Application of minimally invasive percutaneous nephroscopic plasma electrode decortication in the treatment of renal cysts / 现代泌尿外科杂志

Laparoscopic decortication is the standardized surgical treatment for simple renal cysts. With the continuous maturation of minimally invasive techniques, percutaneous nephroscopic decortication and decompression is gradually implemented, which has advantages of minimal invasiveness, fast recovery and good prognosis. Ureteroscopic plasma electrode is a modified procedure, which can achieve more exact intraoperative hemostasis and efficient cutting efficiency than traditional surgery. This article reviews the current treatments of simple renal cysts, and introduces our experience of using minimally invasive percutaneous nephroscopic plasma electrode decortication, its surgical procedures and technical points.

Expression of antigens of foot-and-mouth disease virus in plants: a review / 生物工程学报

Foot-and-mouth disease (FMD) is an acute, severe, and highly contagious infectious disease caused by foot-and-mouth disease virus (FMDV), which seriously endangers the development of animal husbandry. The inactivated FMD vaccine is the main product for the prevention and control of FMD, which has been successfully applied to control the pandemic and outbreak of FMD. However, the inactivated FMD vaccine also has problems, such as the instability of antigen, the risk of spread of the virus due to incomplete inactivation during vaccine production, and the high cost of production. Compared with traditional microbial and animal bioreactors, production of antigens in plants through transgenic technology has some advantages including low cost, safety, convenience, and easy storage and transportation. Moreover, since antigens produced from plants can be directly used as edible vaccines, no complex processes of protein extraction and purification are required. But, there are some problems for the production of antigens in plants, which include low expression level and poor controllability. Thus, expressing the antigens of FMDV in plants may be an alternative mean for production of FMD vaccine, which has certain advantages but still need to be continuously optimized. Here we review the main strategies for expressing active proteins in plants, as well as the research progress on the expression of FMDV antigens in plants. We also discuss the current problems and challenges encountered, with the aim to facilitate related research.

The effectiveness and safety of laparoscopic versus open hepatectomy for intrahepatic cholangiocarcinoma: a meta-analysis / 中华肝胆外科杂志

Objective:To compare the effectiveness and safety of laparoscopic hepatectomy (LH) versus open hepatectomy (OH) for intrahepatic cholangiocarcinoma(ICC).Methods:PubMed, Web of Science, Embase, Cochrane Library, China Biology Medicine Disc, China National Knowledge Infrastructure, Wanfang Database and VIP Database were searched from inception of these databases to May 2022 to compare LH versus OH for ICC. The duration of operation, intraoperative bleeding, proportion of patients with intraoperative blood transfusion, number of resected lymph nodes, proportion of patients with R 0 resection margin, duration of hepatic occlusion, hospital stay, incidence of postoperative complication and postoperative mortality were compared between the two groups. Meta-analysis was carried out using the Review Manager 5.1 software, and the mean difference ( MD) or odds ratio ( OR) was used as the effect index. Results:This meta-analysis included twelve articles, all of which were retrospective cohort studies, with 3 189 patients. There were 667 patients in the LH group and 2 512 in the OH group. Meta-analysis showed that when compared to the OH group, the LH group had significantly less intraoperative bleeding ( MD=-116.06, 95% CI: -173.07--59.06, P<0.001), less proportion of patients receiving intraoperative blood transfusion ( OR=0.25, 95% CI: 0.10-0.62, P=0.003), less number of lymph nodes removed ( MD=-101.91, 95% CI: -124.78--79.03, P<0.001), less patients underwent portal occlusion ( OR=0.37, 95% CI: 0.14 - 0.99, P=0.050), shorter hospital stay ( MD=-2.43, 95% CI: -4.59--0.28, P=0.030) and less postoperative complications ( OR=0.41, 95% CI: 0.28-0.61, P<0.001). However, the proportion of patients with R 0 margin ( OR=1.49, 95% CI: 1.14-1.95, P=0.003) in the LH group was significantly higher than the OH group. There were no significant differences in operative time and postoperative mortality between the 2 groups. Conclusion:LH was more effective and safe than OH in the treatment of ICC. However, its long-term effect still needs to be verified by large randomized controlled trials.

