Copper Catalyst-Promoted Regioselective Multicomponent Cascade Cyclization of 3-Aza-1,5-enynes with Sulfur Dioxide and Cycloketone Oxime Esters to Access Cyanoalkylsulfonylated 1,2-Dihydropyridines.

Radical cascade cyclization via the cracking of alkenyl C-H has emerged as an attractive and remarkable tool for the rapid construction of ring frameworks with endocyclic double bonds. We developed a cascade reaction of 3-aza-1,5-enynes with sulfur dioxide and cycloketone oxime esters to access cyanoalkylsulfonylated 1,2-dihydropyridines, which can be easily converted to pyridine derivatives. This protocol involves radical addition to the C≡C bond and 6-endo cyclization and features high regioselectivity and a broad substrate scope.

Effects of MUC13 on the prognosis and biological behavior of gastric cancer / 中国现代普通外科进展

Objective:To explore the prognostic value of MUC13 expression in gastric cancer(GC)patients and its impact on the biological behavior of GC cells.Methods:Comprehensive anal-ysis of the expression pattern of MUC genes in GC tissues based on the TCGA database to screen for differentially expressed genes.Spearman correlation analysis determined the correlation of ex-pression between MUC genes in GC tissues.Gene Ontology(GO)functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes pathway(KEGG)enrichment analysis were used to explore the potential biological functions of MUC genes.Univariate COX regression analysis was performed to explore the relationship between all differentially expressed MUC genes and the prog-nosis of GC patients to screen out MUC genes that were significantly related to the prognosis of GC.Clinical GC tissue samples were used to further verify the expression of MUC13 through im-munofluorescence,and its relationship with the clinicopathological characteristics and prognosis of GC was analyzed.siRNA was used to silence the expression of MUC13 in GC cells,and the effect of MUC13 on cell proliferation,migration and invasion was analyzed through CCK-8,colony forma-tion and Transwell experiments.Results:Among all MUC members,the expression levels of MUC1,MUC2,MUC3A,MUC4,MCU5B,MUC12,and MUC13 were significantly upregulated in GC tissues(P＜0.05).There are certain interactions between these MUC genes,and they are mainly en-riched in pathways related to digestive system processes,epithelial structure maintenance,apical plasma membrane,saliva secretion,etc.Importantly,upregulation of MUC13 in GC tissues indicates poor patient prognosis(Log-rank P＜0.05).In addition,MUC13 expression was significantly correlat-ed with the age(P＜0.001)of GC patients and tumor size(P=0.035).Further cell function experiments showed that after silencing MUC13,the proliferation ability of GC cells was significantly reduced(P＜0.05),while their migration and invasion abilities were not significantly affected(P＞0.05).Con-clusions:Highly expressed MUC13 is closely related to the poor prognosis of gastric cancer,par-ticipates in the regulation of tumor progression and is a potential therapeutic target and prognostic marker for gastric cancer.

Associations of all-cause mortality with admission blood pressure variability during multiple hospitalizations in acute decompensated heart failure / 中华心血管病杂志

Objective: To investigate whether admission blood pressure (BP) variability during multiple hospitalizations is associated with all-cause mortality independent of baseline BP in acute decompensated heart failure (ADHF). Methods: Patients with ADHF admitted to the Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University from September 2013 to December 2017 were retrospectively enrolled. The risk of all-cause mortality associated with indices of BP variability, including mean admission BPs, standard deviation of BP and coefficient of variation of BP during multiple hospitalizations was assessed, using Cox regression model. Results: A total of 1 006 ADHF patients (mean aged (69.3±13.5) years; 411 (40.8%) female; 670 (66.6%) with preserved ejection fraction) were enrolled. During a median follow-up of 1.54 years, 47.0% of patients died. In all ADHF patients, after adjusting for confounding factors, for every 1-standard deviation (SD) increase in SD and coefficient of variation (CV) of systolic BP, the risk of all-cause mortality increased by 10% and 11%, respectively (SD: HR, 1.10, 95%CI, 1.01-1.21, P=0.029, CV: HR, 1.11, 95%CI, 1.02-1.21, P=0.017); for every 1-SD increase in the mean of diastolic BP, the risk of all cause mortality decreased by 25% (HR, 0.75; 95%CI, 0.65-0.87; P<0.001). In ADHF patients with preserved ejection fraction, after accounted for potential confounders, higher SD and CV of admitted systolic and diastolic BP were significantly associated with higher risk of all-cause mortality, regardless of whether confounding factors were adjusted (P≤0.049); After adjusting for confounding factors, the risk of all-cause mortality increased by 18% and 19% for every 1-SD increase in SD and CV of systolic BP, while the risk of all-cause mortality increased by 11% and 15% for every 1-SD increase in SD and CV of diastolic BP. In ADHF patients with reduced ejection fraction, after adjusting for confounding factors, the higher the mean admission systolic BP during multiple hospitalizations, the lower the risk of total mortality (HR, 0.68; 95%CI, 0.47-1.00; P=0.049). Conclusions: In patients with ADHF, independent of baseline BP, BP variability during multiple hospitalizations was strong predictor of all-cause mortality.

