The Genetic Polymorphism and Structural Analysis of 47 Microhaplotypes in a Jiangsu Changshu Chinese Han Population / 生物化学与生物物理进展

ObjectiveTo investigate the genetic polymorphism and structure of 47 autosomal microhaplotypes in the Han population in Changshu City, Jiangsu Province, and to evaluate the forensic efficiencies and forensic parameters. MethodsThe DNA library of unrelated individual samples was prepared according to MHSeqTyper47 kit manual and sequenced on the MiSeq FGx platform. Microhaplotype genotyping and sequencing depth statistics were processed using MHTyper. The genetic information of samples was then evaluated. The fixation index and genetic distance between the Jiangsu Changshu population and the reference populations in the 1000 Genomes Project phase 3 (1KG) were calculated, and forensic parameters were evaluated. ResultsThe fixation index and genetic distance between the Han population in Changshu, Jiangsu, and the CHB (Han Chinese in Beijing, China) reference population in 1KG were the lowest. The effective allele number (Ae) of each locus is also the closest between the two populations. The combined matching probability (CMP) of the Changshu Han population is close to the 5 populations of the East Asian reference super-population in 1KG, which is 1.25×10-36, and the combined probability of exclusion reached 0.999 999 999 964 1. ConclusionThis study reported the genetic polymorphism and allele frequency of 47 microhaplotypes in a Han population in Changshu City, Jiangsu Province. This information provides a data basis for 47 microhaplotypes in forensic applications. In addition, the polymorphism differences between the 1KG reference population and the Han population in Changshu, Jiangsu were compared, and the genetic structure of 47 microhaplotypes in the Han population in Changshu, Jiangsu was revealed. In general, the reference data of the East Asian super-population in 1KG is more in line with the genetic characteristics of Han population in Changshu, Jiangsu.

Prediction of Vasoactive-Inotropic Score on Prolonged Mechanical Ventilation in Adult Congenital Heart Disease Patients After Surgical Treatment Combined with Coronary Artery Bypass Grafting

ABSTRACT Introduction: This study aimed to investigate the predictive value of the vasoactive-inotropic score (VIS) at different time points for postoperative prolonged mechanical ventilation (PMV) in adult congenital heart disease patients undergoing surgical treatment combined with coronary artery bypass grafting. Methods: Patients were divided into two groups that developed PMV or not. The propensity score matching method was applied to reduce the effects of confounding factors between the two groups. VIS at different time points (VIS at the end of surgery, VIS6h, VIS12h, and VIS12h max) after surgery were recorded and calculated. The value of VIS in predicting PMV was analyzed by the receiver operating characteristic (ROC) curve, and multivariate logistic regression was used to analyze independent risk factors. Results: Among 250 patients, 52 were in the PMV group, and 198 were in the non-PMV group. PMV rate was 20.8%. After propensity score matching, 94 patients were matched in pairs. At each time point, the area under the ROC curve predicted by VIS for PMV was > 0.500, among which VIS at the end of surgery was the largest (0.805). The optimal cutoff point for VIS of 6.5 could predict PMV with 78.7% sensitivity and 72.3% specificity. VIS at the end of surgery was an independent risk factor for PMV (odds ratio=1.301, 95% confidence interval 1.091~1.551, P<0.01). Conclusion: VIS at the end of surgery is an independent predictor for PMV in patients with adult congenital heart disease surgical treatment combined with coronary artery bypass grafting.

