[China guideline for the screening and early detection of prostate cancer (2022, Beijing)].

Prostate cancer (PC) is one of the malignant tumors of the genitourinary system that occurs more often in elderly men. Screening, early diagnosis, and treatment of the PC high risk population are essential to improve the cure rate of PC. The development of the guideline for PC screening and early detection in line with epidemic characteristics of PC in China will greatly promote the homogeneity and quality of PC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. This guideline strictly followed the World Health Organization Handbook for Guideline Development and combined the most up-to-date evidence of PC screening, China's national conditions, and practical experience in cancer screening. A total of fifteen detailed evidence-based recommendations were provided with respect to the screening population, technology, procedure management, and quality control in the process of PC screening. This guideline aimed to standardize the practice of PC screening and improve the effectiveness and efficiency of PC prevention and control in China.

[China guideline for the screening, early detection and early treatment of gastric cancer (2022, Beijing)].

Gastric cancer (GC) is a major digestive tract malignancy in China, which seriously threatens the health of Chinese population. A large number of researches have demons-trated that screening, early detection and early treatment are effective in reducing the incidence and mortality of GC. The development of the guideline for GC screening, early detection and early treatment in line with epidemic characteristics of GC in China will greatly promote the homogeneity and standardization, and improve the effect of GC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. Following the World Health Organization Handbook for Guideline Development, this guideline combined the most up-to-date evidence of GC screening, China's national conditions, and practical experience in cancer screening. This guideline provided evidence-based recommendations with respect to the screening population, technology and procedure management, aiming to improve the effect of GC screening and provide scientific evidence for the GC prevention and control in China.

[China guideline for the screening, early detection and early treatment of esophageal cancer (2022, Beijing)].

Esophageal cancer (EC) is a major digestive tract malignancy in China, which seriously threatens the health of Chinese population. A large number of researches have demonstrated that screening and early detection are effective in reducing the incidence and mortality of EC. The development of the guideline for EC screening and early detection in line with epidemic characteristics of EC in China will greatly promote the homogeneity and standardization, and improve the effect of EC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. Following the World Health Organization Handbook for Guideline Development, this guideline combined the most up-to-date evidence of EC screening, China's national conditions, and practical experience in cancer screening. This guideline provided evidence-based recommendations with respect to the screening population, technology and procedure management, aiming to improve the effect of EC screening and provide scientific evidence for the EC prevention and control in China.

[Development of a Ranking Tool for Scientificity, Transparency and Applicability of Clinical Practice Guidelines].

Objective: To address the limitations of existing methods and tools for evaluating clinical practice guidelines, we aimed to develop a comprehensive instrument focusing on the three main dimensions of guideline development: scientificity, transparency, applicability. We will use it to rank the guidelines according to the scores. We abbreviated it as STAR, and its reliability, validity and usability were also tested. Methods: A multidisciplinary expert working group was set up, including methodologists, statisticians, journal editors, medical professionals, and others. Scoping review, Delphi methods and hierarchical analysis were used to determine the final checklist of STAR. Results: The new instrument contained 11 domains and 39 items. Intrinsic reliability of each domain was indicated by Cronbach's α coefficient, with a average value of 0.646. The Cohen's kappa coefficients for methodological evaluators and clinical evaluators were 0.783 and 0.618. The overall content validity index was 0.905. The R2 for the criterion validity analysis was 0.76. The average score for usability of the items was 4.6, and the mean time spent to evaluate each guideline was 20 minutes. Conclusion: The instrument has good reliability, validity and evaluating efficiency, and can be used for evaluating and ranking guidelines more comprehensively.

[China guideline for the screening and early detection of lung cancer(2021, Beijing)].

