD more than 5 years before index date (95% CI 0.59, 0.81), as compared with subjects without PD. Conclusion: PD is associated with reduced odds of colorectal cancer. Further research is needed to elucidate the mechanisms underlying our findings.