The consistency and application value of MRI-based ovarian-adnexal reporting and data system in the diagnosis of ovarian adnexal masses / 中华放射学杂志

Objective:To explore the consistency of MRI-based ovarian-adnexal report and data system (O-RADS) score and its diagnostic value for ovarian adnexal masses.Methods:The MRI data of 309 patients with ovarian adnexal masses confirmed by pathology were retrospectively collected from January 2017 to August 2021 in the Second Affiliated Hospital of Soochow University, including 327 lesions consisted of 250 benign lesions, 21 borderline lesions, and 56 malignant lesions confirmed by pathology. Borderline and malignant lesions were classified into the malignant group ( n=77) and benign lesions were classified as benign group ( n=250). Two radiologists scored all lesions according to the MRI-based O-RADS, and scored again after 6 months. The proportion of borderline/malignant lesions in each MRI-based O-RADS score was calculated. The weighted Kappa test was used to assess the intra-reader and inter-reader consistency of the image interpretation results. The receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of MRI-based O-RADS classification for distinguishing benign and malignant ovarian adnexal masses. Results:The weighted Kappa value of the MRI-based O-RADS score between the two radiologists was 0.810 (95%CI 0.764-0.855), and the weighted Kappa values of the two radiologists′ scores at different times were 0.848 (95%CI 0.806-0.889) and 0.875 (95%CI 0.835-0.914), respectively. The borderline/malignant lesions accounted for 0/16, 0.8% (1/127), 10.1% (10/99), 76.0% (57/75), 9/10 and 0/17, 0 (0/122), 8.0% (8/100), 76.2% (48/63), and 84.0% (21/25) of the lesions in the two radiologists based on the MRI O-RADS score of 1, 2, 3, 4, and 5, respectively. When adopting O-RADS score>3 as a cut-off value, the area under the ROC curve of the two radiologists for distinguishing benign and malignant ovarian adnexal masses was 0.928 (95%CI 0.895-0.954) and 0.942 (95%CI 0.911-0.965), respectively. The sensitivity was 0.857 and 0.896, the specificity was 0.924 and 0.924, and the accuracy was 0.908 and 0.917 respectively.Conclusion:The MRI-based O-RADS yields high diagnostic efficiency in the evaluation of benign and malignant ovarian adnexal masses, and the intra-reader and inter-reader consistency of the image interpretation is strong.

Comparison between white light endoscopy and narrow-band imaging endoscopy in predicting histological healing of ulcerative colitis in remission / 中华消化内镜杂志

Objective:To investigate the predictive value of mucosal vascular pattern (MVP) under narrow-band imaging (NBI) enteroscopy in patients with ulcerative colitis (UC) in clinical remission for histological healing and clinical recurrence.Methods:A total of 142 patients with UC in clinical remission who visited the First Affiliated Hospital of Weifang Medical University from January 2018 to January 2021 were included in the study and underwent colonoscopy. The white light and NBI endoscopic images were collected and biopsies were obtained. The Mayo endoscopic score (MES) was calculated based on white light images, and MVP staging was evaluated based on mucosal vascular patterns under NBI. Nancy index (NI) was used to evaluate histological healing and patients were followed up for 1 year. The Spearman correlation coefficients of MES and MVP with histological healing and recurrence were calculated. The receiver operator characteristic (ROC) curve was plotted and the area under curve (AUC) was applied to evaluate the accuracy of white light and NBI endoscopy for predicting histological healing of UC in clinical remission.Results:According to the MVP criteria, 47 were defined as clear, 63 blurred, and 32 invisible. Spearman correlation analysis showed a significant correlation between MVP under NBI and histological healing ( r=0.549, P<0.001) and a moderate correlation between MES under white light and histological healing ( r=0.462, P<0.001). Spearman correlation analysis showed a moderate correlation between MVP under NBI and clinical recurrence ( r=0.451, P<0.001) and a moderate correlation between MES under white light and clinical recurrence ( r=0.352, P<0.001). AUC of NBI for diagnosing histological healing of UC in clinical remission was 0.809 (95% CI: 0.738-0.879), with a sensitivity of 84.6% (77/91) and specificity of 64.7% (33/51), superior to the white light endoscopy, of which AUC, sensitivity and specificity were 0.763 (95% CI: 0.678-0.848), 81.3% (74/91) and 66.7% (34/51). Conclusion:MVP staging under NBI could predict histological healing of UC patients in clinical remission and is superior to white light endoscopy.

