Anti-inflammatory Therapy Progress in Major Adverse Cardiac Events after PCI: Chinese and Western Medicine / 中国结合医学杂志

Acute coronary syndrome (ACS) is one of the leading causes of death in cardiovascular disease. Percutaneous coronary intervention (PCI) is an important method for the treatment of coronary heart disease (CHD), and it has greatly reduced the mortality of ACS patients since its application. However, a series of new problems may occur after PCI, such as in-stent restenosis, no-reflow phenomenon, in-stent neoatherosclerosis, late stent thrombosis, myocardial ischemia-reperfusion injury, and malignant ventricular arrhythmias, which result in the occurrence of major adverse cardiac events (MACE) that seriously reduce the postoperative benefit for patients. The inflammatory response is a key mechanism of MACE after PCI. Therefore, examining effective anti-inflammatory therapies after PCI in patients with ACS is a current research focus to reduce the incidence of MACE. The pharmacological mechanism and clinical efficacy of routine Western medicine treatment for the anti-inflammatory treatment of CHD have been verified. Many Chinese medicine (CM) preparations have been widely used in the treatment of CHD. Basic and clinical studies showed that effectiveness of the combination of CM and Western medicine treatments in reducing incidence of MACE after PCI was better than Western medicine treatment alone. The current paper reviewed the potential mechanism of the inflammatory response and occurrence of MACE after PCI in patients with ACS and the research progress of combined Chinese and Western medicine treatments in reducing incidence of MACE. The results provide a theoretical basis for further research and clinical treatment.

Application of oncoplastic round block technique in surgical management of idiopathic granulomatous mastitis / 中华医学美学美容杂志

Objective:To explore the efficacy of the oncoplastic round block technique in surgical management of idiopathic granulomatous mastitis (IGM).Methods:From January 2014 to December 2019, a total of 18 patients (24 to 38 years old, 32.2 years in average) with IGM underwent excision of the inflammatory breast mass with oncoplastic round block technique, the postoperative clinical efficacy was summarized and analyzed.Results:All 18 patients with IGM underwent excision of the inflammatory breast mass with oncoplastic round block technique, among them 2 patients underwent round-block reduction surgery of contralateral breast at the same time. The median follow-up duration was 16.1 months (from 6 to 36 months). Incision poor healing occurred in two cases which was cured after dressing change. Recurrence occurred in one case at 6 months after operation, and then cured with conservative measures. No other severe complications occurred. All patients were satisfacted with the results.Conclusions:Application of oncoplastic round block technique in surgical management of IGM may remove more tissue in order to reduce the recurrent rate, and get a better cosmetic results.

Pharmacoeconomic Evaluation of Enalapril Folic Acid Tablet and Enalapril Tablet for Stroke Prevention in Patients with Hypertension / 中国药房

OBJECTIVE：To evaluate the pharmacoec onomics of Enalapril folic acid tablet and Enalapril tablet for stroke prevention in patients with hypertension. METHODS ：Markov model was constructed by using Excel 2016 software. Patients with essential hypertension were selected as the research object with 1 year cycle and 20 years horizon. From the perspective of health system，the pharmacoeconomics of Enalapril folic acid tablets versus Enalapril tablets for stroke prevention in patients with hypertension was compared by cost-effectiveness analysis ，and the stability of the research results was verified by sensitivity analysis. RESULTS ：Compared with Enalapril tablet ，the incremental cost-effectiveness ratio of Enalapril folic acid tablet was 221 323 yuan/QALY，which was higher than three times of China ’s per capita GDP in 2020（217 341.04 yuan）. The results of single factor sensitivity analysis and probabilistic sensitivity analysis were consistent with that of basic analysis. CONCLUSIONS ： Compared with Enalapril tablet ，Enalapril folic acid tablet doesn ’t have a better economy for patients with hypertension.