In China, the malignant tumor with the highest incidence and motality is lung cancer (LC). As screening and early detection and treatment are effective in reducing LC mortality, formulating a guideline in line with China's national conditions for the screening and early detection and treatment of LC will greatly promote the homogeneity and accuracy of LC screening, and result in an improvement of the effectiveness of LC screening. Commissioned and directed by the Disease Prevention and Control Bureau of the National Health Commission of the People's Republic of China, the guidline was initiated by the National Cancer Center of China and formulated with joint effort by experts from different disciplines. Following the principles and methods in WHO Handbook for Guideline Development, the guidline integrates the latest development in LC screening and early diagnosis and treatment worldwide while fully considering China's national conditions and practical experience in LC screening. It provides detailed evidence-based recommendations for different aspects of LC screening, such as the targeted population, the technologies and the procedures, to regulate the practices of LC screening and early diagnosis and treatment and enhance the effectiveness of the prevention and control of LC in China.

[China guideline for the screening and early detection of female breast cancer(2021, Beijing)].

Breast cancer is the commonest malignant tumor among Chinese females, ranking first in terms of incidence of female cancers. Commissioned by the Disease Prevention and Control Bureau of National Health Commission of the People's Republic of China, the National Cancer Center formulated the Guideline for Screening and Early Diagnosis and Treatment of Female Breast Cancer in China according to WHO Handbook for Guideline Development. The methods on Cochrane China were referred to for the formulation of the system evaluation procedures. The GRADE methods for assessment, formulation and evaluation were adopted for the classification of evidence quality and recommendation strength, and the items were reported according to Reporting Items for Practice Guidelines in Healthcare. Based on the results of evaluation, the guideline gives evidence-based recommendations for the appropriate population and technical procedures for breast cancer screening and early diagnosis and treatment after comprehensive consideration of China's national conditions, the advantages and disadvantages of the evidence, the quality of the evidence, the economic cost of screening, the feedback of multidisciplinary clinical research respondents, and in-person expert consensus. It is aimed at regulating the practices of female breast cancer screening and early diagnosis and treatment and enhancing the effectiveness of the prevention and control of female breast cancer in China.

[Analysis of pathogen monitoring results of infectious diarrhea in Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical University from 2016 to 2019].

Objective: to analyze the distribution characteristics of major enteropathogens in infectious diarrhea cases attending the intestinal outpatient clinic of Beijing Traditional Chinese medicine hospital, Capital Medical University. Methods: From 2016 to 2019, 588 fecal samples of patients with infectious diarrhea in Beijing Hospital of traditional Chinese Medicine Affiliated to Capital Medical University were collected for microbial isolation, culture, identification and pathogen gene detection. Using VITEK 2 compact full-automatic microbial identification/drug sensitivity analysis system to identify the bacteria isolated from the culture; using serum agglutination test to classify the pure colonies; using multiple fluorescence quantitative PCR amplification technology to detect the gene amplification of the samples. Results: In 2016-2019, the total physical examination rate of pathogen was 39.796%. The top three pathogen were diarrhea Escherichia coli (21.769%, n=128), Salmonella (5.782%, n=34), Vibrio (4.762%, n=28). The difference of positive rates of different pathogens in four years was statistically significant (P=0.021), and the peak of incidence was from July to September. The positive rate of norovirus was 5.612% (n=33), and the highest incidence occurred in May. Conclusion: The pathogen of infectious diarrhea patients in Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University from April to October 2016-2019 is mainly diarrhea Escherichia coli, and the pathogen type of norovirus is GⅡ genome.

[Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province].