Identifying DUSP-1 and FOSB as hub genes in immunoglobulin A nephropathy by WGCNA and DEG screening and validation.

Background: The mechanism of immunoglobulin A nephropathy (IgAN) is still unknown. A bioinformatics analysis is a powerful method to identify the biomarkers and possible therapeutic targets of a certain disease from related datasets. Methods: The GSE93973 dataset, obtained from the Gene Expression Omnibus (GEO) database, was used to construct a weighted gene co-expression network (WGCNA) and filter differentially expressed genes (DEGs). The biological process (BP) enrichment among all the genes in the key modules was analyzed through a Gene Ontology (GO) enrichment analysis. We selected the overlap of hub genes in the WGCNA and Protein-Protein Interaction (PPI) network as the final hub genes in IgAN. We verified the final hub genes in two other datasets and in clinical kidney tissue specimens. A receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of hub genes for IgAN. Results: The turquoise module, which contained 1,806 genes, was the module with the highest correlation coefficient with IgAN in the GSE93973 dataset. The GO enrichment analysis showed that these 1,806 genes were mainly enriched in inflammation and immune responses. There were five hub genes identified by WGCNA and 34 hub genes identified in a DEG analysis in the GSE93973 dataset. DUSP1 and FOSB were identified as the final hub genes in IgAN. The validation results of the final hub genes in two other databases and clinical kidney tissue specimens validated the result that, compared to the control group, FOSB and DUSP1 were expressed at lower levels in the glomerulus of IgAN patients. The ROC curve indicated that DUSP1 and FOSB were good diagnostic indicators for IgAN. Conclusions: Our analysis identified two hub genes that might be potential targets for the intervention and treatment of IgAN.

Restorative effects of forest therapy on mental health of fatigued female office workers / 环境与职业医学

Background Female office workers are prone to fatigue due to work and life stress. The natural environment has a positive effect on health, but little research has focused on the effects of forest therapy on physical and mental health of female office workers. Objective To explore the effect of forest therapy on the mental health of fatigued female office workers. Methods In this study, two environments, urban and forest, were selected. A total of 12 subjects with fatigue were recruited and randomly divided into two groups, urban and forest, six subjects in each group, with mean ages of 24.7 and 28.4 years, respectively, all of whom were company employees. The Brief Mood Scale, the Chinese version of Stress Self-Rating Scale, and the Fatigue Self-Rating Scale were distributed to assess baseline psychological indexes of mood, fatigue, and stress status. Higher scores indicate higher levels of negative mood, fatigue, and stress, respectively. The forest group participated in an on-site experiment using forest therapy (forest walks and sits in a forest environment), and the urban group followed the same schedule as the forest group conducting walks and sits in an urban environment. Salivary cortisol was used as the physiological index. Baseline physiological indices were collected on the first day of the experiment, and the on-site forest therapy experiment and collecting physiological and psychological indices were conducted on the second day; physiological indices were collected in the morning before the walk and physiological and psychological indices were collected after the walk, physiological indices were collected in the afternoon before and during the sitting, and psychological indices were collected after the sitting. Subjects' mood and fatigue status were followed up one week after the activity. Mann-Whitney U test and Wilcoxon signed rank test were used to assess the changes of the indicators. Results As to the physiological indicator, the salivary cortisol concentrations before and after the morning walk in the forest group were lower than the corresponding baseline values (both P=0.043); and the decreases were 2.21 and 1.86 nmol·L−1 respectively. Differences between groups showed a trend towards a greater decrease in salivary cortisol concentrations in the forest group than in the urban group after walking and at the 15 th min of sitting (both P=0.068). Among the mood indicators, the forest group showed a greater decrease than the urban group in fatigue dimension after walking (P=0.065) and after sitting (P=0.024); the forest group showed a greater decrease than the urban group in vitality dimension after walking (P=0.054) and after sitting (P=0.045); and the forest group showed a greater decrease than the urban group in "total mood disorder" after sitting (P=0.054). Among the fatigue indicators, the forest group showed a greater decrease in "physical fatigue", "mental fatigue", "consequences of fatigue", and "general fatigue" after walking and sitting than the urban group (all P<0.05). Among the stress indicators, there were not statistically significance of "tension", "loss of control", and "total stress score" between the two groups after sitting (both P>0.05). After one week after the activity, there were not statistically significant differences of mood and fatigue between the two groups (both P>0.05). Conclusion Forest therapy has a regulating effect on symptoms of negative mood, and fatigue in fatigued female office workers, but the effects of a short-term forest therapy last for a limited duration.