Rutaecarpine exerted anti-osteroporosis / 药学学报

Osteoprotegerin (OPG), secreted by osteoblasts, is a marker of bone turnover. OPG can inhibit osteoclastic differentiation by binding receptor activator of nuclear factor-κB ligand (RANKL). In this study, we found that rutaecarpine (RUT) had the up-regulating OPG activity, and it could significantly increase OPG protein levels in both mouse embryonic osteogenic precursor MC3T3-E1 and human osteosarcoma U-2OS cells. Osteoblastogenic differentiation calcified nodules staining results showed that RUT significantly promoted the osteogenic differentiation of MC3T3-E1 cells. Osteoclastic differentiation tartrate resistant acid phosphatase (TRAP) staining results showed that RUT obviously inhibited the osteoclast differentiation of mouse macrophages RAW264.7 induced by RANKL. In vivo studies showed that low-dose RUT group (5 mg·kg-1·day-1) and high-dose RUT group (45 mg·kg-1·day-1) treatments for 3 months significantly increased bone density in ovariectomized (OVX) rats; calcein double labeling experiment and toluidine blue staining results indicated that low-dose RUT group promoted bone formation and decreased bone loss in vivo; immunohistochemistry results showed that low-dose RUT group increased the expression of OPG in rat femur. All animal procedures were performed in accordance with the regulations of the Institutional Animal Care and Use Committee of Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences. In summary, this study demonstrated that RUT could up-regulate OPG expression and had promoting osteoblastic differentiation and inhibiting osteoclastic differentiation effects in vitro and in vivo.

Chronic Exposure to Hypoxia Inhibits Myelinogenesis and Causes Motor Coordination Deficits in Adult Mice / 神经科学通报·英文版

Exposure to chronic hypoxia is considered to be a risk factor for deficits in brain function in adults, but the underlying mechanisms remain largely unknown. Since active myelinogenesis persists in the adult central nervous system, here we aimed to investigate the impact of chronic hypoxia on myelination and the related functional consequences in adult mice. Using a transgenic approach to label newly-generated myelin sheaths (NG2-CreER

Dicer Deletion in Astrocytes Inhibits Oligodendroglial Differentiation and Myelination / 神经科学通报·英文版

Increasing evidence has shown that astrocytes are implicated in regulating oligodendrocyte myelination, but the underlying mechanisms remain largely unknown. To understand whether microRNAs in astrocytes function in regulating oligodendroglial differentiation and myelination in the developing and adult CNS, we generated inducible astrocyte-specific Dicer conditional knockout mice (hGFAP-CreERT; Dicer fl/fl). By using a reporter mouse line (mT/mG), we confirmed that hGFAP-CreERT drives an efficient and astrocyte-specific recombination in the developing CNS, upon tamoxifen treatment from postnatal day 3 (P3) to P7. The Dicer deletion in astrocytes resulted in inhibited oligodendroglial differentiation and myelination in the developing CNS of Dicer cKO mice at P10 and P14, and did not alter the densities of neurons or axons, indicating that Dicer in astrocytes is required for oligodendrocyte myelination. Consequently, the Dicer deletion in astrocytes at P3 resulted in impaired spatial memory and motor coordination at the age of 9 weeks. To understand whether Dicer in astrocytes is also required for remyelination, we induced Dicer deletion in 3-month-old mice and then injected lysolecithin into the corpus callosum to induce demyelination. The Dicer deletion in astrocytes blocked remyelination in the corpus callosum 14 days after induced demyelination. Together, our results indicate that Dicer in astrocytes is required for oligodendroglia myelination in both the developing and adult CNS.

Chronic Exposure to Hypoxia Inhibits Myelinogenesis and Causes Motor Coordination Deficits in Adult Mice / 神经科学通报·英文版

Exposure to chronic hypoxia is considered to be a risk factor for deficits in brain function in adults, but the underlying mechanisms remain largely unknown. Since active myelinogenesis persists in the adult central nervous system, here we aimed to investigate the impact of chronic hypoxia on myelination and the related functional consequences in adult mice. Using a transgenic approach to label newly-generated myelin sheaths (NG2-CreER

Reliability of tibial anterior crest as the anatomical reference of rotating alignment for tibial component in total knee arthroplasty / 中国骨伤