Objective: To study the effect of COVID-19 on pregnancy outcomes and neonatal prognosis in Hubei Province. Method: s A retrospective comparison of the pregnancy outcomes was done between 16 women with COVID-19 and 45 women without COVID-19. Also, the results of laboratory tests, imaging examinations, and the 2019 novel coronavirus (2019-nCoV) nucleic acid test were performed in 10 cases of neonatal delivered from women with COVID-19. Result: s (1) Of the 16 pregnant women with COVID-19, 15 cases were ordinary type and 1 case was severe type. No one has progressed to critical pneumonia.The delivery method of the two groups was cesarean section, and the gestational age were (38.7±1.4) and (37.9±1.6) weeks,there was no significant difference between the two groups (P>0.05). Also, there wee no significant differences in the intraoperative blood loss and birth weight of the newborn between the two groups (all P>0.05). (2) Ten cases of neonates delivered from pregnant women with COVID-19 were collected. The 2019-nCoV nucleic acid test were all negative.There were no significant differences in fetal distress, meconium-stained amniotic fluid, preterm birth, and neonatal asphyxia between the two groups (all P>0.05).(3) In the treatment of uterine contraction fatigue, carbetocin or carboprost tromethamine was used more in cesarean section for pregnant women with COVID-19 (1.3±0.6), compared with Non-COVID-19 group (0.5±0.7),the difference was statistically significant (P=0.001). Conclusions: If there is an indication for obstetric surgery or critical illness of COVID-19 in pregnant women, timely termination of pregnancy will not increase the risk of premature birth and asphyxia of the newborn, but it is beneficial to the treatment and rehabilitation of maternal pneumonia. Preventive use of long-acting uterotonic agents could reduce the incidence of postpartum hemorrhage during surgery. 2019-nCoV infection has not been found in neonates delivered from pregnant women with COVID-19.

[Study on occupational stress response of orphans and disabled children care workers in Nanjing].

Objective: To explore the status quo of occupational stress and its influencing factors of nursing staff for orphaned and disabled children in Nanjing, and to put forward measures for adverse reactions to occupational stress, so as to ensure the psychological health of this occupational population. Methods: From February to May 2017, 236 nursing assistants for orphans and disabled children in Nanjing social welfare home were selected by cluster sampling method. The occupational stress index(occupational stress indictor, OSI) was used to investigate occupational stress response and occupational stress factors. Partial correlation and multiple linear regression were used for statistical analysis. Results: The scores of job satisfaction, mental health and depressive symptoms in occupational stress reaction were (43. 99±6. 83) , (36. 09±4. 59) and (17. 31±2. 44) re- spectively. In terms of job satisfaction, work monotony, logic and compound change were the contributing fac- tors (P<0. 05) , task strategy and task control were negative factors (P<0. 05) ; on mental health, opportunities were raised and participation in decision-making Self-esteem, technology utilization, environmental control, time management, task strategy and support of colleagues as contributing factors (P<0. 05) , ambition and role conflicts as negative factors (P<0. 05) ; on depression, work input, participation Decision-making, promotion opportunities and behavioral characteristics were protective factors (P<0. 05 ) . Conclusion: Occupational stress among caregivers of orphans and disabled children cannot be ignored. Occupational stress reaction is serious. Occupational stress factors should be reduced and individual stress coping ability should be enhanced.

[The current situation of occupational burnout and its influencing factors among orphan child care workers in Nanjing].

Objective: To explore the status of job burnout of nurses for orphans and disabled children in Nanjing and its influencing factors, so as to provide reference for promoting the mental health of nurses for orphans and disabled children. Methods: From February to May, 2017, a cross-sectional survey was conducted among 236 nurses working in social welfare institutions for orphans and disabled children in Nanjing, using Occupational Stress Indicator (OSI) and Maslach Burnout Inventory (MBI) . It investigated the status of job burnout among nurses of orphans and disabled children, logistic regression analysis was used to explore the effect of occupational stress on the incidence of job burnout of nurses for orphans and disabled children. Results: The results showed that the incidence of job burnout was 67.37% (159/236) , the incidence of job burnout was negatively correlated with behavioral characteristics and family support, the incidence of emotional exhaustion was positively correlated with task control and job monotony (P<0.05) , and negatively correlated with role ambiguity and job satisfaction (P<0.05) . The incidence of depersonalization was negatively correlated with job monotony and peer support (P<0.05) . Conclusion: The nurses of orphans and disabled children have serious job burnout. Occupational stress factors, personality characteristics and relieving factors have influence on the incidence of job burnout.

