The casual effects of COVID-19 lockdown on air quality and short-term health impacts in China.

The outbreak of coronavirus (COVID-19) has forced China to lockdown many cities and restrict transportation, industrial, and social activities. This provides a great opportunity to look at the impacts of pandemic quarantine on air quality and premature death due to exposure to air pollution. In this study, we applied the difference-in-differences (DID) model to quantify the casual impacts of COVID-19 lockdown on air quality at 278 cities across China. A widely used exposure-response function was further utilized to estimate the short-term health impacts associated with changes in PM2.5 due to lockdown. Results show that lockdown has caused drastic reduction in air pollution level in terms of all criteria pollutants except ozone. On average, concentrations of PM2.5, PM10, NO2, SO2 and CO are estimated to drop by 14.3 µg/m3, 22.2 µg/m3, 17.7 µg/m3, 2.9 µg/m3, and 0.18 mg/m3 as the result of lockdown. Cities with more confirmed cases of COVID-19 are related to stronger responses in air quality, despite that similar lockdown measures were implemented by the local governments. The improvement of air quality caused by COVID-19 lockdown in northern cities is found to be smaller than that of southern cities. Avoided premature death associated with PM2.5 exposures over the 278 cities was estimated to be 50.8 thousand. Our results re-emphasize the effectiveness of emission controls on air quality and associated health impacts. The high cost of lockdown, still high level of air pollution during lockdown and smaller effects in northern cities implies that source-specific mitigation policies are needed for continuous and sustainable reduction of air pollution.

Application value of ultrasound-guided unilateral subarachnoid block with bupivacaine in hip replacement surgery for elderly patients with femoral neck fractures / 中国现代医生

@#Objective To explore the application value of ultrasound-guided use of bupivacaine for subarachnoid block in hip replacement surgery for elderly femoral neck fractures.Methods A total of 108 elderly patients who underwent hip replacement surgery at Ganzhou Traditional Chinese Medicine Hospital from March 2020 to March 2022 were selected as the study subjects.They were divided into conventional anesthesia group and ultrasound guided anesthesia group by means of random number table,54 cases in each group.Patients in the conventional anesthesia group received routine general anesthesia;Patients in the ultrasound guided anesthesia group received unilateral lumbar anesthesia with bupivacaine under ultrasound-guided guidance.Compare the effectiveness of two anesthesia methods during surgery.Results Compared with the conventional anesthesia group,the anesthesia effect of the ultrasound guided anesthesia group was better(P<0.05);The surgery time,amount of bleeding during surgery,postoperative recovery time,and length of hospital stay in the ultrasound guided anesthesia group were all lower than those in the conventional anesthesia group(P<0.05).The ultrasound guided anesthesia group performed better in terms of hemodynamic stability,with a smaller range of changes,and significantly lower pain scores at different postoperative time points compared to the conventional anesthesia group(P<0.05).Conclusion In elderly patients undergoing hip replacement surgery,using ultrasound-guided bupivacaine for subarachnoid block can achieve ideal anesthesia and analgesic effects compared to traditional general anesthesia,shorten drug onset time,alleviate pain in elderly patients,maintain hemodynamic stability,and have significant clinical application effects.

Research progress on running-related joint injuries and rehabilitation treatment / 国际生物医学工程杂志

Under the backdrop of the "Healthy China 2030" strategy, running has become the most common form of exercise. Fitness running is a kind of endurance aerobic exercise. Compared with swimming, aerobics, and other sports with high activity and intensity, the risk of lower limb fatigue injury during fitness running is higher. In this review paper, the risk factors for running-related injuries were summarized by consulting and analyzing the database and focuses on discussing and analyzing the impact of running on joints. The results showed that hip adduction, knee bending, and ankle joint abnormalities are the three joint-related factors that cause the main injuries during running. Four rehabilitation intervention methods for running-related injuries were proposed, that can guide patients to generate personalized rehabilitation treatment plans through training.