Restorative effects of different forest environments in spring, summer, and autumn / 环境与职业医学

Background It has been proved by many studies that forest environment has good restorative effects. Some researchers have attempted to identify natural factors affecting restorativeness. However, current studies have not focused on the effect of seasonal variation of forest environments on its restorative strength. Objective To evaluate the restorative effect changes of two types of forest environments across different seasons. Methods The experiments were conducted in April (spring), June (summer), and October (autumn) of 2017. Forty subjects were recruited in spring，18 in summer, and 20 in autumn. In spring, the subjects were randomly assigned to a forest park in suburban area and one in semi-pristine area in Beijing where each subject only experienced one kind of forest environment. In summer and autumn, each subject experienced two kinds of forest environments. They spent the first day in the suburban area forest park, and the second day in the semi-pristine area forest park. First the subjects completed the Brief Profile of Mood States (BPOMS) and had their heart rate been monitored for 10 min before test followed by a 30 min forest experience with sedentary sitting. At the end of each experience, the subjects completed the BPOMS again, and also the Restoration Environment Scale-Chinese version. Objective physical environment indicators were monitored simultaneously during forest experience. The changes of each indicator were analyzed before and after forest experience in selected three seasons. Results In the objective physical environment indicators, the concentrations of anion in selected three seasons in the semi-pristine area forest were higher than the values in the suburban development area forest; the concentration of anion in autumn was much higher than those in the other two seasons. In the assessment of the Restorative Environment Scale, the total scores of restorativeness of the semi-pristine area forest were generally higher than the scores in the suburban development area forest, but significant differences were found only in spring and summer (P < 0.001 in spring, P=0.022 in summer, and P=0.083 in autumn). In terms of physiological indicators, the average heart rate was decreased, while short-term R-R interval standard deviation (SD1) and root mean square of difference of successive intervals (RMSSD) were increased after the designed forest experience sessions in the three seasons, and there was statistical difference between forest types. In terms of psychological indicators, a decrease in the score of total mood disorder was presented after the experience session. In spring, there was a trend that the forest park in suburban development area had a better regulation effect on total mood disorder (P=0.07). In summer and autumn, there was a trend that the semi-pristine area forest park had a better regulation effect on total mood disorder (P=0.062 in summer and P=0.001 in autumn). Conclusion Generally, forest environments can improve the psychological and physiological indicators of human, and the improvement varies with frosts types and seasons. The restorative effects of forests in semi-pristine areas is better than those in suburban development area.

Analysis of clinical characteristics and prognostic factors of patients infected with Helicobacter pylori under 30 years ol / 公共卫生与预防医学