Efficacy of ultrasound-guided sclerotherapy combined with radiofrequency ablation on the treatment of complex lymphatic malformations in children / 中华实用儿科临床杂志

Objective:To investigate the safety and efficacy of ultrasound-guided sclerotherapy combined with radiofrequency ablation on the complex lymphatic malformations (LM) in children.Methods:The clinical data of 21 children with complex LM treated with ultrasound-guided sclerotherapy combined with radiofrequency ablation in the First Affiliated Hospital of Zhengzhou University from June 2018 to October 2021 were retrospectively analyzed.Intraoperative and postoperative complications were recorded.Imaging examinations were performed at 1, 3, 6, 9, 12, 18, 24 months postoperatively to observe the recurrence, the volume of the lesions and their reduction rate were calculated, and the efficacy was analyzed. Friedman test was used to compare the lesion volume at different time points before and after surgery, and the reduction rate of lesion volume at 1 month postoperatively and other time points after surgery. Results:A total of 21 children were included in this study, among them, there were 12 males and 9 females, age range from 1 month to 5 years and 6 months, with a median age of 23 months.A total of 26 LM in 21 children were successfully treated, and no serious complications like organ damage occurred during and after surgery.One patient with abdominal LM had a postoperative infection, which was controlled by 3 weeks of catheter drainage.Four LM in 3 children recurred at 3 or 6 months after surgery, while all lesions were significantly narrowed down than those before surgery and they were cured after 1-3 sessions of continued sclerotherapy.There were significant differences in the lesion volumes before surgery and 1, 3, 6, 9, 12, 18 and 24 months postoperatively [222.26(159.57, 316.40) cm 3vs.43.06(22.74, 62.53) cm 3, 31.56(15.49, 45.94) cm 3, 25.21(9.63, 36.22) cm 3, 19.80(6.79, 28.81) cm 3, 12.80(3.93, 20.38) cm 3, 7.13(0, 11.34) cm 3, and 2.79(0, 4.93) cm 3; all P<0.05]. There were significant differences between the volume reduction rates at 1 month postoperatively and 3, 6, 9, 12, 18, and 24 months postoperatively [79.36(73.30, 87.81)% vs.85.40(81.09, 91.61)%, 88.85(84.70, 93.61)%, 91.67(87.87, 95.05)%, 94.15(94.47, 97.35)%, 97.11(95.02, 100.00)%, and 99.04(97.93, 100.00)%; all P<0.05]. Patients were followed up for 24 months, and all of them were cured. Conclusions:Ultrasound-guided sclerotherapy combined with radiofrequency ablation is a minimally invasive, safe and effective therapeutic strategy for children with complex LM.

Comparative study on the curative effect of ultrasound-guided radiofrequency ablation and surgical excision in the treatment of salivary gland mixed tumor / 中华超声影像学杂志