Peritoneal dialysis-related peritonitis caused by Neisseria elongata: a case report and literature review / 中华肾脏病杂志

Neisseria elongata is a normal group of bacteria in human oropharynx and a kind of gram-negative bacillus that cause disease, and its pathogenicity is rarely reported in China. In a few cases, it can cause septicemia, osteomyelitis and infective endocarditis. There are a few reports of other Neisseria causing peritonitis at home and abroad. The paper reported a case of Neisseria elongata-caused peritonitis and reviewed the literature. The patient was initially treated with ceftazidime combined with cefzolin overnight for 3 days, but the effect was not good. The subsequent peritoneal dialysis fluid culture results indicated Neisseria elongata, and the patient was cured and discharged after treatment with levofloxacin combined with drug sensitivity test, hoping to attract clinical workers' attention to the pathogenicity of Neisseria.

Predictive value of shoulder joint anatomical features to the small and medium rotator cuffre-tear rate after rehabilitation / 中华骨科杂志

Objective:To explore the correlation between the anatomical features of shoulder joint and the re-tear rate after surgical repair for small and medium-sized rotator cuff tears.Methods:From June 2017 to June 2019, 55 patients who were diagnosed with small or medium-sized rotator cuff tears and treated with arthroscopic single-row repair were enrolled. Demographics including age, sex, disease course, history of smoking and diabetes mellitus, re-tear rates, Constant-Murley score, University of California, Los Angeles score (UCLA) at 6-month, 1-year, 2-year and 3-year after operation were collected. Postoperative critical shoulder angle (CSA) and acromial index (AI) were measured and calculated based on CT scan. The patients were divided into two groups: patients who got re-tear history during follow-up were included into endpoint re-tear (ER) group, and those who got no re-tear history during follow-up were included into endpoint non-tear (EN) group. One-way Anova was used to compare the CSA\AI among different follow-up point. Fisher's exact test was used to compare sex, morbidity of smoking and diabetes between the ER and EN groups. Two independent samples t-test were used to compare age, disease course, CSA and AI at 1-day after operation, functional scores at each follow-up point between the two groups. Binomial logistic regression analysis was performed to test CSA and AI at 1-day after operation as the risk factors of rotator cuff re-tear at 6-month, 1-year, 2-year and 3-year after operation. The predictive efficacy of CSA and AI at 1-day after operation on re-tear rate at 3-year after operation were evaluated by receiver operating characteristic (ROC) curves, Pearson correlation analysis was used to evaluate the correlation between postoperative CSA/AI and postoperative functional recovery. Results:The CSA and AI of ER group were insignificantly different among all follow-up point ( P>0.05), the CSA and AI of EN group were significantly different among all follow-up point ( F=14.163, P<0.001; F=4.635, P<0.001). The re-tear rates at 6-month, 1-year, 2-year and 3-year after operation were 3.6%, 7.3%, 12.7%, 18.2%. The Constant-Murley score and UCLA scores of ER group at 3-year after operation were 93.60±2.84 and 32.30±1.49, respectively while in EN group, they were 92.11±4.10 and 33.18±1.27, respectively, there were no difference of the Constant-Murley score and UCLA score between ER and EN group at 3-year after operation ( P>0.05). CSA at 1-day after operation was the risk factor to re-tear at 1-year, 2-year and 3-year after operation [ OR=4.622, 95% CI (1.01, 21.06), P=0.048; OR=7.071, 95% CI (1.52, 32.87), P=0.013; OR=3.40, 95% CI (1.42, 8.12), P=0.006]. CSA and AI at 1-day after operation had certain predictive efficacy for rotator cuff re-tear at 3-year after rehabilitation, and CSA was more specific than AI, the optimal cutoff values of CSA and AI at 1-day after operation for predicting rotator cuff re-tear at 3-year after operation were 35.3°and 0.69, the AUC were 0.87 [ OR=3.40, 95% CI (1.42, 8.12), P<0.001]、0.77 [ OR=1.33, 95% CI (0.87, 2.02), P=0.008] respectively. CSA and AI had no relationship with postoperative functional recovery. Conclusion:Greater CSA and AI were predictive factors of small and medium-sized rotator cuff re-tear 1-3 years after surgery with CSA being more specific than AI. However, CSA and AI had no relationship with postoperative functional recovery.