Objective To analyze the clinical characteristics and prognostic risk factors of helicobacter pylori (Hp) infected patients under 30 years old, and to provide a theoretical basis for the eradication of Hp in young Hp-positive patients under 30 years old. Methods A total of 565 patients with upper gastrointestinal symptoms admitted to our hospital from December 2017 to December 2020 were selected. All patients were Hp positive, and all patients were treated with quadruple eradication therapy of Helicobacter pylori. According to the Hp negative status after treatment, the patients were divided into good prognosis group (Hp negative, n=374) and poor prognosis group (Hp not negative, n=191). A self-made questionnaire was used to analyze the age, gender, familial history of gastrointestinal diseases, life habits (long-term smoking, and drinking), eating habits (irregular diet, and excitant food), DOB baseline value, and treatment compliance of the two groups. Logistic regression was used to analyze the factors that may affect the prognosis of HP positive patients. Results Among the 565 Hp positive patients, 347 were males and 218 were females, with an average age of (23.49±4.29) years, 393 (69.56%) aged 18-24 years old and 172 (30.44%) aged 25-29 years old. The diagnosis results of upper gastrointestinal diseases were 54 cases of gastric cancer (9.56%), 229 cases of peptic ulcer (40.53%), 174 cases of chronic gastritis (30.80%), and 108 cases of reflux esophagitis (19.12%). There were no significant differences in age, sex, family history of gastrointestinal diseases and alcoholism between the two groups (P>0.05). There were statistically significant differences between the two groups in long-term smoking, irregular diet, preference for stimulating food, treatment compliance and baseline value of DOB (P<0.05). The results of logistic regression analysis showed that long-term smoking, poor treatment compliance and high DOB value were independent risk factors affecting the prognosis of Hp positive patients (P<0.05). Conclusion Chronic gastritis and peptic ulcer are the main upper gastrointestinal diseases in Hp-positive young patients under 30 years old. Long-term smoking, poor treatment compliance and high DOB value are independent risk factors affecting the prognosis of patients. Treatment compliance of patients should be improved, and intervention should be strengthened in patients with high DOB value and smoking.

A vimentin-targeting oral compound with host-directed antiviral and anti-inflammatory actions addresses multiple features of COVID-19 and related diseases

Damage in COVID-19 results from both the SARS-CoV-2 virus and its triggered overreactive host immune responses. Therapeutic agents that focus solely on reducing viral load or hyperinflammation fail to provide satisfying outcomes in all cases. Although viral and cellular factors have been extensively profiled to identify potential anti-COVID targets, new drugs with significant efficacy remain to be developed. Here, we report the potent preclinical efficacy of ALD-R491, a vimentin-targeting small molecule compound, in treating COVID-19 through its host-directed antiviral and anti-inflammatory actions. We found that by altering the physical properties of vimentin filaments, ALD-491 affected general cellular processes as well as specific cellular functions relevant to SARS-CoV-2 infection. Specifically, ALD-R491 reduced endocytosis, endosomal trafficking, and exosomal release, thus impeding the entry and egress of the virus; increased the microcidal capacity of macrophages, thus facilitating the pathogen clearance; and enhanced the activity of regulatory T cells, therefore suppressing the overreactive immune responses. In cultured cells, ALD-R491 potently inhibited the SARS-CoV-2 spike protein and human ACE2-mediated pseudoviral infection. In aged mice with ongoing, productive SARS-CoV-2 infection, ALD-R491 reduced disease symptoms as well as lung damage. In rats, ALD-R491 also reduced bleomycin-induced lung injury and fibrosis. Our results indicate a unique mechanism and significant therapeutic potential for ALD-R491 against COVID-19. We anticipate that ALD-R491, an oral, fast-acting, and non-toxic agent targeting the cellular protein with multipart actions, will be convenient, safe, and broadly effective, regardless of viral mutations, for patients with early- or late-stage disease, post-COVID complications and other related diseases. IMPORTANCEWith the Delta variant currently fueling a resurgence of new infections in the fully-vaccinated population, developing an effective therapeutic drug is especially critical and urgent in fighting COVID-19. In contrast to the many efforts to repurpose existing drugs or address only one aspect of COVID-19, we are developing a novel agent with first-in-class mechanism-of-actions that address both the viral infection and the overactive immune system in the pathogenesis of the disease. Unlike virus-directed therapeutics that may lose efficacy due to viral mutations and immunosuppressants that require ideal timing to be effective, this agent, with its unique host-directed antiviral and anti-inflammatory actions, can work against all variants of the virus, be effective during all stages of the disease, and even resolve post-disease damage and complications. A further development of the compound will provide an important tool in the fight against COVID-19, its complications, as well as future outbreaks of new viruses.