A preliminary research of the effect of linaclotide combined with compound polyethylene glycol on bowel preparation for colonoscopy / 中华消化内镜杂志

Objective:To evaluate the effect of linaclotide combined with compound polyethylene glycol (PEG) on bowel preparation for colonoscopy.Methods:This trial was a multicenter randomized controlled study. Subjects scheduled for colonoscopy in 3 digestive endoscopy centers of The First Affiliated Hospital of Naval Medical University, Shanxi Province People's Hospital and the 900th Hospital of Joint Logistics Support Force from November 2021 to March 2022 were randomly assigned to 3 groups using completely random method. The bowel preparation of group A was 3-day linaclotide with 3 L PEG, that of group B was only 3 L PEG, and group C was 3-day linaclotide with 2 L PEG. The primary outcome was the rate of adequate bowel preparation, and the secondary outcomes were the rate of excellent bowel preparation, the completion rate of bowel preparation and the willingness to repeat the corresponding bowel preparation regimen.Results:A total of 130 subjects were enrolled, including 46 in group A, 43 in group B, and 41 in group C. There was no significant difference among the 3 groups in the rate of adequate bowel preparation [95.7% (44/46), 93.0% (40/43) and 95.1% (39/41), χ2=0.465, P=0.893], the rate of excellent bowel preparation [43.5%(20/46), 25.6% (11/43) and 34.1% (14/41), χ2=3.151, P=0.207], or the completion rate of bowel preparation [95.7% (44/46), 95.3% (41/43) and 100.0% (41/41), χ2=1.909, P=0.544]. However, there were significant differences in the willingness to repeat the corresponding bowel preparation regimen among the 3 groups [89.1% (41/46), 74.4% (32/43) and 100.0% (41/41), χ2=12.862, P=0.002]. The bowel preparation completion and willingness rate of subjects in group C were both 100.0%, which were higher than those in group A and group B. Conclusion:Linaclotide is able to improve the quality of bowel preparation and reduce the amount of PEG.

Effect of functional sports on children s spatial awareness aged 6-8 years / 中国学校卫生

Objective@#To examine the effect of functional sports training on the development of spatial awareness in children aged 6-8 years old,to provide a reference to improve children s ability of spatial sense.@*Methods@#A class of 125 children aged 6-8 years from first, second, and third grades of an elementary school in Zhengzhou City were conveniently selected by stratified random sampling, who were divided into the experimental group ( n =62) and the control group ( n =63) by random number tables. The experimental group received functional sports intervention for 8 weeks,3 times a week,20 min each time, and the control group received traditional sports game program.@*Results@#After the intervention,the error values of depth perception, orientation perception, and space perception in the experimertal group of 6 and 7 year old children reduced by 1.98 cm, 2.88°, and 22.00 cm (6 year old children) and 1.61 cm, 2.34°, and 17.99 cm (7 year old children) compared with the control group, respectively. Compared with those in the control group of 8 year old after the intervention, and the differences were of statistical signifiance( t =-3.07, -2.94, -3.07 ; -3.25, -3.29, -3.15, P <0.01). There was no significant difference in the error values of depth perception, orientation perception and space perception between the experimental group and the control group after intervention ( P >0.05). In the experimental group, the error values of depth perception, orientation perception and space perception reduced by 2.30 cm, 3.88°, 28.05 cm (6 year old children), 2.16 cm, 2.15°, 17.45 cm (7 year old children) and 1.16 cm, 1.81°, 9.10 cm (8 year old children) in children aged 6-8 years after intervention, significant improvement were observed compared with before intervention ( t = 8.50 , 9.04, 7.35; 7.39, 10.30, 11.05; 4.67, 4.46, 14.14, P <0.01). Compared with before the intervention, children aged 6-8 in the control group only had significant differences in space perception( t =4.13, 6.71, 8.93, P <0.01).@*Conclusion@#Functional sports games can improve depth perception, orientation perception and spatial perception for children aged 6-8 years. It can be integrated into children s daily activities to play a positive role in promoting the healthy growth of children.