OBJECTIVE@#This study aimed to research whether anterior tibial crest is a reliable anatomical reference for rotational alignment of tibial component in TKA.@*METHODS@#The study included 122 patients who underwent computed tomography angiography (CTA) examination for unilateral lower extremity trauma with normal contralateral lower extremities, including 89 males and 33 females, with an average age of(51.4±16.4) years old(ranged 18 to 81 years old). Picture archiving and communication system (PACS) was used to mark 11 lines including the surgical epicondylar axis (SEA) connecting the most prominent points of the lateral epicondyle and the deepest point of the sulcus on the medial epicondyle of the femur, axis of medial border of patellar tendon (MEPT)connecting the middle of the posterior cruciate ligament (PCL) and medial border of the patellar tendon at the level of a standard tibial cut from 8 mm distal of the lateral tibial joint surface, transverse axis of tibia (TAT) at the level of a standard tibial cut from 8 mm distal of the lateral tibial joint surface, Akagi line connecting the projected middle of the PCL and medial border of the patellar tendon at the tibial attachment, the axis of the medial 1/3 of patellar tendon(M1/3) connecting the projected middle of PCL and the medial 1/3 of the patellar tendon at the patellar tendon attachment level, Insall line connecting the projected middle of the PCL and the medial 1/3 of tibial tubercle, the axis of medial border of tibial tubercle (MBTT) connecting the projected middle of the PCL and medial border of tibial tubercle, as well as the axis of the proximal anterior tibial crest (PATC), axis 1 of the middle anterior tibial crest (MATC1), axis 2 of the middle anterior tibial crest (MATC2) and the axis of the distal anterior tibial crest (DATC) which were marked by connecting the 4 equidistant points on the sharp anterior tibial crest and the projected middle of the PCL. The angles between TAT and SEA as well as the angles between other axes and the perpendicular to SEA were measured. Pairwise differences among the 10 tibial axes were examined using One-Way ANOVA and paired @*RESULTS@#The angles between the axes of MEPT, Akagi line, M1/3, Insall line, MBTT, PATC, MATC1, MATC2, DATC and the perpendicular to SEA were (-1.6 ±4.5)° , (1.4 ±5.0)° , (10.2±5.1)°, (11.9±5.4)°, (3.6±4.8)°, (12.0±6.9)°, (7.2±8.6)°, (7.1±10.4)°, (6.6±13.5)°, respectively. The angle between TAT and SEA was (4.1±5.3)°. MEPT was external rotation compared to SEA. M1/3, Insall line and PATC were significantly greater than Akagi line, MBTT, TAT (@*CONCLUSION@#The middle tibial anterior crest can be used as a reference for rotational alignment of tibial component in TKA, and its reliability is better than Insall line, but worse than Akagi line, TAT and MBTT.

Advances in research on the effects of tolerance cells on the treatment of autoimmune thyroiditis / 解放军医学杂志

[Abstract] Tolerance is a state in which the human body is less responsive to changes in internal environmental status caused by drugs or other factors. Tolerance is a biological phenomenon, a natural consequence of the action of drugs or chemical factors. Altered organismal tolerance status often leads to the development of multiple autoimmune diseases. Autoimmune thyroiditis (AIT) is a particular type of autoimmune disease, and is exactly the result of an altered immune tolerance of the thyroid gland to a series of "redundant" antigen-antibody binding reactions that produce specific or non-specific inflammation leading to tissue destruction of the thyroid gland. In recent years, a variety of somatic cell therapies have been developed for the purpose of improving the body's tolerance, partially used in the clinical treatment of autoimmune diseases such as systemic lupus erythematosus, multiple sclerosis and Crohn's disease, etc. Such somatic cells that can regulate tolerance are called tolerogenic cells. The present paper will focus mainly on the specific autoimmune diseases such as AIT, discuss the promising therapeutic implications of tolerogenic cells for this group of diseases, and provide a summary of relevant studies. Hopefully, it will provide new research directions for the treatment of the disease.

Analysis on diagnosis and treatment scheme of traditional Chinese medicine in treatment of COVID-19 in Chinese provinces and regions / 中草药

Since December 2019, a novel coronavirus-infected pneumonia was first detected in Wuhan, such cases had been subsequently discovered in other cities. The disease caused by the novel coronavirus was officially named COVID -19 (coronavirus disease 2019) by the world health organization. National Health Commission of China and other provinces and cities have successively performed syndrome differentiation of COVID-19 and provided corresponding Chinese medicine treatment programs. In this epidemic, the disease is a “dampness toxin”. The best principle for treatment is early detection and early treatment. Both Chinese and Western medicine have their own advantages. The advantages could be complementary and could not be replaced each other. Therefore, we collected the Chinese medicine treatment programs for the treatment of COVID-19 comprehensively, conducted a systematic analysis, and especially analyzed the pharmacological basis of traditional Chinese medicine for the treatment of COVID-19, which provided a basis for the rationality of Chinese medicine prescription for the treatment of COVID-19, and provided a reference of updating the diagnosis and treatment plan for provinces and cities.

