COVID-19 pandemic and its impact on emergency surgery in colorectal cancer: A single centre experience.

INTRODUCTION: The COVID-19 pandemic has led to major changes in the provision of surgical services and also affected patients' health-seeking behaviour. This contributes to delayed presentation of many surgical conditions resulting in poorer outcomes. Colorectal cancer (CRC) patients who present with acute surgical emergencies such as complete bowel obstruction, perforation, bleeding or sepsis often require immediate intervention. This study aimed to assess the impact of COVID-19 pandemic on the proportion of emergency surgery in CRC patients. MATERIALS AND METHODS: This is a retrospective cohort study. All CRC patients who underwent elective and emergency surgery from January until December 2019 (pre-COVID era) and September 2020 until August 2021 (COVID era) were included. Patient demographics, presentation, tumour stage, surgery performed and waiting time for surgery were collected. Data were then compared. RESULTS: Seventy-seven and 76 new cases of CRC underwent surgery before and during COVID-19, respectively. The proportions of emergency surgery before and during COVID-19 are 29% vs 33% (p=0.562). Of those who required emergency surgery, the proportions of patients who required stoma formation are 59% vs 72% (p= 0.351). There was no difference in median waiting time for patients requiring elective surgery (p= 0.668). CONCLUSION: The proportion of emergency surgery for CRC patients is not statistically higher during the pandemic.

[Emphasis on the diagnosis of chronic kidney disease in diabetes mellitus].

Chronic kidney disease (CKD) in diabetes mellitus includes diabetic kidney disease (DKD), non-diabetic kidney disease (NDKD) or a combination of NDKD and DKD. The clinical and renal pathological manifestations of DKD in type 1 diabetes are different from those in type 2 diabetes. Renal biopsy histopathology is the gold standard for distinguishing DKD from NDKD. However, based on the same pathological diagnosis, DKD patients may still have different disease progression and prognosis due to individual differences in molecular biological mechanisms. Metabonomics, proteomics, transcriptomics and artificial intelligence offer hope for biomarkers to diagnose and predict the progress of DKD.

Ag-decorated TiO2 nanograss for 3D SERS-active substrate with visible light self-cleaning and reactivation.

The production of SERS-active substrates which are uniform, sensitive, reproducibile and durable still remains an important issue. Here, we report a strategy for the fabrication of a large-area Ag-decorated TiO2 nanograss SERS-active substrate by a simple solvothermal approach combined with Ag evaporation. The nanograss consists of dense rutile TiO2 nanorods of about 5 nm in diameter and the decorated Ag nanoparticles are an average of 8 nm in diameter. The Ag protrusions and gaps between them contribute to three dimensional SERS "hot spots" which can be modulated by simply controlling the Ag evaporating parameters. The Ag-decorated TiO2 substrate is highly efficient in detecting rhodamine 6G (R6G) and 4-aminothiophenol (4-ATP) molecules and has good homogeneity. An obvious red shift and even high enhancement of b2 vibration mode were observed in detecting 4-ATP due to the effective charge transfer from the Ag atoms to sulfur atoms. The Ag-decorated TiO2 substrate can be easily self-cleaned and reactivated by visible light irradiation without obvious degeneration of SERS signals. Our results demonstrate that the Ag-decorated TiO2 substrate with high and homogeneous SERS activity has potential feasibility as a sensitive SERS probe.

[Recognition of the membrane anatomy-based laparoscopic assisted right hemicolectomy].

Although it has become a consensus in the field of colorectal surgery to perform radical tumor treatment and functional protection under the minimally invasive concept, there exist many controversies during clinical practice, including the concept of embryonic development of abdominal organs and membrane anatomy, the principle of membrane anatomy related to right hemicolectomy, D3 resection, and identification of the inner boundary. In this paper, we analyzed recently reported literature with high-level evidence and clinical data from the author's hospital to recognize and review the membrane anatomy-based laparoscopic assisted right hemicolectomy for right colon cancer, emphasizing the importance of priority of surgical dissection planes, vascular orientation, and full understanding of the fascial space, and proposing that the surgical planes should be dissected in the parietal-prerenal fascial space, and the incision should be 1 cm from the descending and horizontal part of the duodenum. The surgery should be performed according to a standard procedure with strict quality control. To identify the resection range of D3 dissection, it is necessary to establish a clinical, imaging, and pathological evaluation model for multiple factors or to apply indocyanine green and nano-carbon lymphatic tracer intraoperatively to guide precise lymph node dissection. We expect more high-level evidence of evidence-based medicine to prove the inner boundary of laparoscopic assisted radical right colectomy and a more rigorous consensus to be established.