Feasibility of estimating adenoma detection rate based on polyp detection rate in colonoscopy / 中华消化内镜杂志

Objective:To explore the feasibility of estimating adenoma detection rate (ADR) based on polyp detection rate (PDR) in colonscopy.Methods:In the present single-center retrospective study, the conversion coefficient was calculated based on the total colonoscopy cases in 2017. ADR of each colonoscopists was estimated based on PDR and conversion coefficient, which was then verified compared with the actual ADR for consistency.Results:A total of 25 112 colonoscopies with 20 experienced colonoscopists were included. The overall conversion coefficient was 0.483. The intraclass correlation coefficient of the actual ADR and the estimated ADR was 0.818 (95% CI: 0.596-0.924, P<0.01). Conclusion:It is feasible to estimate ADR based on PDR, but this method is only an expediency. More attention should be paid to the establishment of a standardized electronic database.

Application of colonoscopy and cognition of colonoscopists in China: a national survey / 中华消化内镜杂志

Objective:To investigate the current application of colonoscopy at hospitals in China.Methods:From November 2019 to January 2020, an online questionnaire survey was conducted among gastroenterologists and colonoscopists in hospitals of different levels. The contents of questionnaire survey included basic information of colonoscopy at the respondent′s hospital, protocols and patient education of bowel preparation, implementation of colonoscopy quality control, and colonoscopists′ understanding of polypectomy techniques and post-polypectomy follow-up.Results:A total of 236 valid questionnaires were collected, involving 187 hospitals, and 143 (76.5%) had an annual operation capacity of more than 5 000 cases. In terms of bowel preparation, split-dosed polyethylene glycol electrolyte powder (PEG) was the most commonly used (60.4%, 113/187) and the most common volume of PEG was 3 L (67.4%, 126/187). Verbal (90.9%, 170/187) and written (79.7%, 149/187) instructions were given more often than other methods for patient education of bowel preparation. Antifoaming agent was routinely used in 124 (66.3%) hospitals. In terms of quality control, only 11.5% (20/174) hospitals implemented all four measures. In terms of polypectomy techniques, 98.1% (203/207) colonoscopists chose hot snare polypectomy or endoscopic mucosal resection for lesions of diameter>1 cm, while options varied for lesions of diameter<1 cm. The interval of follow-up after polypectomy recommended by colonoscopists was shorter than that by guidelines.Conclusion:Several problems are found in the survey in the application of colonoscopy in China, i. e., patient education of bowel preparation is not diversified; quality control of colonoscopy still needs to be strengthened; polypectomy techniques and follow-up after polypectomy need to be further standardized.

Establishment and preliminary clinical verification of an artificial intelligence-assisted colorectal polyps classification system / 中华消化杂志

Objective:To establish an artificial intelligence (AI)-assisted colorectal polyps classification system (AI polyps system) by using clinical big data, and to conduct the clinical verification.Methods:From June 2018 to June 2019, the colonoscopy images of polyps from 16 participating research centers were prospectively collected. The basic information of the polyps (location, size, shape and pathological biopsy results) in colonoscopy images of colorectal polyps were marked by senior colonoscopist, and the outline of the polyp was circled for the development of the AI polyps system. Taking pathological biopsy results of polyps as the gold standard, the sensitivity, specificity, and positivity predictive value (PPV), negative predictive value (NPV) and accuracy of white light model, narrow band imaging (NBI) model, the combination of white light and NBI model and colonoscopists′ identification of polyps were calculated respectively. Paired McNemar test and Kappa test were used for statistical analysis. Results:A total of 15 441 qualified colonoscopy images were collected, including 9 109 images in white light model and 6 332 images in NBI model. At laboratory level, the sensitivity, specificity, PPV, NPV and accuracy of white light model and NBI model in the identification of the polyps were 90.3%, 98.3%, 89.8%, 98.4%, 97.2%, and 90.5%, 92.5%, 92.3%, 90.6%, 91.5%, respectively. In clinical verification phase, a total of 78 polyps of 56 patients with colorectal polyps were enrolled. The sensitivity, specificity, PPV, NPV and accuracy of the white light model and NBI model in the identification of polyps were 70.3%, 82.1%, 78.8%, 74.4%, 76.3%, and 78.4%, 87.2%, 85.3%, 81.0%, 82.9%, respectively. There were no statistically significant differences between the diagnostic results of colonoscopists, the white light model, the NBI model and the results of pathological results (all McNemar test, all P>0.05), but the consistency were general and the Kappa values were 0.632, 0.525 and 0.657, respectively (all P<0.01). The Kappa value of combination of the white light and NBI model and the pathological results was 0.575, however the consistency was general, but the difterence was statistically significant (McNemar test, P=0.004). Conclusions:The established AI polyps system has a certain role in assisting diagnosis, but the accuracy still needs to be improved.