[Sarcopenia and long-term prognosis of patients with chronic heart failure in patients aged 70 years and over].

To explore the association between sarcopenia (SAR) and long-term prognosis of patients with chronic heart failure (CHF) aged 70 years and over, 182 CHF patients from January 1, 2012 to December 31, 2014 were included in the present study. The patients were divided into the SAR group and the non-SAR group. The median follow-up period was 36 (3, 57) months. The endpoint was any heart failure-related event (HFRE). There were significant differences in age, body mass index, hemoglobin, B-type natriuretic peptide, hypersensitive troponin T (hs-TnT), left ventricular ejection fraction (LVEF) and cardiac function class between the two groups (all P<0.05). The Kaplan-Meier analysis showed that the survival time of the non-SAR patients was much longer than that of the SAR patients (P<0.05). The multivariate Cox regression analysis indicated that SAR was an independent risk factor for HFRE, suggesting a role of sarcopenia on long-term prognosis of patients with chronic heart failure.

Isolation of bacterial strains able to metabolize lignin and lignin-related compounds.

UNLABELLED: In this study, we identified five strains isolated from soil and sediments able to degrade kraft lignin, aromatic dyes and lignin derivatives. Using 16S rRNA gene sequencing, the isolates were identified as Serratia sp. JHT01, Serratia liquefacien PT01, Pseudomonas chlororaphis PT02, Stenotrophomonas maltophilia PT03 and Mesorhizobium sp. PT04. All the isolates showed significant growth on lignin with no water-extractable compounds. Synthetic aromatic dyes were used to assess the presence of oxidative enzymes. All the isolates were able to use the thiazine dye Methylene blue and the anthraquinone dye Remazol Brilliant Blue R as the sole carbon source. Guaiacol, veratryl alcohol and biphenyl were also mineralized by all the strains isolated. These results suggest they could be used for the treatment of aromatic pollutants and for the degradation of the lignocellulosic biomass. SIGNIFICANCE AND IMPACT OF THE STUDY: The valorization of waste lignin and lignocellulosic biomass by biocatalysis opens up new possibilities for the production of value-added substituted aromatics, biofuel and for the treatment of aromatic pollutants. Bacteria with ligninolytic potential could be a source of novel enzymes for controlled lignin depolymerization. In this work, five soil bacteria were isolated and studied. Every isolate showed significant growth on lignin and was able to degrade several lignin monomers and ligninolytic indicator dyes. They could thus be a source of novel ligninolytic enzymes as well as candidates for a bacterial consortium for the delignification of lignocellulosic biomass.

Network meta-analysis of Chinese herb injections combined with FOLFOX chemotherapy in the treatment of advanced colorectal cancer.

WHAT IS KNOWN AND OBJECTIVE: Research has indicated that some Chinese herb injections (CHIs) might be beneficial in combination with chemotherapy, including remedies that might be used as effective chemosensitizers and radiosensitizers, or as palliative therapy. Here, we carried out a network meta-analysis to assess the clinical efficacy and safety of CHIs combined with oxaliplatin, 5-fluorouracil and leucovorin (FOLFOX) for advanced colorectal cancer (CRC). METHODS: PubMed, EMBASE.com, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Biomedical Literature Database (CBM), Wanfang Database and Chinese Journal Full-text Database were searched from inception to 31 December 2014, to identify relevant randomized controlled trails (RCTs). The risk of bias in included RCTs was evaluated according to the Cochrane Handbook version 5.1.0. Standard pairwise meta-analysis and Bayesian network meta-analysis were performed to compare the efficacy and safety of different CHIs combined with FOLFOX. Data were analysed using STATA 12.0 and WinBUGS1.4 software. RESULTS AND DISCUSSION: We identified 63 eligible studies (with 4837 patients in total), involving 9 CHIs. Pairwise meta-analysis showed that compared with FOLFOX alone, combinations with Aidi injection and compound matrine injection could significantly improve the overall response rate and quality of life and reduce the incidence of nausea and vomiting (III-IV), diarrhoea (III-IV), thrombocytopenia (III-IV), leukopenia (III-IV) and peripheral neurotoxicity (III-IV). According to results of indirect comparison, there were no statistically significant differences for most of comparison groups. Aidi+FOLFOX, shenqifuzheng+FOLFOX and compound matrine+FOLFOX had the greatest probability of being the best treatment in clinical efficacy and safety, considering the small sample size. WHAT IS NEW AND CONCLUSIONS: Most of the included studies were of low quality, and there was a scarcity of eligible trials and numbers of participants. Based on currently limited evidence, aidi, shenqifuzheng and compound matrine were superior to other CHIs in patients receiving FOLFOX chemotherapy for advanced CRC. More studies are required to confirm the efficacy of CHIs in combination with FOLFOX for advanced CRC.

