A systematic review and meta-analysis of minimally invasive versus conventional open proctectomy for locally advanced colon cancer.

BACKGROUND: Locally advanced colon cancer is considered a relative contraindication for minimally invasive proctectomy (MIP), and minimally invasive versus conventional open proctectomy (COP) for locally advanced colon cancer has not been studied. METHODS: We have searched the Embase, Cochrane Library, PubMed, Medline, and Web of Science for articles on minimally invasive (robotic and laparoscopic) and COP. We calculated pooled standard mean difference (SMD), relative risk (RR), and 95% confidence intervals (CIs). The protocol for this review has been registered on PROSPERO (CRD42023407029). RESULTS: There are 10132 participants including 21 articles. Compared with COP, patients who underwent MIP had less operation time (SMD 0.48; CI 0.32 to 0.65; I2 = 0%, P = .000), estimated blood loss (MD -1.23; CI -1.90 to -0.56; I2 = 95%, P < .0001), the median time to semi-liquid diet (SMD -0.43; CI -0.70 to -0.15; I2 = 0%, P = .002), time to the first flatus (SMD -0.97; CI -1.30 to -0.63; I2 = 7%, P < .0001), intraoperative blood transfusion (RR 0.33; CI 0.24 to 0.46; I2 = 0%, P < .0001) in perioperative outcomes. Compared with COP, patients who underwent MIP had fewer overall complications (RR 0.85; CI 0.73 to 0.98; I2 = 22.4%, P = .023), postoperative complications (RR 0.79; CI 0.69 to 0.90; I2 = 0%, P = .001), and urinary retention (RR 0.63; CI 0.44 to 0.90; I2 = 0%, P = .011) in perioperative outcomes. CONCLUSION: This study comprehensively and systematically evaluated the difference between the safety and effectiveness of minimally invasive and open treatment of locally advanced colon cancer through meta-analysis. Minimally invasive proctectomy is better than COP in postoperative and perioperative outcomes. However, there is no difference in oncological outcomes. This also provides an evidence-based reference for clinical practice. Of course, multi-center RCT research is also needed to draw more scientific and rigorous conclusions in the future.

A systematic review and meta-analysis of minimally invasive total mesorectal excision versus transanal total mesorectal excision for mid and low rectal cancer.

Background: Minimally invasive total mesorectal excision (MiTME) and transanal total mesorectal excision (TaTME) are popular trends in mid and low rectal cancer. However, there is currently no systematic comparison between MiTME and TaTME of mid and low-rectal cancer. Therefore, we systematically study the perioperative and pathological outcomes of MiTME and TaTME in mid and low rectal cancer. Methods: We have searched the Embase, Cochrane Library, PubMed, Medline, and Web of Science for articles on MiTME (robotic or laparoscopic total mesorectal excision) and TaTME (transanal total mesorectal excision). We calculated pooled standard mean difference (SMD), relative risk (RR), and 95% confidence intervals (CIs). The protocol for this review has been registered on PROSPERO (CRD42022374141). Results: There are 11010 patients including 39 articles. Compared with TaTME, patients who underwent MiTME had no statistical difference in operation time (SMD -0.14; CI -0.31 to 0.33; I2=84.7%, P=0.116), estimated blood loss (SMD 0.05; CI -0.05 to 0.14; I2=48%, P=0.338), postoperative hospital stay (RR 0.08; CI -0.07 to 0.22; I2=0%, P=0.308), over complications (RR 0.98; CI 0.88 to 1.08; I2=25.4%, P=0.644), intraoperative complications (RR 0.94; CI 0.69 to 1.29; I2=31.1%, P=0.712), postoperative complications (RR 0.98; CI 0.87 to 1.11; I2=16.1%, P=0.789), anastomotic stenosis (RR 0.85; CI 0.73 to 0.98; I2=7.4%, P=0.564), wound infection (RR 1.08; CI 0.65 to 1.81; I2=1.9%, P=0.755), circumferential resection margin (RR 1.10; CI 0.91 to 1.34; I2=0%, P=0.322), distal resection margin (RR 1.49; CI 0.73 to 3.05; I2=0%, P=0.272), major low anterior resection syndrome (RR 0.93; CI 0.79 to 1.10; I2=0%, P=0.386), lymph node yield (SMD 0.06; CI -0.04 to 0.17; I2=39.6%, P=0.249), 2-year DFS rate (RR 0.99; CI 0.88 to 1.11; I2=0%, P = 0.816), 2-year OS rate (RR 1.00; CI 0.90 to 1.11; I2=0%, P = 0.969), distant metastasis rate (RR 0.47; CI 0.17 to 1.29; I2=0%, P = 0.143), and local recurrence rate (RR 1.49; CI 0.75 to 2.97; I2=0%, P = 0.250). However, patients who underwent MiTME had fewer anastomotic leak rates (SMD -0.38; CI -0.59 to -0.17; I2=19.0%, P<0.0001). Conclusion: This study comprehensively and systematically evaluated the safety and efficacy of MiTME and TaTME in the treatment of mid to low-rectal cancer through meta-analysis. There is no difference between the two except for patients with MiTME who have a lower anastomotic leakage rate, which provides some evidence-based reference for clinical practice. Of course, in the future, more scientific and rigorous conclusions need to be drawn from multi-center RCT research. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO, identifier CRD42022374141.