Correlation analysis between anatomical features of shoulder joint and postoperative stiffness after rotator cuff repair / 中华骨科杂志

Objective:To investigate the correlation between anatomical features of shoulder joint and postoperative stiffness after rotator cuff repair.Methods:212 patients diagnosed with rotator cuff injury undergoing rotator cuff repair in Civil Aviation General Hospital from March 2016 to December 2021 were enrolled. There were 97 male and 115 female with an average age of 58.87±9.69 years old (range, 41-72). The patients were divided into stiffness group (SG) and non-stiffness group (NG) according to the range of shoulder joint motion at 3-month after operation. Preoperative and postoperative joint anatomical features including critical shoulder angle (CSA), acromial index (AI), lateral acromion angle (LAA) were measured and calculated through CT scan and 3-dimension reconstruction. Age, sex, course of disease, body mass index, tendon fatty infiltration degree, type of rotator cuff injury according to DeOrio & Cofield classification, suture method, and preoperative and 3-month postoperative range of shoulder motion (flexion, abduction, and external rotation), preoperative stiffness condition were collected. All factors between two groups were compared, and binomial logistic regression analysis was performed to find out the risk factors of postoperative joint stiffness. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive efficacy of postoperative CSA, AI, and LAA for postoperative joint stiffness.Results:43 patients were enrolled in SG and 169 patients were enrolled in NG. Age, sex, course of disease, body mass index, tendon fatty infiltration degree, type of rotator cuff injury according to DeOrio & Cofield classification, suture method, and preoperative range of shoulder motion (flexion, abduction, and external rotation) between two groups were insignificantly different ( P>0.05). The ratio of patients with preoperative stiffness in SG is higher than that in NG (χ 2=40.38, P<0.001). Postoperative CSA and AI of SG were greater than those of NG ( t=5.44, P<0.001; t=4.89, P<0.001), and postoperative LAA of SG was smaller than that of NG group ( t=-5.86, P<0.001). Preoperative stiffness, large postoperative AI and small postoperative LAA were all risk factors of joint stiffness after rotator cuff suture [ OR=9.32, 95% CI(3.44, 25.27), P<0.001; OR=2.39, 95% CI(1.58, 3.62), P<0.001; OR=0.64, 95% CI(0.46, 0.91), P=0.012]. Postoperative CSA, AI and LAA had a certain predictive effect on postoperative joint stiffness (AUC>0.70). LAA was the most sensitive factor and CSA was the most specific factor. The optimal cutoff values of CSA, AI and LAA were 34.4°, 0.70 and 74.5° respectively, and the AUC for predicting postoperative joint stiffness were 0.76 [ OR=0.98, 95% CI(0.69, 0.84), P<0.001]、0.78[ OR=2.39, 95% CI(0.70, 0.84), P<0.001]、0.76[ OR=0.64, 95% CI(0.68, 0.83), P<0.001]. Conclusion:Postoperative CSA, AI and LAA had predictive efficacy on joint stiffness after rotator cuff repair. The greater postoperative CSA and AI or smaller postoperative LAA indicates increased risk of postoperative joint stiffness. LAA was the most sensitive factor and CSA was the most specific factor.

Tracking analysis of viral nucleic acid Ct value in patients with re-positive SARS-CoV-2 infection / 中华危重病急救医学

OBJECTIVE@#To track analysis of viral nucleic acid test results in patients with re-positive SARS-CoV-2 infection, and provide clinical reference for nucleic acid test of re-positive cases.@*METHODS@#A retrospective study was conducted. The multiple nucleic acid results of 96 cases with SARS-CoV-2 infection tested by medical laboratory of Shenzhen Luohu Hospital Group from January to September in 2022 were analyzed. The test dates and cycle threshold (Ct) values of detectable positive virus nucleic acid in the 96 cases were summarized and analyzed.@*RESULTS@#A total of 96 patients with SARS-CoV-2 infection were retested re-sampled for nucleic acid testing at least 12 days after the initial positive screening. Among them, 54 cases (56.25%) had Ct value of < 35 for nucleocapsid protein gene (N) and/or open reading frame 1ab gene (ORF 1ab), 42 cases (43.75%) had Ct value ≥ 35. In the re-sampling of infected patients, N gene titers were 25.08 to 39.98 Ct cycles, and ORF 1ab gene titers were 23.16 to 39.56 Ct cycles. Compared with the positive results of the initial screening, the Ct values of N gene and/or ORF 1ab gene positive were increased in 90 cases (93.75%). Among them, the patients with the longest duration of nucleic acid positive could still be positive for double targets (the Ct value of N gene was 38.60, and the Ct value of ORF 1ab gene was 38.11) at an interval of 178 days after the initial positive screening.@*CONCLUSIONS@#Patients infected with SARS-CoV-2 can be sustained or repeatedly tested positive for nucleic acid for a long period of time, and most of them had Ct values < 35. But whether it is infectious needs to be comprehensively evaluated by combining epidemiology, variant type, samples with the alive virus, and clinical symptoms and signs.