Expression of Cx43 and Cx45 in Cardiomyocytes of an Overworked Rat Model / 法医学杂志

Objective To study the effect of overwork stress response on the expression of connexin 43（Cx43） and connexin 45（Cx45） in cardiomyocytes and on cardiac function. Methods The experimental animals were divided into control group, overworked 1-month group and overworked 2-month group. A overworked rat model was established by forcing swimming of overworked group. The expressions of Cx43 and Cx45 in myocardial tissues of experimental animals were detected by Western blotting, while the corresponding myocardial tissues were stained with hematoxylin-eosin （HE） staining and Masson's staining, then histologically observed. Results Western blotting results showed that, compared with the control group, Cx43 expression in myocardial tissues of overworked rats decreased while Cx45 expression increased. HE staining and Masson's staining results showed that hypertrophy, rupture and interstitial fiber tissue hyperplasia were observed in myocardial fibers of overworked rats. Conclusion Overwork stress response may affect cardiac function as an independent factor and may even cause heart failure or arrhythmias and lead to death.

Evaluation of a low-residue diet for bowel preparation of colonoscopy / 中华消化内镜杂志

Objective@#To evaluate the clinical value of a commercial low-residue diet (LRD) for bowel preparation of colonoscopy.@*Methods@#This study was a prospective, endoscopist-blind, and randomized controlled trial. Participants were randomly assigned to two groups according to administration of LRD: the experimental group and the control group. Bowel preparation quality, compliance and tolerability of the two groups were compared.@*Results@#A total of 61 patients were enrolled, with 32 in the experimental group and 29 in the control group. The outcomes were as follows: Boston Bowel Preparation Scale (BBPS) (7.8±1.0 VS 7.1±1.3, P=0.037), the rate of bowel preparation adequacy (87.5% VS 79.3%, P=0.388), compliance rate of dietary restriction (78.1% VS 55.2%, P=0.057), preparation completion rate (93.8% VS 93.1%, P=0.919), cecal intubation rate (both were 100.0%) and cecum arrival time (9.1±2.9 min VS 9.8±3.7 min, P=0.417), incidence of adverse (3.1% VS 3.4%, P=0.944), and hunger rate before colonoscopy (34.4% VS 48.3%, P=0.102).@*Conclusion@#The LRD for bowel preparation of colonoscopy significantly improves BBPS, but its effect on improving the bowel preparation adequacy, patient compliance and tolerability needs to be confirmed by further larger-scale trials.