Pharmacological Analysis of Xuanfei Huazhuo Prescription in Treatment of Coronavirus Disease-2019 / 中国实验方剂学杂志

Objective:The targets and signaling pathways of Xuanfei Huazhuo prescription (XFHZP) for the treatment of coronavirus disease-2019 (COVID-19) were explored, and its possible action mechanisms were described through network pharmacology and basic analysis of modern pharmacology. Method:The compounds and targets in XFHZP were collected through TCMSP and BATMAN-TCM databases. The targets of COVID-19 were studied by GeneCards, NCBI and CTD databases. The PPI network was constructed through STRING database. The networks of "herb-meridian" and "traditional Chinese medicines-compounds-targets-disease" were generated by Cytoscape 3.7.0. Then, Kyoto Encyclopedia of Genes and Genomes（KEGG） analysis and Gene Ontology（GO） analysis were made for shared targets through the Omicshare platform. In addition, the disease targets of multiple organ injury, immune injury and severe acute respiratory syndrome (SARS) were retrieved and then mapped with XFHZP. The ratio of intersection targets to XFHZP's targets was calculated. Result:XFHZP has 10 traditional Chinese medicines in total, including 6 medicines with the meridian tropism to lung, 5 medicines with the meridian tropism to the spleen and 5 medicines with the meridian tropism to the stomach. There were 409 compounds and 2 271 targets. There were 8 same inflammatory factors in targets between XFHZP and COVID-19, and each inflammatory factor corresponded to multiple compounds. XFHZP and COVID-19 had 135 intersection targets, and 36 key targets were screened out. A total of 172 signaling pathways were screened out through KEGG signal pathway enrichment (P<0.05). There were 4 000 biological processes, 254 cell components, and 408 molecular functions (P<0.05) according to GO analysis. XFHZP had many common targets with various organ damage targets and immune damage targets, with the ratio of about 7.6%-97.8%. XFHZP had 173 intersection targets with SARS. Conclusion:XFHZP may treat COVID-19 through anti-inflammatory, organ protecting and immune effects. It will provide a certain theoretical basis for the development of drugs for COVID-19.

Research advances in the clinical features of liver disease during pregnancy / 临床肝胆病杂志

Severe liver disease during pregnancy is uncommon in clinical practice. The most common cause of liver disease during pregnancy is liver dysfunction, with an overall prevalence rate of approximately 3%. Liver disease during pregnancy is classified into the liver diseases directly caused by pregnancy and those co-existing with pregnancy, i.e., pre-existing liver disease or occasional liver disease during pregnancy. A differential diagnosis of pre-existing and co-existing liver diseases may help to improve maternal and fetal outcome. During clinical diagnosis and selection of treatment and intervention measures, priority should be given to the potential impact on mother and fetus. This article introduces the latest research advances in the general information, pathogenesis, treatment, and pregnancy outcome of major liver diseases during pregnancy and elaborates on the risk of pregnancy and related coping measures for patients with pre-existing liver disease, so as to guide clinical diagnosis and treatment and patient management.

Research progress on anti-depression effects of ginsenosides / 药学学报

Ginseng is a traditional Chinese medicine known as the "king of herbs" since ancient time in China. It was found in animal experiments that total saponins, ginsenoside monomers or glycosides from ginseng extraction all showed antidepressant effects in chronic unpredictable stress, corticosterone or lipopolysaccharide induced depression models. Taking ginsenosides as the focus, we reviewed the antidepressive mechanisms from the perspectives of various hypotheses, such as regulations of hypothalamic-pituitary-adrenal axis, monoamine neurotransmitter and neuroplasticity related to the pathogenesis of depression. The mechanism, target and pharmacodynamic targets of ginsenosides for anti-depression were summarized, in order to provide references for multi-targets and multi-level development of new anti-depression drugs, and improvement of diagnosis and treatment of depression from the perspective of traditional Chinese medicine and natural products.

Predicting asymptomatic coronary artery stenosis by aortic arch plaque in acute ischemic cerebrovascular disease: beyond the cervicocephalic atherosclerosis? / 中华医学杂志(英文版)

