Comparison between renal pelvic and ureteral tumors in muscle-invasive upper tract urothelial carcinoma.

Although renal pelvic and ureteral urothelial carcinoma share similarities in their origins, disparities on a genetic and clinical level make them divergent entities. Clinical information from the Surveillance, Epidemiology, and End Results (SEER) database was used to validate the characteristics and molecular subtypes using single-center data, which were compared between the two types of muscle-invasive tumors. Simultaneously, to expand the sample size for further verification, we explored a deep learning algorithm to correctly classify molecular subtypes from H&E histology slides. We suggested that the renal pelvic group might have a proclivity towards luminal and the ureter towards basal and P53-like. Furthermore, we explore the heterogeneity of matrix and immune tumor microenvironment, and the ureteral group had more immune cell infiltration and higher stiffness. Collectively, these results showed that muscle-invasive upper tract urothelial carcinoma exist in distinct properties of clinical characteristics, molecular subtype, and tumor microenvironment.

Evaluation of the determinants of food security within the COVID-19 pandemic circumstances- a particular case of Shaanxi, China.

BACKGROUND: Agricultural food production and distribution industries may play a vital role in determining the current conditions of any country's food security and sustainable development goals. This paper examined the determinants of food security within three distinct aspects (effective utilization of food, food availability, and food access) within the COVID-19 epidemic situation. METHODS: The qualitative set-up of the study comprised with the identification of drivers by critical analysis of published papers and discussion held with some practitioners. The quantitative data used in this research were collected from a survey covering the agricultural food supply industry in China (Shaanxi Province). The survey was conducted from November to December 2020 and we mainly focus on three aspects of food security (effective utilization of food, food availability, and food access). The core analytical assumptions were made by employing exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and structural equation modeling (SEM). RESULTS: After analyzing the data collected from 257 agricultural food productions and distribution personnel along with the hypothesis testing, it found that the determinants of the effective utilization of food were positively related to the determinants of food access (ß = 0.291, p = 0.029) and food availability (ß = 0.298, p = 0.011), and the determinants of food availability were positively related to the food access determinants (ß = 0.128, p = 0.002). The association and variance values between food availability and food access were 0.659 and 0.407; the association and variance values between for effective utilization of food and food availability aspects were 0.465 and 0.298, and between effective utilization of food and economy were 0.508 and 0.475. CONCLUSION: The study critically evaluated the interconnection among the crucial determinants within the banner of three dimensions, which will act as a major contribution to existing literature. This research will help the government and industry to develop policies and strategies for the successful implementation of all the associated determinants of food security in terms of the epidemic situation.

Clinical effect of procaterol hydrochloride combined with Xiaokechuan capsule in the treatment of cough variant asthma and its impact on serological indicators and airway function of children / 新乡医学院学报

Objective To explore the clinical effect of procaterol hydrochloride combined with Xiaokechuan capsule in the treatment of cough variant asthma(CVA)and its impact on serological indicators,airway function of children.Methods A total of 124 children with CVA admitted to the Zigong First People's Hospital from March 2019 to April 2022 were selected as the research subjects.The children were divided into control group and observation group according to random number table method,with 62 cases in each group.The children in the control group were treated with procaterol hydrochloride,and the children in the observation group were treated with procaterol hydrochloride and Xiaokechuan capsule for two weeks.The clinical efficacy of children was compared between the two groups after treatment.The cough scores during the day and night of children were evaluated in the two groups before and 2 weeks after treatment.The serum high mobility group protein B1(HMGB1),Toll like receptor 4(TLR4),nuclear factor-κB(NF-κB),interleukin-4(IL-4),interferon-γ(INF-γ)levels of children in the two groups were measured by enzyme linked immunosorbent assay before and 2 weeks after treatment,and the ratio of INF-γ/IL-was calculated.The 25％maximal expiratory flow-volume(MEF25),50％maximal expiratory flow-volume(MEF50),75％maximal expiratory flow-volume(MEF75)of children in the two groups were measured by lung function detector before and 2 weeks after treatment.The adverse reactions of children in the two groups were recorded during treatment.Results The total effective rate of children in the control group and observation group was 82.26％(51/62)and 95.16％(59/62),respectively;the total effective rate of children in the observation group was significantly higher than that in the control group(P＜0.05).There was no significant difference in cough scores during the day and night of children between the two groups before treatment(P＞0.05);the cough scores during the day and night of children after treatment were significantly lower than those before treatment in the two groups(P＜0.05);after treatment,the cough scores during the day and night of children in the observation group were significantly lower than those in the control group(P＜0.05).There was no significant difference in serum HMGB1,TLR4,NF-κB levels of children between the two groups before treatment(P＞0.05);the serum HMGB1,TLR4,NF-κB levels of children after treatment were significantly lower than those before treatment in the two groups(P＜0.05);after treatment,the serum levels of HMGB1,TLR4,and NF-κB of children in the observation group were significantly lower than those in the control group(P＜0.05).There was no significant difference in MEF25,MEF50,and MEF75 of children between the two groups before treatment(P＞0.05);the MEF25,MEF50,and MEF75 of children after treatment were significantly higher than those before treatment in the two groups(P＜0.05);after treatment,the MEF25,MEF50,and MEF75 of children in the observation group were significantly higher than those in the control group(P＜0.05).There was no significant difference in serum IL-4,INF-γ levels and the ratio of INF-γ/IL-4 of children between the two groups before treatment(P＞0.05);the serum IL-4 level of children after treatment were significantly lower than those before treatment,the INF-γ level and the ratio of INF-γ/IL-4 were significantly higher than those before treatment in the two groups(P＜0.05);after treatment,the serum IL-4 level of children in the observation group was significantly lower than that in the control group,the INF-γ level and the ratio of INF-γ/IL-4 were significantly higher than those in the control group(P＜0.05).All children had good drug tolerance during the treatment period,and no significant adverse drug reactions were observed.Conclusion The combination of Xiaokechuan capsules and procaterol hydrochloride has a significant therapeutic effect for pediatric CVA,and its mechanism of action may be related to the regulation of HMGB1-TLR4-NF-κB signal pathway.