Bayesian network analysis of long-term oncologic outcomes of open, laparoscopic, and robot-assisted radical cystectomy for bladder cancer.

BACKGROUND: To understand the long-term oncologic outcomes of open radical cystectomy (ORC) versus laparoscopic radical cystectomy (LRC) versus robot-assisted radical cystectomy (RARC) for bladder cancer (BCa). Therefore, we performed the conventional meta-analysis and network meta-analysis to evaluate the long-term oncologic outcomes of ORC, LRC, and RARC for BCa. METHODS: A systematic search of PubMed, Embase, Cochrane Library, Medline, and Web of science was performed up until July 1, 2021. Long-term oncologic outcomes include the 5-year overall survival (OS) rate, the 5-year recurrence-free survival (RFS) rate, and the 5-year cancer specific-survival (CSS) rate. The Bayesian network analysis has been registered in PROSPERO (CRD42020208396). RESULTS: We found that 10 articles (including 3228 patients) were included in our Bayesian network analysis. No significant differences were found between ORC, LRC, and RARC in long-term oncologic outcomes in either direct meta-analysis or network meta-analysis. Therefore, the clinical effects of 5-year OS, RFS, and CSS of RARC, LRC, and ORC are similar. But LRC may be ranked first in 5-year OS, RFS, and CSS compared to other surgical approaches by probabilistic analysis ranking via Bayesian network analysis. CONCLUSION: We found that there were no statistical differences in the 3 surgical approaches of RAPC, LPC, and OPC for Bca in long-term oncologic outcomes by direct meta-analysis. However, Subtle differences between these surgical approaches can be concluded that LRC may be a better surgical approach than RARC or ORC in long-term oncologic outcomes by probabilistic analysis ranking via Bayesian network analysis. Moreover, we need a large sample size and more high-quality studies to improve and verify further.

SARS-CoV-2 Spike Protein Impairs Endothelial Function via Downregulation of ACE2

Coronavirus disease 2019 (COVID-19) includes the cardiovascular complications in addition to respiratory disease. SARS-CoV-2 infection impairs endothelial function and induces vascular inflammation, leading to endotheliitis. SARS-CoV-2 infection relies on the binding of Spike glycoprotein (S protein) to angiotensin converting enzyme 2 (ACE2) in the host cells. We show here that S protein alone can damage vascular endothelial cells (ECs) in vitro and in vivo, manifested by impaired mitochondrial function, decreased ACE2 expression and eNOS activity, and increased glycolysis. The underlying mechanism involves S protein downregulation of AMPK and upregulation of MDM2, causing ACE2 destabilization. Thus, the S protein-exerted vascular endothelial damage via ACE2 downregulation overrides the decreased virus infectivity.

Compilation of questionnaire for quality evaluation on problem-based learning of Neurology and analysis of its reliability and validity / 中华医学教育探索杂志

