[Scarf osteotomy combined with soft tissue balance release for severe hallux valgus].

OBJECTIVE: To explore clinical effect of Scarf osteotomy combined with soft tissue balance in treating severe hallux valgus. METHODS: Totally 38 patients(50 feet) with severe hallux valux who underwent Scarf osteotomy combined with soft tissue balance surgery from June 2019 to June 2021 were retrospectively analyzed, aged from 29 to 64 years old with an average of(54.7±6.8) years old; 26 feet on the left side and 24 feet on the right side;the courses of disease ranged from 5 to 23 years with an average of (12.4±3.9) years. Hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) were compared before and after operation, and postoperative complications was observed. American orthopedic foot ankle society(AOFAS) score before operation and final follow-up was used to evaluate recovery of forefoot function, and visual analogue scale (VAS) was used to evaluate pain relief. RESULTS: Thirty-eight patients (50 feet) were followed up from 15 to 23 months with an average of (18.3±3.2) months. Preoperative HVA, IMA and DMAA were (44.61±3.92)°, (18.74±2.51)°, (12.85±2.11)°, and improved to (13.45±2.13)°, (7.83±1.36)°, (7.03±1.39)°at final follow-up, which had statistical differneces(P<0.05). No delayed union or nonunion of osteotomy end, fracture or loosening of internal fixation, hallux varus occurred. VAS and AOFAS score improved from (6.81±2.14), (43.6±8.4)points before operation to (1.97±0.78), (87.6±5.2) points at final follow-up, which had statistical difference(P<0.01). According to AOFAS at final follow-up, 20 feet got excellent result, 28 feet good and 2 feet moderate. CONCLUSION: Scarf osteotomy combined with soft tissue balance release for severe hallux valgus has good stability and corrective effect, but learning curve and postoperative complications should be paid attention.

Pathological outcomes of transanal versus laparoscopic total mesorectal excision for rectal cancer: a systematic review with meta-analysis.

BACKGROUND: Since 2010, comparative studies on transanal and laparoscopic total mesorectal excision (TME) have been published and it remains unclear about the oncological benefit from transanal total mesorectal excision (taTME). METHODS: We have searched English databases to identify all taTME studies published between January 2010 and August 2017. Pathological outcomes included circumferential resection margin (CRM), positive CRM (< 1 M), length of distal resection margin (DRM), positive DRM, quality of mesorectum (complete mesorectum), harvested lymph node, and length of the specimen. Odds ratios (ORs) were calculated for dichotomous outcomes and weighted mean differences (WMDs) for continuous outcomes. RESULTS: We have included ten studies comprising of 762 patients. Compared with laparoscopic TME, taTME had a longer CRM (WMD, 0.833; 95% CI 0.366-1.299; P < 0.001), a lower positive rate of CRM (OR, 0.505; 95% CI 0.258-0.991; P = 0.047), and a longer DRM (WMD, 6.261; 95% CI 1.049-11.472; P = 0.019). There were no significant differences in other pathological outcomes. Both cumulative meta-analysis and sensitivity analysis were unable to detect potential sources of the heterogeneity in DRM. There was no evidence of publication bias. CONCLUSIONS: This meta-analysis revealed that taTME had more advantages on positive CRM, CRM, and DRM compared with laparoscopic TME. Compared with laparoscopic TME, more benefits of taTME on pathological outcomes remained undetected. The current findings are all based on observational studies, RCTs with adequate power are required.

Ultrasonic versus electrosurgical device for laparoscopic cholecystectomy: A systematic review with meta-analysis and trial sequential analysis.