Mutation Y453F in the spike protein of SARS-CoV-2 enhances interaction with the mink ACE2 receptor for host adaption

COVID-19 patients transmitted SARS-CoV-2 to minks in the Netherlands in April 2020. Subsequently, the mink-associated virus (miSARS-CoV-2) spilled back over into humans. Genetic sequences of the miSARS-CoV-2 identified a new genetic variant known as "Cluster 5" that contained mutations in the spike protein. However, the functional properties of these "Cluster 5" mutations have not been well established. In this study, we found that the Y453F mutation located in the RBD domain of miSARS-CoV-2 is an adaptive mutation that enhances binding to mink ACE2 and other orthologs of Mustela species without compromising, and even enhancing, its ability to utilize human ACE2 as a receptor for entry. Structural analysis suggested that despite the similarity in the overall binding mode of SARS-CoV-2 RBD to human and mink ACE2, Y34 of mink ACE2 was better suited to interact with a Phe rather than a Tyr at position 453 of the viral RBD due to less steric clash and tighter hydrophobic-driven interaction. Additionally, the Y453F spike exhibited resistance to convalescent serum, posing a risk for vaccine development. Thus, our study suggests that since the initial transmission from humans, SARS-CoV-2 evolved to adapt to the mink host, leading to widespread circulation among minks while still retaining its ability to efficiently utilize human ACE2 for entry, thus allowing for transmission of the miSARS-CoV-2 back into humans. These findings underscore the importance of active surveillance of SARS-CoV-2 evolution in Mustela species and other susceptible hosts in order to prevent future outbreaks.

Susceptibilities of human ACE2 genetic variants in coronavirus infection

The COVID-19 pandemic, caused by SARS-CoV-2, has resulted in more than 1603 million cases worldwide and 3.4 million deaths (as of May 2021), with varying incidences and death rates among regions/ethnicities. Human genetic variation can affect disease progression and outcome, but little is known about genetic risk factors for SARS-CoV-2 infection. The coronaviruses SARS-CoV, SARS-CoV-2 and HCoV-NL63 all utilize the human protein angiotensin-converting enzyme 2 (ACE2) as the receptor to enter cells. We hypothesized that the genetic variability in ACE2 may contribute to the variable clinical outcomes of COVID-19. To test this hypothesis, we first conducted an in silico investigation of single-nucleotide polymorphisms (SNPs) in the coding region of ACE2 gene. We then applied an integrated approach of genetics, biochemistry and virology to explore the capacity of select ACE2 variants to bind coronavirus spike protein and mediate viral entry. We identified the ACE2 D355N variant that restricts the spike protein-ACE2 interaction and consequently limits infection both in vitro and in vivo. In conclusion, ACE2 polymorphisms could modulate susceptibility to SARS-CoV-2, which may lead to variable disease severity.

Efficacy and Safety of Glucagon-like Peptide-1 Receptor Agonists in the Treatment of Metabolic Associated Fatty Liver Disease: A Systematic Review and Meta-analysis.

BACKGROUND: Clinical trials examining the therapeutic benefits of glucagon-like peptide-1 receptor agonists (GLP-1RA) on patients with metabolic associated fatty liver disease (MAFLD) have reported inconsistent results. The aim of this meta-analysis was to verify the role of GLP-1RA in the treatment of MAFLD patients. MATERIALS AND METHODS: We searched PubMed, Embase, Medline, and the Cochrane Library for randomized controlled trials published that compared GLP-1RA with the control treatment in patients with MAFLD till to July 30, 2020. The effects of GLP-1RA on liver histology, body mass index, waist circumference (WC), aspartate aminotransferase, total cholesterol, triglycerides (TG), low-density lipoprotein and high-density lipoprotein were evaluated. RESULTS: Thirteen trials involving 704 patients were included in the meta-analysis. Compared with the control treatment, GLP-1RA treatment induced a greater resolution of steatohepatitis [RR=2.87; 95% confidence interval (CI): 0.89 to 9.23], delayed the progression of liver fibrosis (RR=3.83, 95% CI: 0.91 to 16.07) and reduced liver fat deposition (MD: -1.40; 95% CI: -2.75 to -0.05). In addition, it reduced the body mass index (MD: -1.15; 95% CI: -2.26 to -0.04), WC (MD: -3.33; 95% CI: -6.31 to -0.35) and improved serum aspartate aminotransferase (MD: -3.04; 95% CI: -5.93 to -0.16) and total cholesterol (MD: -0.20; 95% CI: -0.28 to -0.13). CONCLUSION: GLP-1RA improves liver steatosis and fibrosis. It is also beneficial to metabolic syndrome as it reduces BMI, WC, and hyperlipidemia.