Objective:To compare the therapeutic effects of ultrasound-guided radiofrequency ablation (RFA) and surgical resection on salivary gland mixed tumor with diameter ≤3 cm, and to analyze the feasibility and clinical value of RFA in the treatment of salivary gland mixed tumor.Methods:A retrospective study was conducted on 43 patients with salivary gland mixed tumor whose diameter ≤3 cm were treated in the First Affiliated Hospital of Zhengzhou University from March 2020 to March 2022.According to the treatment method, they were divided into an ablation group of 20 cases and a resection group of 23 cases. The complete ablation rate of the ablation group was evaluated, the postoperative absorption of ablation foci in the ablation group was recorded, and the perioperative indexes and the incidence of postoperative complications of the two groups were compared. The long-term prognosis of the two groups was followed up, and the incidence of recurrence, malignant metastasis and appearance recovery were evaluated.Results:In the ablation group, the complete ablation rate was 100.00% (20/20). The lesion volume reduction rates at 1, 3, 6 and 12 months after operation were -(39.60±16.18)%, (8.61±8.10)%, (31.87±14.68)% and (58.64±14.82)%, respectively. The operation time, recovery feeding time, postoperative hospital stay and intraoperative bleeding in the ablation group were less than those in the resection group, and the differences were statistically significant (all P<0.001). Postoperative complications occurred in 2 cases in the ablation group and 9 cases in the resection group. There was significant difference in the total incidence of postoperative complications between the two groups(χ 2=4.768, P=0.029). There was 1 case of recurrence in the ablation group, and no facial depression or protuberance occurred 1 year after operation. There was no recurrence in the resection group, one year after operation, the incidence of facial depression and facial protuberance was 13.04%(3/23) and 0, respectively.There was no malignant metastasis in both groups. Conclusions:Ultrasound-guided RFA is safe and effective in the treatment of mixed tumors of salivary gland with diameter ≤3 cm, and the therapeutic effect is not significantly different from that of surgery. With minimal trauma and good cosmetic effect, it has a great application prospect.

[Toxicity Management and Efficacy Evaluation of BCMA-CART in the Treatment of Relapsed and Refractory Multiple Myeloma].

OBJECTIVE: To investigate the toxicity management and efficacy evaluation of BCMA-chimeric antigen receptor T cells(CART) in the treatment of relapsed and refractory multiple myeloma (MM). METHODS: The efficacy and adverse reactions of 21 patients with MM who received BCMA-CART treatment at the First Affiliated Hospital of Wenzhou Medical University from December 2017 to September 2020 were evaluated, and the efficacy assessment and survival analysis for high-risk patients and non-high-risk patients were evaluated. RESULTS: After infusion of BCMA-CART cells in 21 MM patients, the number of effective cases was 17, of which the complete remission (sCR/CR) was 10, and the partial remission (VGPR/PR) was 7. The median OS time for all patients was 19.4 months, and the median PFS time was 7.9 months. The number of patients with extramedullary disease(EMD), high-risk genetics, and ISS stage Ⅲ were 5, 15 and 8, and the effective number was 3, 11 and 6, respectively. The treatment of 3 patients without high-risk factors was effective. The median OS and median PFS of patients with EMD were 14.2 and 2.5 months, respectively, which were shorter than those of patients without EMD (19.4 months and 8.9 months, respectively). The median OS and median PFS of patients with high-risk cytogenetic factors and ISS Ⅲ were not significantly different from those of non-high-risk patients. Cytokine release syndrane (CRS) occurred in 20 patients, of which 14 cases were Grade 1 CRS, while 6 were Grade 2, no CRS of Grade 3 or above occurred. IL-6 receptor inhibitors were used in 9 patients. All CRS were controlled effectively, and no patients had neurological toxicity. CONCLUSION: BCMA-CART is a certain curative effect in the treatment of relapsed and refractory multiple myeloma, and the adverse reactions can be well controlled through close monitoring and timely treatment.

Efficacy analysis of ultrasound-guided percutaneous radiofrequency ablation in the treatment of nonmetastatic pheochromocytoma / 中华超声影像学杂志

Objective:To investigate the safety and efficacy of ultrasound-guided percutaneous radiofrequency ablation in the treatment of nonmetastatic pheochromocytoma.Methods:A retrospective analysis was performed on 7 patients with nonmetastatic pheochromocytoma admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2020, all of whom underwent ultrasound-guided percutaneous radiofrequency ablation. The changes of postoperative blood pressure, improvement of symptoms, intraoperative and postoperative complications were observed.Plasma free methoxypinephrine (MN) and normetanephrine (NMN) levels were recorded before and 2 weeks after operation. The reduction rate of ablation lesion volume at 1, 3 and 6 months after operation was calculated.Results:Postoperative blood pressure of all 7 patients was reduced to the normal range within 3 days, and symptoms such as headache were significantly relieved immediately after operation.No serious complications occurred during or after operation. Plasma free MN and NMN levels decreased to normal levels 2 weeks after operation. The mean reduction rates of the ablation lesions at 1, 3 and 6 months after operation were (46.61±13.42)%, (67.21±10.54)% and (85.73±4.15)%, respectively. Postoperative follow-up of 12-30 months showed that the blood pressure, plasma free MN and NMN levels of the patients were all in the normal range, and no symptoms such as headache and palpitation occurred again. All the tumors were completely ablated, and no recurrence was observed.Conclusions:Ultrasound-guided percutaneous radiofrequency ablation in the treatment of nonmetastatic pheochromocytoma is minimally invasive, safe and effective, and can retain adrenal cortex function, which is worthy of clinical promotion.