Effects of electromyographic biofeedback therapy combined with mirror therapy on lower limb motor and balance function in stroke patients / 中国康复医学杂志

Objective:To study the influence of electromyographic biofeedback therapy(EMGBFT)combined with mirror therapy(MT)on lower limb motor and balance function in stroke patients. Method:Sixty patients with hemiplegia after stroke were randomly divided into two groups:MT based EMG-BFT group and EMGBFT group,30 patients in each group.On the basis of conventional rehabilitation,the patients in the EMGBFT group received sham MT stimulation combined with EMGBFT,and the patients in the MT based EMGBFT group received MT combined with EMGBFT.Before and after treatment,the lower limb motor function of the patients was evaluated using Fugl-Meyer assessment scale-lower extremity(FMA-LE)and surface electromyography-integrated electromyography(iEMG)of knee flexion and ankle dorsiflex-ion,co-contraction ratio(CR).Plantar pressure-symmetry index(SI)of mean pressure and contact area of both feet,elliptical area of body center of gravity,anteroposterior(AP)and mediolateral(ML)displacement distance of body center of gravity under eye-opening and eye-closed states were calculated to evaluate pa-tients'weight-bearing and balance function. Result:After treatment,FMA-LE,CR and iEMG of biceps femoris and rectus femoris under knee flexion,tibialis anterior and medial gastrocnemius under ankle dorsiflexion were markedly ameliorated in the two groups(P＜0.01).After treatment,in the eye-opening state,the SI of mean pressure and contact area of both feet,elliptical area of body center of gravity,AP and ML displacement distances of body center of gravity were greatly enhanced in the two groups(P＜0.05,P＜0.01),in the eye-closed state,the SI of mean pressure and contact area of both feet,ML displacement distances of body center of gravity were observably ameliorat-ed in the two groups(P＜0.05,P＜0.01).Compared with the EMGBFT group,the FMA-LE,iEMG of biceps femoris and tibialis anterior muscles,elliptical area of body center of gravity,AP and ML displacement dis-tance of body center of gravity with eyes open,SI of contact area of both feet with eyes closed had more significant changes in the MT based EMGBFT group after treatment(P＜0.05,P＜0.01). Conclusion:Electromyographic biofeedback therapy combined with mirror therapy can improve lower limb motor and balance function in stroke patients,the underlying mechanism of which may be the activation of lower limb weak muscle motor units,the relief of lower limb spasm,and the improvement of standing static balance ability.