Comparative analysis reveals the species-specific genetic determinants of ACE2 required for SARS-CoV-2 entry

Coronavirus interaction with its viral receptor is a primary genetic determinant of host range and tissue tropism. SARS-CoV-2 utilizes ACE2 as the receptor to enter host cell in a species-specific manner. We and others have previously shown that ACE2 orthologs from New World monkey, koala and mouse cannot interact with SARS-CoV-2 to mediate viral entry, and this defect can be restored by humanization of the restrictive residues in New World monkey ACE2. To better understand the genetic determinants behind the ability of ACE2 orthologs to support viral entry, we compared koala and mouse ACE2 sequences with that of human and identified the key residues in koala and mouse ACE2 that restrict viral receptor activity. Humanization of these critical residues rendered both koala and mouse ACE2 capable of binding the spike protein and facilitating viral entry. The single mutation that allowed for mouse ACE2 to serve as a viral receptor provides a potential avenue for the development of SARS-CoV-2 mouse model.

Functional and Genetic Analysis of Viral Receptor ACE2 Orthologs Reveals Broad Potential Host Range of SARS-CoV-2

The pandemic of Coronavirus Disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a major global health threat. Epidemiological studies suggest that bats are the natural zoonotic reservoir for SARS-CoV-2. However, the host range of SARS-CoV-2 and intermediate hosts that facilitate its transmission to humans remain unknown. The interaction of coronavirus with its host receptor is a key genetic determinant of host range and cross-species transmission. SARS-CoV-2 uses angiotensin-converting enzyme 2 (ACE2) as the receptor to enter host cells in a species-dependent manner. It has been shown that human, palm civet, pig and bat ACE2 can support virus entry, while the murine ortholog cannot. In this study, we characterized the ability of ACE2 from diverse species to support viral entry. We found that ACE2 is expressed in a wide range of species, with especially high conservation in mammals. By analyzing amino acid residues of ACE2 critical for virus entry, based on structure of SARS-CoV spike protein interaction with human, bat, palm civet, pig and ferret ACE2, we identified approximately eighty ACE2 proteins from mammals that could potentially mediate SARS-CoV-2 entry. We chose 48 representative ACE2 orthologs among eighty orthologs for functional analysis and it showed that 44 of these mammalian ACE2 orthologs, including those of domestic animals, pets, livestock, and animals commonly found in zoos and aquaria, could bind SARS-CoV-2 spike protein and support viral entry. In contrast, New World monkey ACE2 orthologs could not bind SARS-CoV-2 spike protein and support viral entry. We further identified the genetic determinant of New World monkey ACE2 that restricts viral entry using genetic and functional analyses. In summary, our study demonstrates that ACE2 from a remarkably broad range of species can facilitate SARS-CoV-2 entry. These findings highlight a potentially broad host tropism of SARS-CoV-2 and suggest that SARS-CoV-2 might be distributed much more widely than previously recognized, underscoring the necessity to monitor susceptible hosts to prevent future outbreaks.

Safety and effectiveness of infra-hepatic inferior vena cava clamping combined with Pringle’s maneuver during hepatectomy: a meta-analysis / 中华肝胆外科杂志