Ultrasound-guided transgluteal puncture and catheter drainage in the treatment of deep pelvic abscess with pelvic adhesion / 中华超声影像学杂志

Objective:To investigate the safety and efficacy of transgluteal ultrasound-guided puncture and drainage in prone position in the treatment of deep pelvic abscess with pelvic adhesion.Methods:A total of 24 cases of deep pelvic abscess with pelvic adhesion treated in the ultrasound intervention room of the First Affiliated Hospital of Zhengzhou University from October 2018 to May 2021 were selected.Ultrasound-guided puncture and drainage were performed through the buttocks. The operation time, blood loss and distal limb pain during the operation were recorded. The decreasing trend of body temperature, the white blood cell, C-reactive protein and abscess size were observed. The incidence of complications such as bleeding, pain, infection and intestinal injury were counted.Results:There were 28 abscesses in 24 patients were successfully intubated through the buttocks, the abscesses disappeared after drainage, and there were no serious complications after operation. During the follow-up of 3-22 months, there was no abscess recurrence and no long-term complications.Conclusions:Ultrasound-guided transgluteal puncture and drainage is safe and effective in the treatment of deep pelvic abscess with pelvic adhesion.

Clinical value of ultrasound-guided radiofrequency ablation in the treatment of retroperitoneal tumors / 中华肿瘤杂志

Objective: To explore the clinical value of ultrasound-guided radiofrequency ablation in the treatment of retroperitoneal tumors. Methods: The clinical data of 13 patients with retroperitoneal tumors treated with ultrasound-guided radiofrequency ablation in the First Affiliated Hospital of Zhengzhou University from January 2018 to January 2020 were analyzed retrospectively. The ablation effect was evaluated and the postoperative complications were observed. The changes of tumor volume before and after radiofrequency ablation were compared. Results: The symptoms of pain and dyspepsia were significantly improved after radiofrequency ablation, and the hospital stay was (9.2±2.9) days. The tumor was ablated completely in 10 cases, tumor residual in 1 case and tumor metastasis in 2 cases. One patient had postoperative duodenal perforation complicated with intra-abdominal infection, and no serious complications occurred in other patients. There were 20 lesions in 13 patients. The maximum diameter of 20 lesions before operation and 1, 3, 6 months after operation were (39.5±15.9) mm, (30.6±4.9)mm, (15.6±7.7) mm and (9.9±3.1) mm, respectively, the maximum diameters of 1, 3 and 6 months after operation were smaller than that before operation (P<0.05). Conclusion: Ultrasound-guided radiofrequency ablation is a real-time, accurate, safe and effective minimally invasive treatment with few complications, and has a high clinical value for retroperitoneal tumors.

Domestic clinical application of vascular dementia scales / 中国中药杂志

To analyze the domestic clinical application of vascular dementia scales, and provide the basis for the refinement of clinical scales. VIP, SinoMed, Wanfang and CNKI databases were searched by computer to analyze the clinical application of vascular dementia scales published in Chinese Core Periodicals in Library of Peking University, CSSCI and CSCD, with time limit from database establishment to August 31, 2020. According to the inclusion or exclusion criteria, the combination of Note Express software and manual search was used to complete the literature duplicate detection and screening. According to the research needs, the relevant data were extracted and a new database was established. In this study, a total of 4 246 related literatures were initially searched, 2 048 repetitive literatures were eliminated, 1 484 literatures were manually screened out, and finally 714 literatures and 44 scales were included. The total using frequency of scales was 2 660. The results of descriptive analysis showed that there were many kinds of clinical scales for vascular dementia. In order to avoid the repeated use of scales with similar functions, it is correct to include the possible influences such as the purpose of use, way, frequency and function of the scales into reference factors of scale selection according to the disease diagnostic criteria. It is necessary to develop the scales with traditional Chinese medicine characteristic for objective clinical evaluation of traditional Chinese medicine.