BACKGROUND@#Asymptomatic coronary artery stenosis (ACAS) ≥50% is common in patients with acute ischemic cerebrovascular disease (AICVD), which portends a poor cardiovascular and cerebrovascular prognosis. Identifying ACAS ≥50% early may optimize the clinical management and improve the outcomes of these high-risk AICVD patients. This study aimed to investigate whether aortic arch plaque (AAP), an early atherosclerotic manifestation of brain blood-supplying arteries, could be a predictor for ACAS ≥50% in AICVD.@*METHODS@#In this cross-sectional study, atherosclerosis of the coronary and brain blood-supplying arteries was simultaneously evaluated using one-step computed tomography angiography (CTA) in AICVD patients without coronary artery disease history. The patients were divided into ACAS ≥50% and non-ACAS ≥50% groups according to whether CTA showed stenosis ≥50% in at least one coronary arterial segment. The AAP characteristics of CTA were depicted from aspects of thickness, extent, and complexity.@*RESULTS@#Among 118 analyzed patients with AICVD, 29/118 (24.6%) patients had ACAS ≥50%, while AAPs were observed in 86/118 (72.9%) patients. Increased AAP thickness per millimeter (adjusted odds ratio [OR]: 1.56, 95% confidence interval [CI]: 1.18-2.05), severe-extent AAP (adjusted OR: 13.66, 95% CI: 2.33-80.15), and presence of complex AAP (adjusted OR: 7.27, 95% CI: 2.30-23.03) were associated with ACAS ≥50% among patients with AICVD, independently of clinical demographics and cervicocephalic atherosclerotic stenosis. The combination of AAP thickness, extent, and complexity predicted ACAS ≥50% with an area under the receiver-operating characteristic curve of 0.78 (95% CI: 0.70-0.85, P < 0.001). All three AAP characteristics provided additional predictive power beyond cervical and intracranial atherosclerotic stenosis for ACAS ≥50% in AICVD (all P < 0.05).@*CONCLUSIONS@#Thicker, severe-extent, and complex AAP were significant markers of the concomitant ACAS ≥50% in AICVD, possibly superior to the indicative value of cervical and intracranial atherosclerotic stenosis. As an integral part of atherosclerosis of brain blood-supplying arteries, AAP should not be overlooked in predicting ACAS ≥50% for patients with AICVD.

An improved peak extraction method for heart rate estimation / 生物医学工程学杂志

In order to solve imperfection of heart rate extraction by method of traditional ballistocardiogram (BCG), this paper proposes an improved method for detecting heart rate by BCG. First, weak cardiac activity signals are acquired in real time by embedded sensors. Local BCG beats are obtained by signal filtering and signal conversion. Second, the heart rate is estimated directly from the BCG beat without the use of a heartbeat template. Compared with other methods, the proposed method has strong advantages in heart rate data accuracy and anti-interference, and it also realizes non-contact online detection. Finally, by analyzing the data of more than 20,000 heart rates of 13 subjects, the average beat error was 0.86% and the coverage was 96.71%. It provides a new way to estimate heart rate for hospital clinical and home care.

Comparison and reflections on the training of rehabilitation physicians in Taiwan and Mainland China / 中华医学教育探索杂志

Rehabilitation physician training is an important part of the development of rehabilitation medicine.Rehabilitation physician education in Taiwan has a complete and standardized training system,and rehabilitation physician training in mainland China is mainly achieved through standardized residency training.This article compares the differences in training processes for rehabilitation physicians in education in medical colleges and universities,residency training,and specialist training between Taiwan and mainland China.The results show that rehabilitation physician training in Taiwan is rigorous and orderly,with reasonable contents,clear objectives,strong specialty,and standardized assessment,while in mainland China,rehabilitation physicians in mainland China have insufficient training time,and there is a lack of detailed training plan and unified assessment standards.Rehabilitation physician training in mainland China needs to learn from advanced experience,further reform the training process,improve the operability of the overall education program,and perfect the training system of rehabilitation physicians.

Interval of ≤2 weeks between 12-core prostate biopsy and laparoscopic radical prostatectomy does not affect perioperative parameters or surgical outcomes / 中华男科学杂志

<p><b>Objective</b>To determine whether a short interval (≤2 weeks) between 12-core prostate biopsy and laparoscopic radical prostatectomy (LRP) affects perioperative parameters and the outcome of surgery.</p><p><b>METHODS</b>This retrospective study included 102 cases of prostate cancer treated by LRP after 12-core prostate biopsy from January 2012 to December 2016. Based on the interval between prostate biopsy and LRP, we divided the patients into three groups: ≤2 wk (n = 35), >2－6 wk (n = 21), and >6 wk (n = 46). The patients averaged 69.87 (59－84) years in age, 24.99 (15.62－33.14) kg/m2 in the body mass index (BMI), 24.41 (0.41－111.78) μg/L in the baseline PSA level, 56.05 (15.97－216.52) ml in the prostate volume, and 7.51 (6－9) in the Gleason score. We analyzed the clinical data, perioperative parameters and outcomes of surgery, and compared them among the three groups of patients.</p><p><b>RESULTS</b>Operations were completed successfully in all the 102 cases without transferring to open surgery. There were no statistically significant differences among the three groups of patients in age, BMI, baseline PSA level, prostate volume, Gleason score, or T stage, nor in the operation time, estimated intraoperative blood loss, blood transfusion rate, intestinal injury, positive incision margin rate, or urinary continence rate at 3 months after surgery.</p><p><b>CONCLUSIONS</b>Laparoscopic radical prostatectomy at ≤2 weeks after 12-core prostate biopsy is safe and effective in the treatment of prostate cancer and does not affect the perioperative parameters and outcomes of surgery.</p>