BACKGROUND: Ultrasonic and electrosurgical energy dissectors are main dissecting devices widely used for the laparoscopic cholecystectomy. Trial sequential analyses can establish whether firm evidence favoring a specific device has been reached from accumulated literature. To explore this, we performed a meta-analysis and trial sequential analyses. METHODS: PubMed, Embase, and the Cochrane Library were searched from inception to October 2016. The primary outcome was operative time. The secondary outcomes included adverse events during operation, postoperative complications, intra-abdominal collection, hospital stay, hospital costs, and sick leave or time to full recovery. Relative risks (RRs) were calculated for dichotomous outcomes and mean differences (MDs) for continuous outcomes. Finally, we calculated numbers needed to treat to examine benefits of the ultrasonic device. RESULTS: We identified 19 studies. Compared with the electrosurgical device, the ultrasonic device led to shorter operative time (MD, -14.86; 95% confidence interval (CI), -21.45 to -8.27; P < 0.00001), less blood loss (MD, -47.24; 95% CI, -79.57 to -14.90; P = 0.004), fewer gallbladder perforations (RR, 0.45; 95% CI, 0.35 to 0.57; P < 0.00001), shorter hospital stay (MD, -0.37; 95% CI, -0.61 to -0.14; P = 0.002), and fewer abdominal pains (MD, -0.95; 95% CI, -1.40 to -0.50; P < 0.0001). The trial sequential analysis demonstrated that the cumulative z-curve crossed the trial sequential monitoring and reached the required information size of the operative time. The numbers needed to treat to avoid one gallbladder perforation and postoperative nausea, respectively, were 7 and 15. CONCLUSIONS: Compared with the electrosurgery device, the ultrasonic device could be superior with more clinical effectiveness. The trial sequential analysis demonstrated that further studies about the operative time were not needed.

Potential protective effect of arginine against 4-nitrophenol-induced ovarian damage in rats.

4-nitrophenol (PNP) is generally regarded as a diesel exhaust particle (DEP). Arginine plays an important role as a new feed additive, possessing highly efficient antioxidant activities. Here we investigated the effects of dietary supplementation with arginine against ovarian damage induced by PNP in rats. A total of thirty-two female rats postnatal day 28 (PND 28) were randomly divided into four groups. Two groups were fed with basal diet or 13 g/kg arginine in diet for 4 weeks, respectively; the other two groups were given PNP (100 mg/kg b.w.) daily by subcutaneous injection for 2 weeks following pretreatment with either basal diet or arginine diet for 2 weeks. The values of body weight gain (BWG), average daily gain (ADG) and percentage weight gain (PWG) upon PNP treatment were significantly reduced than those in other groups. The relative liver weight in the PNP group was significantly decreased compared with the control group. Treatment with PNP significant reduced the number of corpora lutea, although serum 17ß-estradiol (E2) and progesterone (P4) concentrations were unchanged. The morphology of the ovaries in PNP-treated rats displayed necrosis, follicular deformation and granulosa cells irregular arrangement. Moreover, exposure to PNP enhanced production of malondialdehyde (MDA) and hydrogen peroxide (H2O2), and decreased the activities of total superoxide dismutase (T-SOD) and catalase (CAT), and the co-administration of arginine can attenuate the oxidative stress caused by PNP. These results suggest that arginine may have a protective effect against ovarian damage induced by PNP owing to its antioxidant capacity effect.

VEZT as a novel independent prognostic factor in gastric cancer.

BACKGROUND: Vezatin is an transmembrane protein associated with cell-cell adhesion junctions. In our previous studies, we found that the tumor suppressor function of VEZT was related to methylation of CpG island and were down-regulated in tumor tissue and cells compared to normal controls. However, the role of VEZT gene as a novel putative tumor suppressor in biological characteristics and the relationship with clinicopathological factors and prognosis of gastric cancer was not yet clear. Therefore, we sought to explore these questions and prepare for further research in this study. METHODS: We examined the vezatin expression levels in 119 gastric cancer tissues and adjacent normal tissues by immunohistochemistry. Furthermore, we evaluated the expression of VEZT and its relationship with clinicopathological factors, lymphatic metastasis and prognostic value for gastric cancer. RESULTS: The expression of VEZT was significantly down-regulated in gastric cancer tissues and cell lines and its expression levels was related to differentiation, TNM staging and lymphatic metastasis. Furthermore, analysis of 5-year survival of 119 gastric cancer patients showed that those with strong vezatin expression had significantly longer overall survival time than those with negative vezatin expression. CONCLUSIONS: These data provided an innovative insight that up-regulation of vezatin can be taken as a meaningful way for treating human gastric and other types of cancers. And VEZT expression levels can be considered as a biomarker for gastric cancer progression, lymphatic metastasis and as a novel independent prognostic factor.