Effect of Banxia Xiexintang-containing Serum on Epithelial-mesenchymal Transition of Peritoneal Mesothelial Cells Induced by Gastric Cancer-derived Exosomes / 中国实验方剂学杂志

Objective:To investigate the effect of Banxia Xiexintang on the epithelial-mesenchymal transition （EMT） of human peritoneal mesothelial cell line （HMrSV5） induced by gastric cancer-derived exosomes （Exo）. Method:Banxia Xiexintang-containing serum was prepared and the human gastric cancer NCI-N87-derived exosomes （NCI-N87-Exo） were extracted， followed by their identification by transmission electron microscopy and Western blotting and labeling with 1，1-dioctadecyl-3，3，3，3- tetramethylindocarbocyanine perchlorate （Dil）. The cells were divided into the blank group， model group， and low-， medium-， and high-dose （13.5，27，54 g·kg^-1） Banxia Xiexintang groups. HMrSV5 cells in the blank group were cultured alone， the ones in the model group with 100 mg·L^-1 NCI-N87-Exo， and those in the low-， medium-， and high-dose Banxia Xiexintang groups with 100 mg·L^-1 NCI-N87-Exo plus low-， medium-， and high-dose 10% Banxia Xiexintang-containing serum， respectively. Confocal laser microscope was used to observe the uptake of NCI-N87-Exo by HMrSV5 cells at 24 h， 48 h and 72 h. Seventy-two hours later， the morphological changes in HMrSV5 cells were observed. The protein expression levels of E-cadherin， cytokeratin 19 （CK19）， <italic>α</italic>-smooth muscle actin （<italic>α</italic>-SMA）， elastin， and transforming growth factor-<italic>β</italic>₁ （TGF-<italic>β</italic>₁）， Smad2/3， and p-Smad2/3 were assayed by Western blot. Result:It was observed under the transmission electron microscope that NCI-N87-Exo showed an oval or dish-shaped vesicle structure with a particle size ranging from 40 to 80 nm. Exo marker proteins CD9 and CD63 were highly expressed while calreticulin was not expressed， implying that the NCI-N87-Exo was confirmed. After 24 h， 48 h， 72 h of co-culture， it was observed under the fluorescence microscope that NCI-N87-Exo were taken up by HMrSV5 cells， which was positively correlated with time. Compared with the blank group， Banxia Xiexintang significantly inhibited the uptake of NCI-N87-Exo by HMrSV5 cells， with better effect noticed in the middle- and high-dose Banxia Xiexintang groups（<italic>P</italic><0.05，<italic>P</italic><0.01）. After intervention with Banxia Xiexintang-containing serum， the HMrSV5 cells were arranged densely， and the intercellular space was significantly reduced， with the most obvious changes present in the high-dose Banxia Xiexintang group. Western blot revealed that the protein expression levels of E-cadherin and CK19 in HMrSV5 cells after being intervened with the medium- and high-dose Banxia Xiexintang-containing serum were increased significantly as compared with those in the blank group， whereas the levels of <italic>α</italic>-SMA and Elastin were decreased significantly （<italic>P</italic><0.01）. Banxia Xiexintang-containing serum at the low， medium， and high doses remarkably down-regulated TGF-<italic>β</italic>₁ and p-Smad2/3 protein expression（<italic>P</italic><0.05，<italic>P</italic><0.01）. However， there was no significant change in Smad2/3. Conclusion:NCI-N87-Exo can be taken up by HMrSV5 cells to induce EMT. Banxia Xiexintang can inhibit the uptake of NCI-N87-Exo by HMrSV5 cells and the resulting EMT induced by NCI-N87-Exo， which is related to the regulation of TGF-<italic>β</italic>₁/Smads signaling pathway.