Enhanced electroluminescence from SiN-based multilayer structure by laser crystallization of ultrathin amorphous Si-rich SiN layers.

Luminescent SiN-based multilayers were prepared in a plasma enhanced chemical vapor deposition system followed by subsequently laser crystallization of ultrathin amorphous Si-rich SiN sublayers. The cross-sectional TEM analysis reveals that grain size of Si nanocrystals embedded in the Si-rich SiN sublayers is independent of the laser fluence, while the grain density can be well controlled by the laser fluence. The devices containing the laser crystallized multilayers show a low turn-on voltage of 5 V and exhibit strong green light emission under both optical and electrical excitations. Moreover, the device after laser-irradiated at 554 mJ/cm(2) shows a significantly enhanced EL intensity as well as external quantum efficiency compared with the device without laser irradiation. The EL mechanism is suggested from the bipolar recombination of electron-hole pairs at Si nanocrystals. The improved performance of the devices was discussed.

Pets keeping in home, parental atopy, asthma, and asthma-related symptoms in 12,910 elementary school children from northeast China.

UNLABELLED: The effects of pet exposure and parental atopy on respiratory symptoms were investigated in 12,910 children residing in twelve districts of northeast China. Responses to a self-administered questionnaire completed by parents of children were used to ascertain children with persistent cough, persistent phlegm, doctor-diagnosed asthma, current asthma and current wheeze. Exposure to animals during pregnancy was positively associated with doctor-diagnosed asthma [adjusted odds ratio (ORs), 1.86; 95% confidence interval (CI) 1.35-2.57], current asthma (adjusted OR, 3.06; 95% CI, 1.95-4.81) and asthma-related symptoms. Pet exposure in the first year of life and currently having animals in household were also related to a significantly higher prevalence of doctor-diagnosed asthma and asthma-related symptoms in these children. Associations with respiratory symptoms strengthened with higher levels of animal exposure. Parental atopy increased the risk of asthma diagnosis (OR, 3.49; 95%CI, 2.84-4.30), current asthma (OR, 3.94; 95%CI, 2.81-5.54) and asthma-related symptoms. There was an interaction between parental atopy and pet exposure in persistent phlegm, but not in doctor-diagnosed asthma. We conclude that pet keeping and parental atopy increased the risk of respiratory symptoms in children. Parental atopy did modify the effect of pet exposure on persistent phlegm but not on doctor-diagnosed asthma. PRACTICAL IMPLICATIONS: The relationship between exposure to animals and allergic respiratory diseases in childhood is controversial. Inconsistent with other cross-sectional studies mostly conducted in industrialized countries, our study indicates that exposure to animals may increase the occurrence of respiratory symptoms and diseases in children, and the associations with respiratory symptoms strengthened with higher levels of animal exposure parental atopy did modify the effect of pet exposure on persistent phlegm but not on doctor-diagnosed asthma. These findings support the view that measures should be taken to reduce animal exposure for children in China.

[Meta-analysis on common causes of paraesthesia pharyngis in China].

Objective:To evaluate the common causes of paraesthesia pharyngis in China.Method:By means of searching CBM,and VIP,CNKI,CSCD,WanFang Database,etiology of paraesthesia pharyngis cross-sectional studies published from January 2005 to December 2015.were chosen and R software was used for meta analysis.Result:Sixteen cross-sectional study were chosen with a total of 6 624 cases.Meta analysis results showed that the etiology ratio of non-organic disease,nose and throat inflammation,digestive system disease,thyroid disease,cervical vertebra disease (95%CI)were 17.07(10.06-27.49),55.37(45.86-64.50),15.36(11.95-19.52),1.38(0.89-2.11),1.40(0.89-2.21) respectively.Conclusion:Inflammation of the nose and throat is the most important cause of paraesthesia pharyngis in China,and non organic diseases,digestive system and thyroid,cervical disease are the common causes of paraesthesia pharyngis.