Objective:To design and compile quality evaluation questionnaire on problem-based learning (PBL) of Neurology and to test its reliability and validity.Methods:Referring to the framework of the evaluation system and according to the characteristics of the discipline, we designed the questionnaire on PBL of Neurology. The clinical medical students who participated in neurologic PBL course were taken as the objects of investigation. The reliability of the questionnaire and the reliability of internal consistency were tested. Correlation analysis and exploratory factor analysis were used to evaluate the validity of the questionnaire.Results:The questionnaire on PBL of Neurology included three first-level indicators: teaching plan quality evaluation, teaching method evaluation and teaching quality evaluation, containing 6 second-level indicators and 25 third-level indicators. The correlation coefficient ρ=0.990 ( P<0.01) showed that the retest reliability was good. The cronbach's α coefficient is 0.901, meeting the internal consistency reliability requirement. And the content validity correlation coefficient was 0.307-0.7 ( P<0.05), indicating that each third-level index had a significant correlation with the total score, and the questionnaire item design was good. The three first-level indicators were used as common factors to evaluate the structural validity by exploratory factor analysis and identify the direction of optimization. Conclusion:The questionnaire has good reliability and validity, which can be used as a tool for scientific evaluation on PBL of neurology, and also provide an optimization direction for further research in the future.

Advances in comprehensive diagnosis and treatment of gallbladder cancer / 国际外科学杂志

Gallbladder cancer is a highly malignant tumor of the digestive system,and its incidence in China has been increasing year by year.Due to the lack of specific symptoms in the early stage,early diagnosis is difficult for gallbladder cancer and it is often at advanced stage once discovered.Surgery is still the only method to cure gallbladder cancer.Therefore,early diagnosis is particularly important for radical resection and improving overall prognosis of gallbladder cancer patients.However,there is still no specific molecular diagnostic target for gallbladder cancer.The continuous improvement of research and surgical skills have made the operational procedure of gallbladder cancer more standardized.With the increasing understanding on the epidemiology and pathogenesis of gallbladder cancer and the improvement of imaging,radiotherapy and chemotherapy technology,the comprehensive diagnosis and treatment of gallbladder cancer has also developed rapidly in recent years.However,high-quality clinical research is still needed.Comprehensive treatment model including radical surgery,adjuvant radiotherapy and chemotherapy,targeted therapy and immunotherapy will be the trend of gallbladder cancer treatment in the future.This article summarizes the advances in comprehensive diagnosis and treatment of gallbladder cancer by reviewing literatures.

Development and verification of indirect immunofluorescence assay for detection of baculovirus titer / 中华微生物学和免疫学杂志

Objective To develop, optimize and preliminarily verify an indirect immunofluores-cence assay ( IFA) for detecting the titer of recombinant baculovirus. Methods Conditions for performing IFA, including cell concentration, co-incubation time, reaction temperature, dilution ratio, reaction time and types of fixative solution, blocking liquid and antibodies, were optimized to establish an IFA method for the detection of baculovirus titer. Specificity, accuracy, reproducibility and intermediate precision of the es-tablished assay were verified. And the results were compared with those of baculovirus rapid titer kit. Re-sults The optimal cell concentration for coating was 0. 6×106 cell/ml, and the optimal reaction time be-tween viruses with cells was 3 d. The optimal conditions for conducting IFA were as follows: formaldehyde buffered acetone (-20℃) was used as fixative, normal goat serum was used as blocking liquid and the first and second generation antibodies at a dilution of 1 : 200 were incubated at 37℃ for 1 h, respectively. Spe-cific fluorescence was observed only in baculovirus but not in others by using the method. No significant difference in virus titers was observed between the established IFA and baculovirus rapid titer kit. The two methods showed a good linear correlation (R2=0. 996). Coefficients of variation for evaluating the reproduc-ibility and intermediate precision were less than 10％. Conclusion IFA for the detection of baculovirus ti-ter was established with good specificity, accuracy, reproducibility and intermediate precision.

Objective Quality Assessment of Image Retargeting by Incorporating Fidelity Measures and Inconsistency Detection.

The tremendous growth in mobile devices has resulted in huge generation and usage of digital images. Image quality assessment is thus an important issue for mobile media applications. In this paper, we focus on the quality evaluation of images generated by content-aware image retargeting, in which the reference and the distorted images are of different sizes. Through retargeting, many types of deformation inconsistency lead to shape distortion, deformation artifacts, and content information loss, worsening its perceptual quality. The deformation inconsistency occurs on different levels of the retargeted images. Limited by the accuracy of the alignment between the original and retargeted images, previous methods only focus on pixel-level and patch-level fidelity analyses and fail to detect deformation inconsistency. In this paper, we improve the alignment algorithm and propose a three-level representation of the retargeting process. Based on the analysis of this three-level representation, both fidelity measures and inconsistency detection are combined to determine the final retargeting quality. The proposed algorithm is validated on the public data sets RetargetMe and CUHK. Experimental results demonstrate that inconsistency detection contributes to accurately assessing the image retargeting perceptual quality. This inspires us to investigate more about deformation inconsistency to formulate the objective quality of image retargeting.