Effects of mutations on the structure and function of silkworm type 1 acetylcholinesterase.

AChE is the target of organophosphate (OP) and carbamate (CB) pesticides, and mutations in the gene can significantly reduce insects' sensitivity to these pesticides. Bombyx mori is highly sensitive to pesticides. To investigate the effects of mutations on AChE1 structure and function, we used a prokaryotic system to express B.mori wild type AChE1 (wAChE1) and mutant AChE1 (mAChE1) in this study. Active AChE1 proteins were obtained after refolding and purification, and wAChE1 and mAChE1 had similar activities. After incubation with 10(-6)M physostigmine and 10(-3)mg/mL phoxim, the remaining enzyme activity of mAChE1 was 4.42% and 8.86% higher than that of wAChE1's, respectively. Three-dimensional analysis of mutation AChE1 (mAChE1) revealed that the Ser and Ala side chains extended toward the central part of S285 with distances of just 2.80Å and 3.68Å, respectively, which changed the spatial structure of the active center and reduced its sensitivity to pesticides. These results indicated that the mutations altered the 3D structure of AChE1, which may affect the binding of physostigmine and phoxim to the serine residue at the active center, leading to reduced sensitivity. Our study helps understand the relationship between AChE1 mutations and pesticide resistance and provides a new direction for the cultivation of new pesticide-resistant varieties of B.mori.

Mechanisms of TiO2 NPs-induced phoxim metabolism in silkworm (Bombyx mori) fat body.

Silkworm is an important economic insect. Abuse of organophosphorus pesticides in recent years often leads to poisoning of silkworms, which significantly affects sericulture development by reducing silk production. Previous studies have shown that TiO2 NPs can effectively mitigate the damages caused by organophosphorus pesticides in silk glands and nerve tissues. The fat body is an important metabolic detoxification organ of silkworms, but it is unknown whether TiO2 NPs affect pesticide metabolism in fat body. In this study, we characterized the transcription of antioxidant genes and enzyme activity in fat body after TiO2 NPs and phoxim treatments using transcriptome sequencing, real-time PCR, and enzyme activity assay. Transcriptome sequencing detected 10 720, 10 641, 10 403, and 10 489 genes for control group, TiO2 NPs group, phoxim group, and TiO2 NPs+phoxim group, respectively. The TiO2 NPs+phoxim group had 705 genes with significantly differential expression (FDR<0.001), among which the antioxidant genes thioredoxin reductase 1 and glutathione S-transferase omega 3 were significantly upregulated. In phoxim group, the expression levels of superoxide dismutase (SOD), catalase (CAT), glutathione S-transferase delta (GSTd), and thioredoxin peroxidase (TPx) were increased by 1.365 -fold, 1.335 -fold, 1.642 -fold, and 1.765 -fold, respectively. The level changes of SOD, CAT, GSTd, and TPx were validated by real time PCR. The contents of reactive oxygen species (ROS), malondialdehyde (MDA), and hydrogen peroxide (H2O2) were increased by 1.598 -fold, 1.946 -fold, and 1.506 -fold, respectively, indicating that TiO2 NPs treatment can relieve phoxim-induced oxidative stress. To clarify the mechanism of TiO2 NPs's effect, the transcription levels of P450 gene family were measured for the TiO2 NPs+phoxim group; the expression levels of CYP4M5, CYP6AB4, CYP6A8, and CYP9G3 were elevated by 2.784 -fold, 3.047 -fold, 2.254 -fold, and 4.253 -fold, respectively, suggesting that high expression of P450 family genes can enhance the metabolism of phoxim in the fat body. The results of this study indicated that TiO2 NPs treatment promoted the transcriptional expression of the P450 family genes to improve the fat body's ability to metabolize phoxim and reduce phoxim-induced oxidative stress. This may be the main mechanism of TiO2 NPs' mitigation of phoxim-induced damages in the fat body.