Progresses of CEUS in diagnosis of breast cancers / 中国医学影像技术

CEUS is a pure blood pool imaging depending on the non-linear effect and strong backscatter of gas-filled microbubbles in blood to obtain contrast-enhanced images.With the advantages of displaying tumor microvascular dynamically and intuitively,CEUS has been widely used for diagnosis and evaluating prognosis of breast cancers.CEUShas high sensitivity and specificity in detecting early breast cancers and identifying sentinel lymph nodes,with wide application prospects in assessing the efficacy of neoadjuvant therapy,predicting molecular typing and targeted therapy of breast cancers.The features of CEUS in breast cancers and the relationships with biomarkers,progresses in assessing neoadjuvant therapy and assisting sentinel lymph node biopsy were reviewed in the article.

Depression and anxiety caused by pegylated interferon treatment in patients with chronic hepatitis B and the therapeutic effects of escitalopram and alprazolam / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the incidence of depression and anxiety caused by pegylated interferon α (PegIFN-α) treatment for chronic hepatitis B (CHB) and assess the efficacy of intervention with escitalopram and alprazolam.</p><p><b>METHODS</b>A total of 165 CHB patients receiving PegIFN-α-based treatment for 12 weeks were assessed for moderate to severe depression and anxiety using Patient Health Questionnaire (PHQ-9) and 7-item Generalized Anxiety Disorder Scale (GAD-7)]. The patients identified to have moderate to severe depression and anxiety treated with escitalopram or alprazolam and the psychological condition of the patients was assessed at the 2nd, 4th and 8th weeks of the treatments.</p><p><b>RESULTS</b>In the 165 patients receiving PegIFN-α treatment, 51 patients developed moderate to severe psychiatric symptoms, incuding 37 (22.4%) with depression, 31 (18.8%) with anxiety, and 17 (10.3%) with both. The symptoms of depression and anxiety was both significantly improved by intervention with escitalopram (P=0.000); alprazolam was effective for anxiety (P=0.001) but did not produce obvious effects on depression (P=0.904). Nevertheless, alprazolam had a much better therapeutic effect than escitalopram on anxiety in these patients (t=-3.198, P=0.010).</p><p><b>CONCLUSION</b>Psychological symptoms are common in CHB patients receiving PegIFN-α treatment. The symptoms of depression and anxiety can be ameliorated by intervention with escitalopram and alprazolam, respectively.</p>

Therapeutic effect of extralevator abdominoperineal excision in combination with conventional abdominoperineal excision on distal rectal cancer:A Meta-analysis / 西安交通大学学报(医学版)

Objective To explore the short and long-term efficacy of extralevator abdominoperineal excision (ELAPE)vs.conventional abdominoperineal excision (APE)on distal rectal cancer.Methods Relevant studies were identified by search of Medline,EMBASE,and Web of Science published between January 1,2008 and February 28,2015,and included in the systematic review and meta-analysis with Stata software (version 12.0). Results Our Meta-analysis included 14 studies involving 3278 patients,of whom 1843 (56.2%)underwent ELAPE and 1435 (43.8%)underwent APE.Compared with patients undergoing APE,those undergoing ELAPE had a significantly reduced risk of intraoperative bowel perforation (IBP)involvement (OR=0 .55 ,95% CI= 0 .37-0 .85 ),but no significant reduction in the occurrence of CRM positivity (OR=0 .81 ,95% CI=0 .52-1 .25 ), local recurrence (LR)(OR=0.49,95% CI=0.18-1.30),wound complications (WCs)(OR=0.93,95% CI=0.65-1.35)or in-hospital death (IHD)(OR=0.89,95% CI=0.47-1.71).Conclusion ELAPE can reduce the risk of IBP but not for CRM positivity or LR when compared with APE.Therefore,more higher-quality studies are needed to verify the short-and long-term effects of ELAPE procedure on distal rectal cancer.