Primary study of radiofrequency ablation for early breast cancer with negative sentinel lymph node / 中华超声影像学杂志

Objective:To summarize the preliminary experience of percutaneous radiofrequency ablation(RFA) in the treatment of early breast cancer(the length of the lesion<15 mm) with negative sentinel lymph node(SLN), and to evaluate its feasibility and efficacy.Methods:From October 2016 to November 2019, 18 patients with early breast cancer(the length of the lesion<15 mm) treated in the First Affiliated Hospital of Zhengzhou University underwent FNAC of axillary SLN under the guidance of CEUS were enrolled. Patients with pathologically negative axillary SLN were treated with percutaneous RFA of breast cancer. The complete ablation rate and the relapse rate were evaluated. Intraoperative pain, postoperative complications and postoperative patient satisfaction were analyzed.Results:Eighteen patients underwent CEUS-guided FNAC of SLN, of which 1 case was positive and 17 cases were negative. Seventeen breast cancer lesions of the 17 negative patients underwent percutaneous RFA. The length of the lesions was 3.3-14.0 (8.2±3.9)mm, the complete ablation rate was 100%, the ablation time was 9-18 (12.8±2.7)min. During the follow-up of 9-46 months, no patient developed tumor progression. There were no serious complications related to RFA after operation. The patients′ satisfactory rate for postoperative appearance was 100%.Conclusions:RFA of early breast cancer(the length of the lesion<15 mm) with negative SLN is feasible and has the advantages of safety, minimal invasion and beauty.

Clinical efficacy of ultrasound-guided percutaneous radiofrequency ablation in the treatment of ectopic pregnancy / 中华超声影像学杂志

Objective:To investigate the clinical efficacy of ultrasound-guided percutaneous radiofrequency ablation in the treatment of ectopic pregnancy.Methods:A retrospective analysis was performed on 8 patients with ectopic pregnancy admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to January 2020, all of whom underwent ultrasound-guided percutaneous radiofrequency ablation. Contrast ultrasonography was performed immediately after the operation to observe the changes of pregnancy sac. The length of hospital stay, mass absorption time and menstrual recovery time of the patients were recorded. Postoperative complications and serum human chorionic gonadotropin (HCG) negative conversion time were observed. At 3 months after the operation, hysterosalpingography was performed 3-7 days after the menstruation to observe the patency of the fallopian tubes, all patients were followed up for 1 year to observe the postoperative intrauterine pregnancy and re-ectopic pregnancy.Results:All the 8 patients were successfully treated with radiofrequency ablation, and postoperative ultrasonography showed that the mass remained unenhanced. The length of hospital stay was (3.0±0.8)d. The packet absorption time was (32.4±14.3)d. The recovery time of menstruation was (39.6±2.7)d. There were no serious complications.Blood HCG levels decreased rapidly within a week, and all returned to normal level of non-pregnancy 2-3 weeks after the operation. Three months after the operation, the salpingogram showed that the fallopian tubes were recanalized in 3 patients. After a follow-up of 1 year, 1 patient had a natural intrauterine pregnancy, and there was no case of recurrent ectopic pregnancy.Conclusions:Ultrasound-guided percutaneous radiofrequency ablation is effective in the treatment of ectopic pregnancy with minimal trauma and rapid recovery, and can retain the reproductive ability of patients to some extent, which is worth popularizing in clinical application.

Ultrasound-guided radiofrequency ablation for treatment of gallbladder polyps / 中华肝胆外科杂志

Objective:To study the safety and efficacy of ultrasound-guided radiofrequency ablation in treatment of gallbladder polyps.Methods:The clinical data of 13 patients who underwent ultrasound-guided radiofrequency ablation for gallbladder polyps at the First Affiliated Hospital of Zhengzhou University from April 2019 to March 2020 were retrospectively analyzed. These were 8 males and 5 females, with ages ranging from 20 to 49 years. The incidence of adverse reactions and complications after treatment, the complete ablation rate of polyps and the absorption of postoperative lesions were studied, and the gallbladder systolic function of patients before and after treatment were compared.Results:Of 13 patients, surgery was successfully carried out and there was no serious complications of gallbladder perforation, bleeding and collateral organ injury. The median radiofrequency ablation time was 30 s, and the complete ablation rate was 100.0%(13/13). After 6 months of follow-up, the rate of reduction of lesion volume was 100.0(98.0, 100.0)% at 6 months after surgery, which was significantly higher than the rates of 46.0(40.0, 54.0)%, 72(64.0, 100.0)% and 87.0(81.0±100.0)% at 1, 2 and 3 months after surgery ( P<0.05). The gallbladder contractility rate at 3 months after operation was (78.38±10.83)% compared with that before operation (77.46±11.28)%, and there was no significant difference ( P>0.05). Conclusion:Ultrasound-guided radiofrequency ablation for gallbladder polyps was safe. It had a significant short-term efficacy for treatment of gallbladder polyps.