Objective@#To study the safety and effectiveness of infra-hepatic inferior vena cava clamping combined with Pringle’s maneuver during hepatectomy.@*Methods@#The databases of PubMed, Cochrane Center, CNKI, VIP, Wan Fang were searched to extract the relevant data for the meta-analysis using the Revmanage 5.3 software.@*Results@#A total of 14 studies with 1595 patients were included in this meta-analysis. The results showed that total bleeding during the combined clamping was significantly lower than that of the Pringle’s maneuver alone (MD=-314.59, 95%CI: -362.37~-266.81, P<0.05). Bleeding during hepatectomy was significantly lower (MD=-217.79, 95% CI: -284.57~-151.00, P<0.05); so was the intraoperative blood transfusion rate (OR=0.48, 95% CI: 0.36~0.62, P<0.05). The incidence of complications was significantly lower (OR=0.74, 95% CI: 0.57~0.95, P<0.05). However, there were no significant differences in operation time, length of hospital stay, intraoperative monitoring index and postoperative liver and kidney function recovery (P>0.05).@*Conclusions@#Infra-hepatic inferior vena cava clamping combined with Pringle’s maneuver in hepatectomy was safe and reliable. Compared with the Pringle’s maneuver alone, the combined technique reduce bleeding and the incidence of complications. This technique is worth promoting in clinical practice.

Safety and effectiveness of infra-hepatic inferior vena cava clamping combined with Pringle' s maneuver during hepatectomy:a meta-analysis / 中华肝胆外科杂志

Objective To study the safety and effectiveness of infra-hepatic inferior vena cava clamping combined with Pringle' s maneuver during hepatectomy. Methods The databases of PubMed, Cochrane Center, CNKI, VIP, Wan Fang were searched to extract the relevant data for the meta-analysis using the Revmanage 5. 3 software. Results A total of 14 studies with 1595 patients were included in this meta-analysis. The results showed that total bleeding during the combined clamping was significantly lower than that of the Pringle's maneuver alone (MD= -314. 59, 95％CI:-362. 37～ -266. 81, P<0. 05). Bleeding during hepatectomy was significantly lower ( MD= -217. 79, 95％ CI: -284. 57 ～ -151. 00, P<0. 05); so was the intraoperative blood transfusion rate ( OR = 0. 48, 95％ CI: 0. 36 ～ 0. 62, P<0. 05). The incidence of complications was significantly lower (OR =0. 74, 95％ CI: 0. 57 ～0. 95, P<0. 05). However, there were no significant differences in operation time, length of hospital stay, intrao-perative monitoring index and postoperative liver and kidney function recovery ( P >0. 05 ) . Conclusions Infra-hepatic inferior vena cava clamping combined with Pringle' s maneuver in hepatectomy was safe and reliable. Compared with the Pringle' s maneuver alone, the combined technique reduce bleeding and the incidence of complications. This technique is worth promoting in clinical practice.

The value of MRI in the differential diagnosis of intraductal papilloma and invasive ductal carcinoma / 实用放射学杂志

Objective To investigate the MRI features and characteristics of irregular intraductal papilloma (IDP)and invasive ductal carcinoma (IDC),and to improve the diagnostic accuracy of MRI.Methods This study retrospectively included 3 3 patients with IDP and IDC confirmed by surgery and pathology,and analyzed MRI findings including lesion size,boundary,internal components,plain signal intensity,enhancement mode,ADC value and TIC curve χ.2 test,t test and rank-sum test were performed.Results Compared with the two groups,lesion boundary (P＜0.001),size (P＜0.001 ),ADC value (P＜0.001 ),enhancement mode (P＝0.001 ),TIC curve peak time (P＜0.001),slope (P＜0.001)and peak enhancement rate (P＜0.001)were statistically significant (P＜0.05);lesion (P＝0.159), internal components (P＝0.778),T2 WI signal (P＝0.438)and curve type (P＝0.406)were no statistically difference.Conclusion The irregular mass type IDP and IDC have similar MRI findings,the edge of the lesion,the ADC value,the enhancement mode,and the peak time,slope and peak enhancement rate of the curve are important for the identification of the two diseases.