Evaluation of a low-residue diet for bowel preparation of colonoscopy / 中华消化内镜杂志

Objective To evaluate the clinical value of a commercial low-residue diet (LRD) for bowel preparation of colonoscopy. Methods This study was a prospective, endoscopist-blind, and randomized controlled trial. Participants were randomly assigned to two groups according to administration of LRD:the experimental group and the control group. Bowel preparation quality, compliance and tolerability of the two groups were compared. Results A total of 61 patients were enrolled, with 32 in the experimental group and 29 in the control group. The outcomes were as follows:Boston Bowel Preparation Scale ( BBPS) (7. 8±1. 0 VS 7. 1±1. 3, P=0. 037), the rate of bowel preparation adequacy (87. 5％ VS 79. 3％, P=0. 388), compliance rate of dietary restriction (78. 1％ VS 55. 2％, P=0. 057), preparation completion rate (93. 8％ VS 93. 1％, P=0. 919), cecal intubation rate (both were 100. 0％) and cecum arrival time (9. 1± 2. 9 min VS 9. 8±3. 7 min, P=0. 417), incidence of adverse (3. 1％ VS 3. 4％, P=0. 944), and hunger rate before colonoscopy (34.4％ VS 48.3％, P=0.102). Conclusion The LRD for bowel preparation of colonoscopy significantly improves BBPS, but its effect on improving the bowel preparation adequacy, patient compliance and tolerability needs to be confirmed by further larger-scale trials.

MR Lymphangiography for Focal Disruption of the Thoracic Duct in Chylothorax of an Infant: a Case Report and Literature Review / 中国医学科学杂志(英文版)

Chylothorax is a rare cause of pleural effusion in children, and it is usually difficult to identify the location of chyle leakage due to the small size of the thoracic duct in children. Herein we report an infant case with chylothorax whose leakage of the thoracic duct was successfully located by magnetic resonance lymphangiography (MRL) using pre-contrast MR cholangiopancreatography (MRCP) and gadodiamide-enhanced spectral presaturation inversion recovery (SPIR) T-weighted imaging, which demonstrate the imaging method is easy and effective for detecting the focal disruption of the thoracic duct in children with chylothorax and younger than 8 months old.

Prior Radial-Scanning Endoscopic Ultrasonography Training Did Not Contribute to Subsequent Linear-Array Endoscopic Ultrasonography Study Performance in the Stomach of a Porcine Model

BACKGROUND/AIMS: The optimal training mode for linear array endoscopic ultrasonography (EUS) has not been established. Prior radial-scanning EUS training seems to improve subsequent linear array EUS learning. The objective of this randomized controlled trial was to evaluate its value in linear array EUS training. METHODS: In total, 18 freshman trainees conducted hands-on EUS operations on a live pig model. The training contents consisted of visualization and tracking of the pancreas and splanchnic vasculature and performing fine-needle aspiration of the body or tail of the pancreas and celiac plexus neurolysis through the stomach. The trainees were randomized into two groups: group A received linear array EUS training after receiving radial-scanning EUS training, whereas group B conducted linear array EUS training alone. Two teachers assessed the competence of each trainee using a scoring system and relevant parameters before and after the training process. RESULTS: Groups A and B showed significant improvement between the pretests and posttests in terms of diagnostic and interventional procedures. There was no intergroup difference in terms of improvement. CONCLUSIONS: Prior radial-scanning EUS training did not contribute to subsequent linear array EUS study performance in the pig stomach model; thus, this training mode may need to be changed.

An experimental study of EUS-guided radiofrequency ablation of porcine pancreas in vitro / 中华胰腺病杂志

Objective To investigate the extent of radiofrequency ablation of pig pancreas in vitro with various power and duration,and to establish the regression equation of radiofrequency ablation of porcine pancreas in vitro.Methods Among the 4 settings of power (from 5 w ～ 20 w) and 11 settings of duration (from 40s ～ 240s),44 combinations were selected,and every combination was performed twice,then a randomization table including 88 combinations was established,and 88 ablation procedures on porcine pancreases in vitro were performed.The uhrasonography changes were observed,ablation widths (Y) were measured,and pathological examination was performed.In order to construct optimal model and to establish the regression equation of radiofrequency ablation,9 parameters (duration,power,duration × power,the square of duration,the square of power,the square root of duration,the square root of power,the natural logarithm of duration,the natural logarithm of power) derived from duration and power were analyzed via stepwise regression method.Results A rectangular echo enhanced region was observed along the working area of catheter when radiofrequency ablation started,and it gradually became wider during ablation.A hoar-like cylindrical ablation region that was clearly different from surrounding normal pancreatic tissue was formed.Carbonation of necrotic tissue could be observed after radiofrequency ablation under 15 w or 20 w.The optimal model showed a linear positive correlation between ablation width (Y) with the square of power and the natural logarithm of duration.The coefficient of determination of this model was 0.71.Both Fitting curve and Residual scatter diagram showed good fitting effect.Finally,a significant regression equation of radiofrequency ablation was established:Y (mm) =0.005 × E2 + 0.9374 × ln (t)-0.6943.Conclusions A significant regression equation of radiofrequency ablation is established,which provides experimental base for EUS-guided radiofrequency ablation of pancreatic tumors in clinical practice.