The incidence of malignant tumors and its risk factors in patients on maintenance hemodialysis / 中国医师杂志

Objective:To analyze the incidence of malignant tumors and its risk factors in patients on maintenance hemodialysis.Methods:Clinical data of 627 hemodialysis patients in Huadu District People′s Hospital of Guangzhou who met the inclusion criteria and exclusion criteria from January 2015 to December 2020 were retrospectively collected. Clinical characteristic of patients with malignant tumors was summarized. Multivariate logistics regression analysis was performed to explore the related factors of malignant tumors.Results:Among the 627 patients, 19(3.03%) developed malignant tumors. There were 14 males and 5 females with a mean age of (65.7±13.7)years. Their mean dialysis duration was (45.16±38.18)months. Gastrointestinal tumor was the most common tumor type (9/19). Univariate analysis showed that the age of the patients combined with malignant tumors was significantly higher, and the serum prealbumin was significantly lower than those patients without malignant tumors (all P<0.05). Logistic regression analysis showed that age was the independent risk factor of developing cancers after adjusting dialysis age, hemoglobin, albumin and parathyroid hormone ( P<0.05). Conclusions:The incidence of malignant tumor is significantly higher in maintenance hemodialysis patients than that in the general population. Age is the risk independent risk factor. Therefore, we should strengthen the monitoring of elderly hemodialysis patients, discover the disease in time, and take measures to improve the prognosis.

Research progression in the application of radiotherapy in the comprehensive treatment of diffuse gastric cancer / 国际外科学杂志

The incidence of diffuse gastric cancer is increasing year by year, comprehensive therapy is the main treatment. The main reason of surgical treatment failure is local recurrence, and the long-term curative effect is generally poor. Radiotherapy is an important part of comprehensive treatment for diffuse gastric cancer, which can reduce tumor stage before surgery and prevent recurrence and metastasis after surgery. Effective neoadjuvant radiotherapy is one of the approaches to improve surgical resection rate in patients with diffuse gastric cancer. In this paper, the clinical application of radiotherapy for diffuse gastric cancer will be reviewed, including the selection of reasonable radiotherapy system, precise location, dose setting, application of sensitization technology and mechanism of sensitization, in addition, the prevention and treatment of neoadjuvant radiotherapy and radiotherapy complications will be introduced.

Relatedfactors of blood transfusion during total hip arthroplasty / 中国输血杂志

【Objective】 To investigate the related factors of allogeneic blood transfusion (ALBT) in total hip arthroplasty. 【Methods】 Thebasic information, surgical details and laboratory data of 258 patients who underwent total hip arthroplasty in Orthopedics Department of our hospital were collectedfrom the electronic medical record system and laboratorytest system. The factors concerningALBT were obtainedby single factor and multivariate logistic regression analysis. 【Results】 The ALBT rate in this study was 19%, and the differencesin such important factors affecting ALBT as gender, age, intraoperative blood loss, drainage volume, operation duration, preoperative hemoglobin (Hb), preoperative activated partial thromboplastin time (APTT), preoperative prothrombin time (PT) andhypertension between the two groupswere notable (P<0.05). Multivariate regression analysisrevealed that the independent related factors ofALBT were age ≥ 60 years (OR3.577), intraoperative blood loss (OR1.003), drainage volume (OR1.004)and preoperative PT (OR1.888). Preoperative Hb (OR0.94) was a protective factor. 【Conclusion】 Specific and individualized evaluation of ALBT, aimed atreducingunnecessary blood transfusion, can be provided through the analysis of relevant factors.