[Effect of traditional Chinese medicine treatment as maintenance therapy on regulating the serum concentration of sCTLA-4 in patients with advanced non-small-cell lung cancer and its relationship with prognosis].

Objective: To evaluate the effect of traditional Chinese medicine (TCM) treatment as maintenance therapy on regulating the serum concentration of soluble cytotoxic T lymphocyte associated antigen-4 (sCTLA-4) in patients with advanced non-small-cell lung cancer (NSCLC) and the relationship between sCTLA-4 and time to progression (TTP). Methods: This study was conducted as a prospective, randomized, controlled trial. 64 non-progressive patients who responded to initial therapy were randomized 1∶1 to the TCM arm (treated with cinobufacini injection, herbal decoction and Chinese acupoint application, n=32) or to the chemotherapy arm (n=32). Each cycle was 21 days. Cycles were repeated until disease progression, unacceptable toxicity, or until the patient requested therapy discontinuation.The serum concentration of sCTLA-4 was detected by enzyme linked immunosorbent assay (ELISA) in the 64 patients with advanced NSCLC before and after two cycles of maintenance treatment. Cox regression was used to analyze the relative ratio for the risk of disease progression. Results: After 2 cycles of maintenance TCM treatment, the serum concentration of sCTLA-4 in patients with advanced NSCLC was (12.77±2.37 pg/ml), significantly lower than that before treatment (40.30±10.75)(P=0.013). After 2 cycles of maintenance chemotherapy, the serum concentration of sCTLA-4 was higher than that before treatment, but was not significantly different (44.48±10.12 vs. 46.64±11.21 pg/ml, P=0.612). After 2 cycles of maintenance treatment, TCM treatment can significantly bring down the serum concentration of sCTLA-4 compared to chemotherapy (12.77±2.37 vs. 46.64±11.21 pg/ml, P=0.004). The multivariate analysis indicated that sCTLA-4 levels and treatment regimen were independent prognostic factors for TTP (P<0.05 for both). Conclusions: Regulating the serum concentration of sCTLA-4 may be one of the mechanisms of TCM maintenance treatment of NSCLC. Trial registration Chinese Clinical Trial Register, ChiCTR-TRC-10001017.

[The efficiency of different biliary cannulation in endoscopic retrograde cholangiopancreatography: a meta-analysis].

Objective: To compare the success rates of wire-guided biliary cannulation (WGC) and conventional cannulation (CC) and their effect on the outcome of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). Methods: All randomized controlled trials (RCTs) were collected by searching CNKI, WanFang Data, CBM, PubMed, Embase and Cochrane Library.The assessment of methodological quality and data extraction of the included studies were performed independently by two reviewers. Meta-analysis was conducted with RevMan 5.2 software. Results: Ten RCTs, with a total of 3 262 patients enrolled, were retrieved.Meta-analysis demonstrated that WGC had a higher success rate(RR=1.04, 95%CI 1.01-1.06, P<0.01)and a lower risk of PEP after cannulation (RR=0.54, 95%CI 0.41-0.71, P<0.01). The main reason for the lower risk of PEP was due to lower proportion of mild PEP patients after WGC(RR=0.52, 95%CI 0.36-0.73, P<0.01), while the incidence of modest and severe PEP was comparable in the two groups(modest group: RR=0.84, 95%CI 0.43-1.64, P=0.61; severe group: RR=0.53, 95%CI 0.22-1.31, P=0.17). Conclusion: WGC may increase the success rate of cannulation and reduce the incidence of PEP because of less complications of mild PEP.