Effects of Qishu Granule on PI3K/Akt Signaling Transduction Pathways in the Process of Hepatic Fibrosis / 中国中医药信息杂志

Objective To observe the effects of Qishu granule on PI3K/Akt signaling transduction pathways in the process of hepatic fibrosis, and further explain the anti-hepatic fibrosis mechanism of Qishu granule.Methods Wistar rats were randomly divided into normal group, model group, experimental control group and Qishu granule group. Liver fibrosis was duplicated in rats by intraperitoneal injection of CCl4, and the rats were given appropriate treatment at the same day. Rats in Qishu granule group were given a gavage 2 g/(kg?d), 1.0 mL/100 g, while rats in experimental control group and normal group were given the same amount of aquae sterilisata. Rats in each group were taken liver tissue samples in the 1st, 2nd and 4th week, and were checked for the protein expression levels of p-Akt (Ser473), p-Akt (Thr308), Bad (Ser136) and Caspase9 by Western blot.Results Compared with the model group, expression levels of p-Akt (Ser473), p-Akt (Thr308), Bad (Ser136) and Caspase9 in model and Qishu granule groups increased in every time points (P0.05).Conclusion Qishu granule could regulate PI3K/Akt signaling transduction pathways, and inhibit the occurrence and development of liver fibrosis.

The optimal power of experimental endoscopic ultrasonography-guided pancreas radiofrequency ablation therapy / 中华消化内镜杂志

Objective To explore the optimal power of experimental pancreatic endoscopic ultrasonography (EUS)-guided radiofrequency ablation (RFA) therapy.Methods Six healthy live minipigs were randomly divided into two groups according to random number table,which received RFA under EUS or in laparotomy.Each pig in each group was randomly allocated to received RFA at different power (5 W,10 W,15 W).The impedance was monitored and the time for each therapy was recorded.The width diameter of coagulation necrosis from RFA was measured by EUS and gross pathology.Results RFA was completed in all pigs smoothly with stable life signs and without complications.Gross and micro pathologic observation confirmed formation of coagulation necrosis lesions.The width diameter of lesions from EUS-RFA was similar to that from surgery RFA,both having a maximum value at 10 W power (11 nun VS 10 mm).Conclusion The optimal power of experimental pancreatic EUS-RFA in pig is 10W,which should be further explored for the clinical purpose.

Treatment of type C pelvic fracture with Stoppa approach and posterior percutaneous plate fixation / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical effects of Stoppa approach and posterior percutaneous plate in treating type C pelvic fracture.</p><p><b>METHODS</b>From June 2009 to July 2011,16 patients with type C pelvic fracture were treated with reconstruction plate fixation in Stoppa approach for anterior lesions combined with posterior percutaneous plate fixation for posterior lesions.There were 11 males and 5 females,with an average age of 38.8 years (ranged, 22 to 59 years). According to the Tile classification,10 cases belonged to C1,4 belonged to C2,2 belonged to C3. Tometta and Majeed score standards were used to evaluate clinical results.</p><p><b>RESULTS</b>Sixteen patients were followed up from 4 to 13 months with an average of 7.3 months. Operative time was from 80 to 140 min with an average of 100 min;blood loss volume was from 200 to 500 ml with an average of 280 ml; and the healing time of fracture was from 12 to 16 months with an average of 14 months. According to the Tometta score classification, 9 cases got excellent results, 6 good, 1 fair. According to the Majeed score classification, 9 cases obtained excellent results, 5 good, 2 fair.</p><p><b>CONCLUSION</b>Reconstruction plate fixation in Stoppa approach for anterior lesions combined with posterior percutaneous plate fixation for posterior lesions is an ideal minimally invasive operation in treaing type C pelvic fracture. It can early exercise and has the advandages of small trauma, safe operaton,less complication, stable fixation.</p>