Analysis of phenotypes of Hb J-Bangkok and concomitant thalassemia / 中华医学遗传学杂志

OBJECTIVE@#To analyze the hematological phenotypes of Hb J-Bangkok and concomitant thalassemia.@*METHODS@#In total 72 397 samples were screened by using capillary electrophoresis. Samples with Hb J-Bangkok were identified by DNA sequencing and analysis of red blood cell parameters. Gap-PCR and PCR-reverse dot blotting (PCR-RDB) were used for analyzing the thalassemia genes.@*RESULTS@#Thirty one cases of Hb J-Bangkok were identified, all of which were heterozygotes. The hematological phenotype index (Hb, mean corpuscular volume, mean corpuscular hemoglobin, Hb J-Bangkok, Hb A@*CONCLUSION@#Hb J-Bangkok heterozygotes have normal hematological phenotypes, though they may show different hematological characteristics when concomitant with different types of thalassemia, for which genetic counseling should be provided accordingly.

Analysis of the clinical effect of arthroscopic adhesiolysis in the treatment of patients with primary frozen shoulder / 国际外科学杂志

Objective:To investigate the clinical outcomes of arthroscopic adhesiolysis on patients with primary frozen shoulder and its effect on shoulder joint function.Methods:The clinical data of 54 patients with primary frozen shoulder who visited Civil Aviation General Hospital from March 2017 to July 2018 were retrospectively analyzed. According to different treatment regimens, the patients were divided into a study group and a control group, with 27 patients in each group, there were 11 males and 43 females, aged (47.6±3.4) years, and the age ranged from 41 to 64 years. Patients in the control group were treated with conventional conservative treatment measures, and patients in the study group were treated with loose adhesion under arthroscope on the basis of the control group. The shoulder joint activity (range of motion angles for flexion, abduction and lateral rotation), Constant score, UCLA score and VAS score as well as the complications of the two groups were compared. The measurement data were expressed as mean±standard deviation ( Mean± SD), the t test was used for comparison between groups. The count data were expressed as percentage and the chi-square test was used for comparison between groups. Results:In the study group, postoperative anterior flexion, abduction, lateral external rotation were (160.2±20.7)°, (163.6±20.1)°, (50.5±8.9)°, respectively. The patients in the control group experienced (119.5±19.5)° of anterior flexion, (121.2±19.5)° of abduction, (35.6±6.4)° of lateral external rotation. After treatment, the activity of the shoulder joint in the study group was significantly better than that in the control group, there were statistically significant differences between the two groups( P<0.05). In the study group, the postoperative Constant score was (83.1± 9.3) scores, VAS score was (2.8±0.3) scores, UCLA score was (31.7±3.1) scores; in the control group, the postoperative Constant score was (71.7±9.7) scores, VAS score was (4.4±0.3) scores, UCLA score was (22.8±3.6) scores ( P<0.05). Compared with the control group, the Constant score and UCLA score in the study group were significantly higher, and the VAS score was significantly lower, differences were statistically significant( P<0.05). The difference in the incidence of complications between the two groups was not statistically significant ( P>0.05). Conclusions:For patients with primary frozen shoulder, arthroscopic adhesiolysis can significantly improve the shoulder function of patients. At the same time, this operation has significant clinical treatment effect, which is conducive to the clinical application and promotion.

Research progress in the role of microRNA-155 in regulation of autophagy and diagnosis and treatment for gastric cancer / 中南大学学报(医学版)

China is one of the regions with a high incidence of gastric cancer worldwide. Low detection rate and poor curative effect lead to unsatisfied prognosis and low five-year survival rate. Surgery combined with radiotherapy and chemotherapy is the mainstream comprehensive treatment scheme, however, multi-drug resistance may gradually prevail in the chemotherapy process. Chemotherapy, miRNA and autophagy interact with each other, but the mechanism is complex. MiR-155 is abnormally expressed in gastric cancer, which could promote autophagy, inhibit apoptosis, and interact with Helicobacter pylori to induce gastric cancer. Through its regulatory effect on autophagy, miR-155 can be used to treat gastric cancer, improve chemotherapy sensitivity and reverse drug resistance. The high expression of miR-155 in gastric cancer tissues suggests poor prognosis.