Systematic review and meta-analysis of the effectiveness and safety of extended lymphadenectomy in patients with resectable gastric cancer.

BACKGROUND: The extent of lymphadenectomy in the treatment of gastric cancer has been debated for more than two decades. This meta-analysis sought to evaluate the effectiveness and safety of extended lymphadenectomy in patients with gastric cancer. METHODS: A comprehensive search was performed to identify randomized clinical trials (RCTs) comparing the outcomes of D1 and D2 dissection for gastric cancer in PubMed, EMBASE, the Cochrane Library, Science Citation Index, Web of Science and the Chinese Biomedical Literature Database in any language from inception of the database to March 2012. Meta-analyses were performed using Review Manager software. RESULTS: Eight RCTs including a total of 2044 patients (D1, 1042; D2, 1002) were eligible for meta-analysis. Five-year survival and haemorrhage rates were similar in the two groups. There were significant differences in morbidity, anastomotic leakage, pancreatic leakage, reoperation rates, wound infection, pulmonary complications and postoperative mortality, all of which favoured D1 dissection. Subgroup analysis indicated a trend towards lower gastric cancer-related mortality in patients undergoing D2 dissection who did not also have resection of the spleen or pancreas. CONCLUSION: D2 dissection was associated with a significantly higher postoperative risk. A trend towards lower gastric cancer-related mortality was found following D2 dissection that did not include resection of the spleen or pancreas, but further long-term survival data are needed to determine whether there is a specific survival benefit after D2 dissection.

Effects of different activation regimens on pronuclear formation and developmental competence of in vitro-matured porcine oocytes after intracytoplasmic sperm injection.

To improve the activation protocol for in vitro-maturated porcine oocytes after intracytoplasmic sperm injection (ICSI), we examined the combined effect of U0126, a specific inhibitor of mitogen-activated protein kinase kinases, and an electrical pulse on pronuclear formation and developmental competence. Two approaches were tested: (i) 6-h treatment of ICSI oocytes with U0126 applied at different intervals (0, 2, 3 or 4 h) after the electrical pulse and (ii) treatment of ICSI oocytes with U0126 applied 4 h after the electrical pulse over an additional 4, 6 or 8 h. Another protein kinase inhibitor, 6-dimethylaminopurine, was used as a chemical activator in control experiments. The highest rates of diploid embryo formation, normal fertilization and blastocyst formation were observed after 6 h of exposure to U0126 starting 4 h after the electrical pulse. Therefore, U0126 can be used as an activating agent for porcine oocytes fertilized by ICSI.

[QUADAS-C-A tool for assessing risk of bias regarding Quality Assessment of Diagnostic Accuracy Studies-Comparative].

This paper introduced the Quality Assessment of Diagnostic Accuracy Studies-Comparative (QUADAS-C), illustrated the comparison with the QUADAS-2, and using QUADAS-C together with QUADAS-2 to present QUADAS-C results through systematic reviews. Like the domain for QUADAS-2, QUADAS-C retained four domains, including patient selection, index test, reference standard, flow, and timing, and comprised additional questions for each QUADAS-2 part. Unlike the QUADAS-2 tool, the starting question of each domain for QUADAS-C was designed to summarize the risk of biased information captured by QUADAS-2. QUADAS-C only dealt with the risk of bias but did not include the part of concerns regarding applicability. The answers to signaling questions for each domain of QUADAS-C would lead to a 'low''high' or 'unclear' risk of biased judgment for the original study.