[Study on seed quality test and quality standard of Changium smyrnioides].

OBJECTIVE: To study seed quality test methods, and provide basis for establishing seed quality standard of Changium smyrnioides. METHOD: According to the seed testing regulations, the seed quality of C. smyrnioides from different producing area and in different growing years was measured. RESULT AND CONCLUSION: The range of seed purity, weight per 1000 seeds, seed moisture content, seed viability were determined and the primary seed quality classification standard was established.

[Effect of seedling and fertilizering on yield and quality of cultivated Changium smyrnioides].

OBJECTIVE: To study the effects of seedling and fertilizer on yield and quality of cultivated Changium smyrnioides and build a basis for its GAP. METHOD: Experiments were conducted to study the effects of seedling quality and different fertilizering measures on yield and quality of cultivated C. smyrnioides. RESULT: The seedling and fertilizering depth affected the yield of roots obviously. Organic fertilizer combined with nitrogen and phosphorus could increase the amylose content obviously. CONCLUSION: In cultivation, the seedling (root length > 5.0 cm, root diameter > 0.3 cm, fresh root weight > 0.3 g) is optimal. The ideal combination is nitrogen, phosphorus and organic fertilizer. The suggested fertilizering depth ranged from 10 to 15 cm.

[Investigation on biologically characterst of wild species and herbal quality of Changium smyrnioides].

OBJECTIVE: To investigate the species resources of Changium smyrnioides. METHOD: Nine habitat populations of C. smyrnioides, included with population environment, time limit, morphological characters and so on were investigated. The phylogenetic relationship of different habitat populations of C. smyrnioides was studied by isoenzyme electrophoretic analysis of the EST. RESULT: The results showed that wild resources of C. smyrnioides were endangered. Seed germinating rate of cultivated plant was significantly higher than that of wild seed, but polysaccharide content in the root of wild species was significantly higher than that of cultivated plant. There existed a geographic phylogenetic relationship among different habitat populations. CONCLUSION: The wild C. smyrnioides resources are endangered. The wild C. smyrnioides around Nanjing city are better than the others, it could be used for the further selecting of species resources.

[Study on seed dormancy mechanisms of Changium smyrnioides and its geminating conditions].

OBJECTIVE: To study the seed dormancy mechanisms and the optimal seed germinating conditions, so as to provide basis for the seed testing of Changium smyrnioides. METHOD: Put the seeds into wettish sand under temperature of 25, 20, 15, 10, 5 degrees C, observe the shape changing of embryo and measure its length every other 10 days. Carry on experiments of seed germination under temperature of 25,20, 15, 10, 5 degrees C on the paper bed and sand bed, determine the time of germination starting, time of germination lasting, germination rate and germination energy. RESULT: Embryo grew the most quickly under 15 degrees C. The seed germination was largely prohibited when the temperature is higher than 20 degrees C. The mildew rate was very high under 25, 20, 15, 10 degrees C. Put the seeds under 5 degrees C for 45 days could quickly break off its dormancy, and its mildew rate was lower. The seeds germinate fastest under the condition of 15-10 degrees C on the paper bed, and its germination rate was the highest. CONCLUSION: The morphological post-maturation seems the major dormancy mechanism of C. smyrnioides. Temperature is a major factor that affect seed germination of C. smymioides. The best pretreatment method is to put the seeds into 5 degrees C of wettish sand for 45 days. The best germination bed is the paper bed, and the best germination temperature is 15-10 degrees C.