Increased beta-cell secretory capacity as mechanism for islet adaptation to nicotinic acid-induced insulin resistance.

To determine whether prolonged nicotinic acid (NA) administration produces insulin resistance and, if so, how the normal pancreatic islet adapts to prolonged insulin resistance, we administered incremental doses of NA to 11 normal men for 2 wk, ending at 2 g/day. Insulin sensitivity was measured with Bergman's minimal model. Islet function was evaluated by measurement of acute insulin (AIR) and glucagon (AGR) responses to arginine at three glucose levels. Insulin resistance was demonstrated and quantified by a marked drop in the insulin sensitivity index (Sl) from 6.72 +/- 0.77 to 2.47 +/- 0.36 x 10(-5) min-1/pM (P less than .0001) and resulted in a doubling of basal immunoreactive insulin levels (from 75 +/- 7 to 157 +/- 21 pM, P less than .001) with no change in fasting glucose (5.5 +/- 0.1 vs. 5.7 +/- 0.1 mM). Proinsulin levels also increased (from 9 +/- 1 to 15 +/- 2 pM, P less than .005), but the ratio of proinsulin to immunoreactive insulin did not change (12.7 +/- 1.9 vs. 10.3 +/- 1.9%). beta-Cell changes were characterized by increases in the AIR to glucose (from 548 +/- 157 to 829 +/- 157 pM, P less than .005) and in the AIR to arginine at the fasting glucose level (from 431 +/- 54 to 788 +/- 164 pM, P less than .05). At the maximal hyperglycemia level the AIR to arginine represents beta-cell secretory capacity, and this increased with administration of NA (from 2062 +/- 267 to 2630 +/- 363 pM, P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

[Study on polymorphism of gossypol by infrared spectrophotometry and X-ray diffraction].

The polymorphism of gossypol has been investigated by IR spectrophotometry and X-ray diffraction. Nine samples of gossypol crystallized from mixed solvent of ether, ethanol and water (1:2:2), five samples from chloroform and ten samples from petroleum ether (bp 60-90 degrees C) were determined. Significant differences in the infrared spectra of gossypol crystallized from three solvents were observed near 3500 cm-1. The spectrum of gossypol crystallized from mixed solvent of ether, ethanol and water (mp 183-184 degrees C) showed bands at 3500 (sh), 3470, 3375 cm-1; that from chloroform (mp 198-199 degrees C) at 3455, 3415 (sh) cm-1 and that from petroleum ether (mp 213-214 degrees C) at 3510, 3495, 3430 (sh), 3410 cm-1. Moreover, the spectra of the three forms of gossypol showed slightly different bands at 780 and 600-400 cm-1. Gossypol crystallized from the three solvents showed the same infrared spectra after being crystallized from acetone. Significant differences in the X-ray diffraction pattern of gossypol crystallized from the three solvents were also observed. Angles, intensities and D-values of most of the X-ray diffraction peaks were listed.

[Characteristics of traditional Chinese medicine syndromes in both spontaneous and variant angina. An analysis of 21 cases].

An analysis of TCM syndromes is reported in 21 cases with both spontaneous and variant angina as compared with 147 cases with effort angina. The results showed that 3 characteristic features were present, which were as follows: the Biao-Shi syndrome of cold condensation was more than that of the control group in ratio of 42.86% to 3.40%; the Ben-Xu syndrome of Yang deficiency was more and that of Qi deficiency less than those in the control group, and they were in ratio of 33.33% to 6.12% and 33.33% to 72.11% respectively. An absolute reduction of blood supply resulted from coronary spontaneous spasm in both spontaneous and variant angina causes severe chest pain during attacks as a cold condensation type. Hyperfunction of parasympathetic nerves often occurring in coronary heart disease with Yang deficiency is liable to vasoconstriction of the large coronary arteries leading to episodes of both spontaneous and variant angina. The presence of less Qi deficiency type may be related to the less impairment of cardiac function resulted from the short course in these cases and only relatively mild state of an illness, even no marked lesion in coronary arteries in a part of patients with both spontaneous and variant angina. No significant difference in TCM syndromes occurred between spontaneous and variant angina. Both Yang and Yin deficiency, as the Ben-Xu syndromes, were more present in angina of cold condensation type.(ABSTRACT TRUNCATED AT 250 WORDS)