Clinical application of percutaneous ultrasonography-guided gallbladder polyp biopsy and radiofrequency ablation: a primary study / 中华超声影像学杂志

Objective:To analyze the feasibility and efficacy of ultrasound-guided percutaneous biopsy and radiofrequency ablation of gallbladder polyps.Methods:From April 2019 to January 2021, 25 patients with gallbladder polyps underwent ultrasound-guided biopsy and radiofrequency ablation in the ultrasound department of the First Affiliated Hospital of Zhengzhou University were collected, the maximum diameter of the lesion was 11.00(10.00, 12.50)mm. Under general anesthesia, ultrasound-guided injection of water into the gallbladder serosa layer was performed to make the gallbladder edema thicker than or equal to 10 mm. Percutaneous biopsy and radiofrequency ablation of gallbladder polyps were performed to ablate the gallbladder mucosa layer of polyps and polyp attachment.Intraoperative contrast-enhanced ultrasound was used to evaluate the need for supplementary ablation.The operation time, intraoperative and postoperative conditions were recorded. The complete ablation rate of gallbladder polyps, the reduction rate of lesion volume after ablation, the incidence of complications and the effect of operation on gallbladder wall thickness and gallbladder contraction rate were evaluated.Results:Biopsy and radiofrequency ablation of gallbladder polyps were successfully performed in 25 patients.There were 14 cases of cholesterol polyp, 5 cases of adenoma, 5 cases of inflammatory polyp and 1 case of gallbladder adenomyosis. Twenty-nine gallbladder polyps showed changes after ablation, and the lesion volume was reduced to varying degrees. In the first, third and sixth months, the volume reduction rates of ablation focus were 70.74%(58.55%, 77.56%), 89.47%(85.04%, 96.87%) and 100%(95.68%, 100%) respectively, and the differences were statistically significant ( P<0.05). There were no significant differences in gallbladder wall thickness and gallbladder contraction rate before and 1 month after operation ( P>0.05). The operation time was 14-39(23.32±6.68)min. During the operation, 3 patients(12.0%) had a decrease in heart rate, 2 patients(8.0%) had mild abdominal pain and 1 patient(4.0%) had obvious abdominal pain, which was relieved after treatment. No bleeding, gallbladder perforation, abdominal infection and other complications occurred. All patients were followed up for 1 to 22 months, with a median of 6 (3, 7) months. No patients were lost or follow-up, polyp recurrence, or new polyps, or secondary gallstone. Conclusions:Ultrasound-guided biopsy and radiofrequency ablation of gallbladder polyps is a feasible choice for gallbladder preserving treatment of gallbladder polyps with low complication rate.

Association between new-onset postoperative atrial fibrillation and 1-year mortality in elderly patients after hip arthroplasty.

BACKGROUND: The purpose of this study is to determine whether new-onset postoperative atrial fibrillation (NOPAF) among patients after hip arthroplasty can predict 1-year mortality. METHODS: All patients over 65 years who underwent hip arthroplasty from January 2013 to December 2017 in a Chinese tertiary hospital were retrospectively analyzed. Patients with paroxysmal and persistent atrial fibrillation were ruled out. 2438 patients were identified to be eligible. The primary endpoint was 1-year mortality after the arthroplasty. RESULTS: Among the 2438 patients, 101 (4.1%) had NOPAF and 2337 (95.9%) had not. Only the current use of beta blocker could predict the occurrence of NOPAF after hip arthroplasty. 1-year mortality for patients with NOPAF was significantly higher than that for patients without NOPAF (70.3% vs 19.0%; p < 0.001). Anti-arrhythmic and anticoagulant treatments were related to 1-year mortality, respectively. With multivariate analysis, NOPA was the most significant variable related to 1-year mortality (hazard ratio 7.8, 95% CI 2.9-24.6). CONCLUSIONS: Among elderly patients after hip arthroplasty, 1-year mortality is increased significantly for patients with NOPAF.

Survival of stage II nasopharyngeal carcinoma patients with or without concurrent chemotherapy: A propensity score matching study.