RIFLE and AKIN criteria for mortality and risk factors of acute kidney injury in hospitalized patients / 中南大学学报(医学版)

Objective:To evaluate the mortality and risk factors for acute kidney injury (AKI) in hospitalized patients by the risk, injury, failure, loss, end stage kidney disease (RIFLE) and acute kidney injury network (AKIN). Methods:We constructed a retrospective study of all AKI patients in the Second Xiangya Hospital of Central South University between February 2006 and January 2011. The diagnosis and classiifcation of AKI were reconifrmed and categorized by RIFLE and AKIN criteria. To compare the clinical characteristics, mortality and associated risk factors in AKI patients by the RIFLE and AKIN stage, univariate analysis and multivariate logistic regression analysis were performed. Results:The patients were diagnosed as AKI by AKIN (n=1027) or by RIFLE criteria (n=1020). There was no signiifcant difference in the hospital mortality, hospital length stay (days), or the proportion of complete recovery in each stage of AKI patients by RIFLE and AKIN (P>0.05). In the univariate analysis, age, pre-renal causes, proportion of hospital acquired AKI, mechanical ventilation, hypotension, the number of failed organs, acute tubular necrosis-index severity score (ATN-ISS), and the peak of serum potassium ion concentration were signiifcantly higher in the non-survivors than in the survivors (P<0.05). Logistic regression analysis revealed that age older than 65, hospital acquired AKI, hypotension, number of failed organs, ATN-ISS scores, and the peak of serum potassium ion concentration were independent risk factors for hospital mortality. Conclusion:Both RIFLE and AKIN criteria have similar scientiifc value in assessing hospital mortality. AKI stage is associated with the recent prognosis of AKI patients.

A randomized controlled trial of intensity-modulated radiation therapy plus docetaxel and cisplatin versus simple intensity-modulated radiation therapy in II-III stage esophageal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the efficacy and toxicity of intensity- modulated radiation therapy plus chemotherapy (IMRT-TP) with simple intensity-modulated radiation therapy (IMRT) in the treatment of locally advanced esophageal carcinoma.</p><p><b>METHODS</b>A total of 170 eligible patients with locally advanced esophageal carcinoma were recruited prospectively from September 2004 to April 2008 and randomly divided into IMRT-TP group and IMRT group. Two groups were treated with IMRT of 6MV-X. The radiation dose was 60 Gy in 30 fractions in IMRT-TP group and 66 Gy in 30 fractions in IMRT group. The regimen of chemotherapy consisted of docetaxel and cisplatin in IMRT-TP group for 2 cycles.</p><p><b>RESULTS</b>Of 170 patients, 160 completed the trial, including 75 patients of IMRT-TP group and 85 of IMRT group. As compared to IMRT group, total recurrence rate [69.3% (52/75) vs. 84.7% (72/85), P=0.020] and local recurrence rate [50.7% (38/75) vs. 67.1% (57/85), P=0.035] decreased in IMRT-TP group, the 5-year overall survival (29.3% vs. 15.3%, P=0.031) and 5-year recurrence free survival (24.0% vs. 10.6%, P=0.015) increased in IMRT-TP group. While severe side effect ratio increased obviously in IMRT-TP group [54.7% (41/75) vs. 4.7% (4/85), P=0.000].</p><p><b>CONCLUSION</b>As compare to simple IMRT, IMRT plus docetaxel and cisplatin can decrease the local recurrence rate, prolong the overall survival and regression-free survival, but bring more side effects.</p>