Recyclable magnetic photocatalysts of Fe2+/TiO2 hierarchical architecture with effective removal of Cr(VI) under UV light from water.

We report the synthesis and photocatalytic removal of Cr(VI) from water of hierarchical micro/nanostructured Fe(2+)/TiO(2) tubes. The TiO(2) tubes fabricated by a facile solvothermal approach show a three-level hierarchical architecture assembled from dense nanosheets nearly vertically standing on the surface of TiO(2) microtube. The nanosheets with a thickness of about 20 nm are composed of numerous TiO(2) nanocrystals with size in the range of 15-20 nm. Ferrous ions are doped into the hierarchical architecture by a reduction route. The Fe(2+)/TiO(2) catalyst demonstrates an effective removal of Cr(VI) from water under UV light and the removal effectiveness reaches 99.3% at the initial Cr(VI) concentration of 10 mg L(-1). The ferrous ion in the catalyst serves not as the photo-electron trap but as an intermedium of a two-step reduction. The TiO(2) photoreduces the Fe(2+) ions to Fe atoms firstly, then the Fe atoms reduce the Cr(VI) to Cr(III), and the later is removed by adsorption. The hierarchical architecture of the catalyst serves as a reactor for the photocatalytic reaction of Cr(VI) ions and an effective absorbent for the removal of Cr(III) ions. The catalyst can be easily magnetically separated from the wastewater after photocatalytic reaction and recycled after acid treatment.

Effects of environmental tobacco smoke on respiratory health of boys and girls from kindergarten: results from 15 districts of northern China.

UNLABELLED: The effects of childhood environmental tobacco smoke (ETS) exposure on respiratory symptoms were investigated in 6053 kindergarten-aged children residing in 15 districts of northern China. Responses to a self-administered questionnaire completed by parents of children from 30 kindergartens were used to ascertain children with persistent cough, persistent phlegm, asthma symptom, current asthma, wheeze and wheeze without asthma. In first 2 years ETS exposure and current ETS exposure were associated with increased prevalence of persistent cough, persistent phlegm, wheeze and wheeze without asthma. Among boys, ETS exposure was associated with more respiratory symptoms and diseases than in girls. ETS exposure during pregnancy was associated with asthma symptom [odds ratio (OR), 3.00; 95% confidence interval (CI): 1.28-7.03], current asthma (OR, 3.38; 95% CI: 1.25-9.14), persistent cough (OR, 1.64; 95% CI: 1.13-2.37), persistent phlegm (OR, 1.74; 95% CI: 1.01-3.01), wheeze (OR, 1.75; 95% CI: 1.15-2.68), and wheeze without asthma (OR, 1.46; 95% CI: 1.01-2.37) only among boys. In boys, the adjusted ORs for increased risk of asthma symptom and current asthma for household exposures (> or =10 cigarettes smoked per day vs. none smoked) during workday were 2.04 (95% CI: 1.01-3.89) and 2.76 (95% CI: 1.06-9.58), respectively. We conclude that ETS exposure increases the occurrence of respiratory symptoms and diseases during childhood. Boys may be more susceptible to ETS than girls. PRACTICAL IMPLICATIONS: Environmental tobacco smoke (ETS) is a highly prevalent respiratory irritant. In agreement with previous cross-sectional studies, our study indicates that exposure to ETS may increase the occurrence of respiratory symptoms and diseases in children, and the association of ETS exposure and respiratory health of children increased in strength with number of cigarettes smoked inside the house per day during workday and day-off. Boys may be more susceptible to ETS than girls. These findings support the view that measures should be taken to reduce ETS exposure for children.