BACKGROUND: To ascertain if concurrent chemotherapy (CCT) benefits people with stage II nasopharyngeal carcinoma (NPC) treated with two-dimensional radiotherapy (2DRT) or intensity-modulated radiotherapy (IMRT). METHODS: A total of 4157 patients diagnosed with stage II NPC were evaluated. Patients received radiotherapy (RT) with/without CCT. Patients were divided into 2DRT and IMRT subgroups. After propensity score matching, the role of CCT was explored in these two subgroups. Overall survival (OS) was the primary endpoint and progression-free survival (PFS), locoregional relapse-free survival (LRFS) and distant metastasis-free survival (DMFS) were secondary endpoints. RESULTS: In the 2DRT subgroup, CCT addition to RT benefited cases with T1N1/T2N1 in OS, PFS and LRFS (P < .001, P = .003 and P = .003, respectively) significantly, but no difference was observed in patients with T2N0. DMFS were similar in the two arms. CCT was a significant protective factor for OS, PFS, and LRFS for patients with stage N1. In the IMRT subgroup, RT alone could maintain equivalent OS, PFS, LRFS and DMFS (P = .209, .448, .477 and .602 respectively) and cause less acute toxicity compared with concurrent chemoradiotherapy (CCRT). CONCLUSION: CCRT was better than 2DRT alone among patients with T1-2N1M0 stage. CCT application for NPC patients receiving IMRT led to no survival benefit and greater toxic effects.

Clinical efficacy of percutaneous radiofrequency ablation in the treatment of gestational trophoblast tumor / 中华超声影像学杂志

Objective:To investigate the safety and efficacy of ultrasound-guided percutaneous radiofrequency ablation for gestational trophoblast tumor.Methods:The clinical data of 5 patients with gestational trophoblast tumor treated by ultrasound-guided percutaneous radiofrequency ablation in the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2019 were retrospectively analyzed, the postoperative complications, changes in blood human chorionic gonadotropin (hCG), and the volume reduction rate of ablation lesion at 1, 3, and 6 months after surgery were observed.Results:None of the 5 patients with gestational trophoblast tumor had postoperative complications.Blood hCG decreased to normal level on 7 d, 8 d, 8 d, 12 d and 26 d, respectively. The volume reduction rates of ablation lesions 1, 3 and 6 months after operation in cases 1-5 were respectively 34.7%, 62.5%, 87.5%; 45.3%, 60.4%, 84%; 85.6%, 89.9%, 92.2%; 38.3%, 72.6%, 85.5%; 40.8%, 57.3%, 87%.Conclusions:Percutaneous radiofrequency ablation is minimally invasive, low risk, safe and effective treatment for gestational trophoblast tumors.

Advances in snake venom studies: from lethal toxins to new drug development / 药学学报

Snake bite is a common acute and severe disease in tropical and subtropical regions, and its public health importance has been largely neglected. Snake venom is a complex mixture of active proteins, polypeptides, and other toxins. Many of these components can target multiple ion channels, cell receptors, and membrane transporters. Compared with traditional small molecule drugs, the proteins and polypeptides from snake venom have stronger specificity and affinity to targets and are especially suitable for novel drug design. The current studies show that snake venom and its components have great potential for development as leading compounds of new drugs. In this paper, the recent advances in main components, toxic effects, and detoxification strategies of snake venom, as well as its pharmacological activities and medical application are reviewed. The aim is to provide reference for clinical diagnosis and treatment of snake bite and development of new drugs based on snake venom.

Extraskeletal osteosarcoma in right neck subcutaneous tissue: A case report of an extremely rare tumour.

Extraskeletal osteosarcoma (ESOS) is a rare soft-tissue sarcoma that is treated with surgical resection, chemotherapy and radiotherapy; however, as it is now considered to be radiation resistance, it is associated with conflicting management principles and poor outcomes. A multimodality approach is currently used to treat ESOS, which entails the incorporation of multidrug chemotherapy and/or radiotherapy coupled with surgery to obtain the best outcome; however, there are many factors that influence the treatment effects and clinical outcomes of ESOS. In the present study, a case of an 81-year-old man who suffered from primary ESOS in the subcutaneous tissue of the right-hand side of the neck was reported. The patient was treated several times with partial resection and once with radiotherapy, and was still living following 3 years of follow-up. Thus, the present case report demonstrated that surgical resection and postoperative radiotherapy regimens may be favourable in the short term with a disease-free survival of ~15 months; however, patients are prone to relapse.