Analysis of characteristics of elbow fractures in pediatric patients / 中华实用儿科临床杂志

Objective To study the distribution and the characteristic of elbow fractures in children according to the age,sex,year,season and anatomical location.Methods The data of pediatric elbow fractures which were treated either in outpatient department or hospitalized in the First Affiliated Hospital of Guangxi Medical University between January 2011 and December 2016 were collected.The distribution and characteristics of the fractures were analyzed by using SPSS 18.0 software and Excel 2010.Results A total of 613 patients with elbow fractures (628 different anatomical sites) were registered.The incidence seemed to increase by each year.Among them,414 cases were male and 199 cases were female (male/female ratio 2.08 ∶ 1.00).There were 3 distinct peaks which were respectively at the ages of 1,3 and 5.The fractures happened frequently from April to October.The most common type was supracondylar fracture of humerus(71.29％,437/613 cases),followed by lateral condylar fracture of humerus(14.68％,90/613 cases),olecranon fracture(3.26％,20/613 cases) and radial neck fracture (2.28％,14/613 cases).The most common cause of injury was falling on the same level (67.54％,414/613 cases),followed by dropping from heights (16.64％,102/613 cases),then sports injury (7.83％,48/613 cases),traffic accidents (5.55％,34/613 cases) as well as some intentional injuries (0.65％,4/613 cases).Conclusions The highest incidence of elbow fracture was found in children around 1 year,and 3-6 years.Boys are more affected than girls,probably attributed to their active nature.Fractures are more frequent in summer in which supracondylar fracture of humerus is the most common type.Most fractures occur after falling on the same level,indicating how easy it is to get injured in children.So careful examination is necessary to all the pediatric cases who came with a history of fall.Attention should be paid to intentional injuries especially so as to rule out if the cases belong to brutal abuse.

A study on the timing and modality of surgery for pancreatic sinistral portal hypertension / 中华普通外科杂志

Objective To investigate the opportunity and skill of surgery for pancreatic sinistral portal hypertension.Methods Clinical data were retrospectively analyzed on 15 cases of pancreatic sinistral portal hypertension admired from Dec 2015 to Dec 2017.Results All fiften cases underwent surgical treatment,among them three cases were initially treated conservatively in the early stage and treated surgically for gastrointestinal bleeding,12 cases with definite pancreatic disease and pancreatic sinistral portal hypertension treated in the first stage.Three patients underwent second surgery for recurrent gastrointestinal bleeding.The patients were followed up for 6 to 18 months with symptoms significantly impioved without deaths.Conclusions Splenectomy combined with esophagogastric devascularization is the basic surgical treatment for pancreatic sinistral portal hypertension.

Evaluation on validity of Manual of Home-Based Rehabilitation Mode for Stroke Patients in Community / 中华全科医师杂志

The evaluation tools were developed based on the theory of validity,the development process and results of the Manual of Home-Based Rehabilitation Mode for Stroke Patients were evaluated by a panel of experts,and the opinions and suggestions for improvement were collected from the evaluation experts.The results showed that the average score for development process and results of the manual were ＞4 points in structural validity,content validity and surface validity,indicating that the manual was of high quality,and the development of the manual was scientific and the results were practical.The manual may provide the guidance for the home-based rehabilitation in community.At the same time,this study has enriched the reviewing tools and evaluation method of manuals,and provided reference for the peers.

Criteria of admission and discharge for stroke patients in home-based rehabilitation / 中华全科医师杂志

Sixteen experts were invited and two-round Delphi expert consultation of admission and discharge criteria for stroke patients in home-based rehabilitation were conducted from April to October 2015.Results showed that the enthusiasm and authority degree of experts in two rounds consultation were favorable.The modified admission criteria included 8 inclusive conditions and 6 exclusive conditions.Among 8 inclusive conditions,home-based rehabilitation intervention time and NIHSS score were the necessary conditions for admission,in addition to 6 exclusion conditions.With the necessary conditions,if patients had disturbances of one or more following conditions:motor function,tactile and proprioceptive function,communication function,cognitive function,quality of life and other symptoms,they were eligible to be admitted in home-based rehabilitation in community.The discharged criteria contained two aspects:1.the conditions in admitted criteria reaching the plateau;2.the occurrence of unexpected situations,including disease worsening,deep vein thrombosis and stroke recurrence.The admission and discharged criteria developed in this study has high credibility and can be recommended for practical application in other communities in home-based rehabilitation of stroke patients,which also can be used for implementation of level-classified rehabilitation for stroke patients.