Application progress of multilocus-sequence typing in the adaptive evolution of Helicobacter pylori / 国际外科学杂志

Helicobacter pylori (HP) is a kind of gram-negative bacillus parasitizing in human gastric mucosal tissue,which coevolved with human body.HP is one of the most genetically diverse bacterial species,which is mainly attributed to its high mutation and recombination rate.After tens of thousands of years of historical evolution,HP experienced numerous genetic polymorphisms and adaptive evolution in order to maintain a relatively stable colonization relationship with human hosts,making it became one of the species with the largest genome variation among prokaryotes.With such a long history with human beings,HP can be used as reference information for human migration in a sense.With the development of biological information technology,multilocus-sequence typing (MLST) technology plays a great role in the study of the evolution of bacterial strains.It has the characteristics of high repeatability and resolution,and the analysis results can be compared between different countries and laboratories.This paper mainly reviews the research and application progress of MLST technology in the genetic evolution of HP.

Analysis of clinical phenotype of a α2-globin gene mutation -IVS-Ⅱ-55 (T→G) / 临床检验杂志

Objective@#To identify a α-globin gene mutation-IVS-Ⅱ-55 (T→A) and analyze hematological characteristics of IVS-Ⅱ-55 (T→G) carriers. @*Methods@#The peripheral blood samples were collected from the members of five family and three sporadic IVS-Ⅱ-55(T→G) carriers for the analysis of RBC parameters and hemoglobin electrophoresis. Gap-PCR, PCR-RDB (reverse dot blot) and DNA sequencing were carried out for the identification of gene deletion and mutation of α-globin and β-globin. @*Results@#The results of RBC parameters of five infant probands which presented with microcytic hypochromic anemia were below the normal reference interval. One of the adult carriers of IVS-Ⅱ-55 (T→G) heterozygote alone presented with microcytic hypochromic anemia, and the others showed normal RBC parameters. The hematological phenotype index (MCV, MCH and HbA 2 ) of one adult carrying a compound heterozygote for IVS-Ⅱ-55 (T→G) and βCD27-28M/N were 65.0 fL, 20.3 pg and 5.8% respectively. The hematological phenotype index (MCV, MCH, HbA 2 and HbF) of one adult carrying a compound heterozygote for IVS-Ⅱ-55 (T→G) and SEA-HPFH were 81.9 fL, 26.5 pg, 3.0% and 29.0% respectively. The HbA 2 levels of all carriers of IVS-Ⅱ-55 (T→G) heterozygote alone were in normal range. No abnormal hemoglobin band was detectable on hemoglobin electrophoresis for all the carries. @*Conclusion@#The carriers of IVS-Ⅱ-55(T→G) heterozygote alone were asymptomatic. The phenotype of compound heterozygote for β-thalassemia was similar to that of β-thalassemia alone.

Sofosbuvir-based regimens combined with ribavirin for recipients with genotype 1 hepatitis C after liver transplantation: a Meta-analysis / 器官移植

Objective To evaluate whether sofosbuvir (SOF)-based direct-acting antiviral agents (DAAs) combined with ribavirin (RBV) (combined RBV) can yield benefits to the recipients infected with hepatitis C virus (HCV) genotype 1 (GT1) after liver transplantation through systematic evaluation and Meta-analysis. Methods Multiple databases at home and abroad were systematically searched, the literature screening was conducted according to relevant standards, the quality of literatures was evaluated and data extraction was performed. The literature was divided into two groups according to the recipients with HCV-GT1 hepatitis after liver transplantation who received the treatment combined RBV or SOF-based DAAs alone without RBV (not combined RBV). Meta-analysis of the data was carried out using Rev Man 5.3 and R3.4.3 software. The incidence of sustained virological response 12 weeks (SVR12) after therapy was evaluated. Results A total of 2 195 articles were retrieved, and 6 articles published in English were eventually included according to the inclusion criteria. The Meta-analysis results demonstrated that the incidence of SVR12 did not significantly differ between the combined RBV and not combined RBV groups (P=0.28). However, the incidence of anemia in the combined RBV group was significantly higher than that in the other group (P < 0.01). Both combined RBV and not combined RBV therapies were efficacious in treating HCV-GT1a and HCV-GT1b subtypes after liver transplantation with similar clinical efficacy (P=0.33). The incidence of SVR in HCV-GT1 recipients did not significantly differ after receiving 12- and 24-weeks therapy after liver transplantation (P=0.95). Conclusions When SOF-based DAAs regimen is adopted to treat HCV-GT1 in recipients after liver transplantation, combination with RBV not only fails to improve the virus clearance rate and bring clinical benefits, but also increases the risk of anemia in the recipients.