Prevalence of Hymenolepis nana and H. diminuta from Brown Rats (Rattus norvegicus) in Heilongjiang Province, China

Hymenolepis nana and Hymenolepis diminuta are globally widespread zoonotic cestodes. Rodents are the main reservoir host of these cestodes. Brown rats (Rattus norvegicus) are the best known and most common rats, and usually live wherever humans live, especially in less than desirable hygiene conditions. Due to the little information of the 2 hymenolepidid species in brown rats in China, the aim of this study was to understand the prevalence and genetic characterization of H. nana and H. diminuta in brown rats in Heilongjiang Province, China. Total 114 fecal samples were collected from brown rats in Heilongjiang Province. All the samples were subjected to morphological examinations by microscopy and genetic analysis by PCR amplification of the mitochondrial cytochrome c oxidase subunit 1 (COX1) gene and the internal transcribed spacer 2 (ITS2) region of the nuclear ribosomal RNA gene. In total, 6.1% (7/114) and 14.9% (17/114) of samples were positive for H. nana and H. diminuta, respectively. Among them, 7 and 3 H. nana isolates were successfully amplified and sequenced at the COX1 and ITS2 loci, respectively. No nucleotide variations were found among H. nana isolates at either of the 2 loci. Seventeen H. diminuta isolates produced 2 different COX1 sequences while 7 ITS2 sequences obtained were identical to each other. The present results of H. nana and H. diminuta infections in brown rats implied the risk of zoonotic transmission of hymenolepiasis in China. These molecular data will be helpful to deeply study intra-specific variations within Hymenolepis cestodes in the future.

Corneal biomechanical properties in different anterior chamber angle of glaucoma / 中华实验眼科杂志

Background Recent studies have demonstrated that glaucoma progression had great relationship with corneal biomechanical properties.However,there are not enough studies about corneal biomechanical properties in different types of glaucoma.Objective This study was to evaluate the corneal biomechanical properties in chronic primary angle-closure glaucoma (CPACG) and primary open angle glaucoma (POAG).Methods Prospective observational study was adopted.Sixty-eight cases (68 eyes) with CPACG and 69 POAG patients (69 eyes) from Zhongshan Ophthalmic Center were investigated by a novel technique named Corvis-ST which can measure corneal deformation.The Cronbach's αt coefficient and intraclass correlation coefficient (ICC) were used to evaluate the repeatability of the parameters from Corvis-ST.The differences of corneal biomechanical properties between POAG and CPACG were evaluated by independent-samples t test.Multiple regression analysis was used to assess the association between parameters of deformation response and clinical factors.This study protocol was approved by Ethic Committee of Zhongshan Ophthalmic Center and complied with Helsinki Declaration.Written informed consent was obtained from each patient prior to any medical examination.Results There were no statistic differences about age,sex and intraocular pressure (IOP) between CPACG and POAG patients (all at P＞0.05).However,differences existed in the number of anti-glaucoma medications (t =-2.388,P =0.020).Measurements of central corneal thickness (CCT),deformation amplitude (DA),and peak distance (PD) demonstrated excellent repeatability (ICC≥ 0.8).There were no statistic differences about CCT,first applanation time/length/velocity (A1 T,A1 L,A1V),second applanation time/length/velocity (A2T,A2L,A2V),DA between CPACG and POAG patients (all at P＞ 0.05).The highest concavity time was shorter (t =2.920,P =0.005),PD was bigger (t =-2.453,P =0.017),and central curvature radius (CCR) was smaller (t =1.997,P =0.050) in POAG than those in the CPACG patients.DA,A1V,A2T and PD were negatively associated with IOP (r =-0.709,-0.531,-0.645,-0.554;all at P＜0.001).However,A1T and A2V were positively associated with IOP (r=0.744,0.546;both at P＜0.001).And CCR was positively associated with CCT (r =0.181,P =0.039).Conclusions It is useable to evaluate corneal biomechanical properties of glaucoma by Corvis ST.Under the same level of IOP,the corneal concavity of POAG is easier than that of CPACG,which indicates that cornea in POAG patients is more deformable.