Prevention and treatment of post-ERCP complications / 中华肝胆外科杂志

Postoperative complications of ERCP include pancreatitis,cholangitis,hemorrhage,mechanical damage (such as perforation) of the digestive tract and drug reaction.Since the the complications definition,surgical indications,operation technique,data collection and processing method were inconsistent,there were controversies for the incidences of complications after ERCP and its risk factors for different institutions.This paper discussed the evolution of ERCP risk factors,current situation and prophylaxis of major complications after ERCP and summarized the current research progress in order to provide theoretical help for prevention and prophylaxis of postoperative complications of ERCP.

Prowess in the diagnosis and treatment of hepatic echinococcosis / 中华消化外科杂志

Hepatic echinococcosis is a common zoonotic parasitic disease and popular in animal husbandry developed areas of the world,which seriously endangers human health and economic development.It is a crucial public health problem.At present,the main diagnostic measures are imaging and laboratory examinations.Surgery is the main treatment of hepatic echinococcosis,and drug therapy also plays a certain role.The diagnosis and treatment methods of hepatic echinococcosis were analyzed and summarized in this article,in order to provide a reference for clinical diagnosis and treatment.

Wnt/β-catenin signaling pathway and gastric cancer / 国际外科学杂志

Wnt/β-catenin signaling pathway is an evolutionarily conserved signaling pathway that plays an important role in embryonic and organ development,which is not only invovled in regulating several cellular proliferation,differentiation,polarity,migration and apoptosis,but aslo playing an critical role in initiation,invasion,metastasis,progression and drug resistance of gastric cancer.This article will review the newest studies about gastric cancer of Wnt/β-catenin and provide fundamenal theories to design new drugs for the treatment of gastric cancer.

Protective effect and mechanism of hydrogen-rich water on ethanol-induced acute gastric injury / 中华消化外科杂志

Objective To explore the protective effect and mechanism of hydrogen-rich water (HRW) on ethanol-induced acute gastric injury.Methods The experimental study was conducted.Forty kunming mice were divided into the 4 groups by random number table method:normal control group [0.01 mL/g normal saline (NS)+ 0.03 mL/g NS],HRW group (0.01 mL/g NS +0.03 mL/g HRW),ethanol model group (0.01 mL/g 56°alcoholic drinks +0.03 mL/g NS),HRW treated group (0.01 mL/g 56°alcoholic drinks +0.03 mL/g HRW).Ten mice in each group were administrated twice a day for 7 days.Testing indicators:(1) gastric ulcer index was measured,(2) pathological examination of gastric tissues,(3) activity of serum superoxide dismutase (SOD) and expressions of malondialdehyde (MDA),interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were measured,(4) expressions of SOD and MDA in gastric tissues were measured,(5) protein expressions of apoptosis related factors (caspase-3,bax,caspase-9,fas and caspase-8) in gastric tissues were measured by immunohistochemistry,(6) relative expressions of mRNA of apoptosis related factors (caspase-3,bax,caspase-9,fas and caspase-8) in gastric tissues were measured by realtime polymerase chain reaction (RT-PCR).Measurement data with normal distriburion were presented as (x)±s.Comparisons among groups were done using the one-way ANOVA and comparison between groups was done using the LSD-t test.Results (1) Gastric ulcer index was measured:gastric ulcer index of mice in the normal control group,HRW group,ethanol model group and HRW treated group were respectively 0,0,10.40± 1.64 and 3.92 ± 0.23,with statistically significant differences (F=175.050,P＜0.05).There was a statistically significant difference between the ethanol model group and normal control group or HRW treated group (t =19.835,12.352,P＜ 0.05).(2) Pathological examination pathological examination of gastric tissues:① Macropathology of gastric tissues:the surface of the gastric mucosa was normal and smooth in the normal control group and the HRW group,without ulcer,erosion and inflammation.The partial gastric mucosal erosion and ulcer in the ethanol model group was large and very severe.Compared with the ethanol model group,the area of gastric mucosal lesion was reduced in the HRW treated group.② Results of pathological examination of gastric tissues:gastric mucosa in the normal control group and HRW group were integrity.Compared with the normal control group,the partial gastric surface epithelium was degenerate and impaired in the ethanol model group.Compared with the ethanol model group,the gastric mucosal erosion and inflammatory cell infiltration were alleviated in the HRW treated group.(3) Expressions of serum SOD,MDA,IL-6 and TNF-α:expressions of serum SOD,MDA,SOD/MDA and IL-6 were respectively (70±6)U/mL,(7.52±0.23) μmol/L,9.40 ± 1.07,(6.3 ± 1.8) ng/L in the normal control group and (74 ± 4) U/mL,(7.61 ±0.91) μmol/L,9.91 ± 1.55,(5.1 ± 1.6)ng/ L in the HRW group and (101 ± 4) U/mL,(16.95 ± 0.66) μmol/L,5.99±0.17,(19.2±4.9) ng/L in the ethanol model group and (115±5) U/mL,(14.02±0.58) μmol/L,8.23±0.32,(7.1±1.8)ng/L in the HRW treated group,with statistically significant differences among the 4 groups (F=97.405,269.950,16.486,25.663,P＜0.05).The serum TNF-α levels were respectively (53± 14) ng/L,(67± 17) ng/L,(52± 13) ng/L,(58±21) ng/L in the above 4 groups,with no significant difference (F=0.862,P＞0.05).(4) Expressions of SOD and MDA in gastric tissues were measured:expressions of SOD and MDA and SOD/MDA were respectively (93 ± 18) U/mL,(7.90± 1.72) μmol/L,12.48±4.54 in the normal control group and (93±13) U/mL,(6.96± 1.49) μmol/L,13.83±3.40 in the HRW group and (121±31) U/mL,(17.10±4.88) μmoL/L,7.88± 3.70 in the ethanol model group and (143 ± 26) U/mL,(7.31 ± 1.58) μmoL/L,20.00±4.68 in the HRW treated group,with statistically significant differences among the 4 groups (F=5.463,15.051,7.388,P＜ 0.05).(5) The expressions of apoptosis related factors in gastric tissues:the results of immunohistochemistry showed that the levels of caspase-3,bax and fas were repectively 0.065 5± 0.003 7,0.065 7±0.003 0,0.225 4±0.024 3 in the normal control group and 0.065 7±0.002 7,0.064 9±0.003 0,0.246 0±0.022 3 in the HRW group and 0.330 7±0.017 3,0.335 4±0.033 3,0.397 0±0.028 5 in the ethanol model group and 0.096 7±0.003 0,0.084 8±0.001 7,0.375 0±0.035 6 in the HRW treated group,showing statistically significant differences among the 4 groups (F=1 004.222,309.171,48.555,P＜0.05).The levels of caspase-9 and caspase-8 were respectively 0.049 2±0.000 4,0.151 5±0.010 2 in the normal control group and 0.047 9±0.002 0,0.154 00.013 5 in the HRW group and 0.047 0±0.003 7,0.157 2±0.006 2 in the ethanol model group and 0.048 7±0.000 8,0.153 9±0.006 3 in the HRW treated group,with no statistically significant difference among the 4 groups (F=0.998,0.297,P＞0.05).(6) The mRNA expressions of apoptosis related factors in gastric tissues:resutls of RT-PCR showed that relative expressions of mRNA of caspase-3,bax,caspase-9 and fas were respectively 1.00±0.00,1.00±0.00,1.00±0.00,1.00±0.00 in the normal control group and 0.72±0.43,0.66±0.26,1.57±0.31,0.50±0.19 in the HRW group and 3.19±0.87,1.58±0.76,3.04± 1.15,2.84±0.98 in the ethanol model group and 0.49±0.16,0.69±0.25,2.98±0.85,0.53±0.24 in the HRW treated group,showing statistically significant differences among the 4 groups (F=32.106,5.038,9.706,23.387,P＜0.05).The mRNA levels of caspase-8 were respectively 1.00±0.00,1.50±0.60,1.36±0.34,1.32±0.43 in normal control group,HRW group,ethanol model group and HRW treated group,with no significant difference among the 4 groups (F=1.337,P＞0.05).Conclusions Hydrogen-rich water could alleviate ethanolinduced acute gastric injury by antioxidant,anti-inflammatory and anti-apoptosis.Hydrogen-rich water is safe and reliable,without toxic and side effects on the body.