Clinical use of quantitative computed tomography to evaluate the effect of less paraspinal muscle damage on bone mineral density changes after lumbar interbody fusion

Methods@#This retrospective analysis included a total of 155 patients who underwent single-level lumbar fusion, with 81 patients in the traditional group and 74 patients in the Wiltse group (less paraspinal muscle damage). QCT was used to measure the volumetric BMD (vBMD), Hounsfield unit value, and cross-sectional area of the paraspinal muscles at the upper instrumented vertebrae (UIV), vertebrae one segment above the UIV (UIV+1), and the vertebrae one segment above the UIV+1 (UIV+2). Statistical analyses were performed. @*Results@#No significant differences in general data were observed between the two groups (p>0.05). Strong correlations were noted between the preoperative and 1-week postoperative vBMD of each segment (p0.05). Vertebral BMD loss was significantly higher in UIV+1 and UIV+2 in the traditional group than in the Wiltse group (−13.6%±19.1% vs. −4.2%±16.5%, −10.8%±20.3% vs. −0.9%±37.0%; p0.05). @*Conclusions@#QCT can reliably determine BMD in the instrumented spine after lumbar interbody fusion. With QCT, we found that reducing paraspinal muscle destruction through the Wiltse approach during surgery can help preserve the adjacent vertebral BMD; however, it does not help increase the BMD in the instrumented vertebrae.

Clinical outcome of kidney transplantation from DBD donors complicated with acute kidney injury / 器官移植

Objective To evaluate the clinical outcome of kidney transplantation from donation after brain death (DBD) donors complicated with acute kidney injury (AKI). Methods Clinical data of 216 DBD donors were retrospectively analyzed, and they were divided into the AKI group (n=69) and control group (n=147) according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Donors in the AKI group were further divided into the KDIGO stage 1 and stage 2-3 subgroups. One hundred and thirty-five recipients were assigned into the AKI group and 288 recipients in the control group. Postoperative recovery of renal function and clinical outcomes of the recipients were recorded. The risk factors of delayed graft function (DGF) were identified. Results The highest serum creatinine (Scr) level, Scr level before procurement, the highest blood sodium level and blood sodium level before procurement in the AKI group were higher than those in the control group. The application duration of vasopressors in the AKI group was longer than that in the control group. In the AKI group, the amount of fluid resuscitation within 48 h was higher, the HCO3− level at admission was lower, and the incidence of diabetes insipidus and hypotension was higher than those in the control group. The highest Scr level and the Scr level before procurement in KDIGO stage 2-3 donors were significantly higher than those in KDIGO stage 1 counterparts (all P<0.05). Compared with the control group, the incidence of DGF and acute rejection was higher, the proportion of continuous renal replacement therapy was higher, the Scr level within postoperative 90 d was higher, and the urine amount within postoperative 3 d was less than those of recipients in the AKI group. Compared with KDIGO stage 1 recipients, KDIGO stage 2-3 recipients had higher Scr levels at postoperative 3, 4, 5 and 15 d, and less urine amount at postoperative 2 d (all P<0.05). Univariate analysis showed that donor age, the highest Scr level, the highest blood sodium level and the amount of fluid resuscitation within 48 h were the risk factors for DGF in recipients after kidney transplantation. Multivariate analysis showed that donor age was the independent risk factor for DGF in recipients after kidney transplantation (all P<0.05). Conclusions For the application of DBD donors complicated with AKI, active organ maintenance should be performed to alleviate AKI. It exerts no effect upon graft function and survival rate at postoperative 6 months, which may achieve equivalent efficacy as non-AKI donors and may be used as a source of extended criteria donor kidneys.

Challenges and Thoughts on Improving Subject Protection during the Period of Rapid Development of Biomedical Technology / 中国医学伦理学

With the development of technologies such as gene editing, artificial intelligence, and big data, cutting-edge technologies have brought increasing ethical risks in medical research, and the ability to protect subjects has become increasingly inadequate. However, the current means of ethical governance are relatively weak, the ethical awareness of researchers is not strong, and existing ethical governance methods can no longer meet the needs of new technological developments. Therefore, combined with the Guidelines to Strengthen Governance over Ethics in Science and Technology issued by the General Office of the CPC Central Committee and the General Office of the State Council in March 2022, this paper proposed that subject protection needed to be improved from the following aspects: improving regulations and systems, strengthening the construction of ethics committees, conducting research on ethical governance methods, raising the quality of ethics committees, constructing regional ethics systems, and improving the ethical literacy of researchers. To carry out the above work, it is necessary for the government, ethical professional organizations, research institutions, biomedical enterprises, medical institutions, and the public to explore the "ethical pre-examination" management model with the concept of "prevention", so as to improve the subject protection in the modern society with the continuous development of new technologies.

Effect of self-made Bushen Jiangu Decoction combined with conventional western medicine therapy on the postoperative efficacy and bone transformation markers of osteoporotic vertebral compression fracture in the elderly / 国际中医中药杂志

Objective:To investigate the effect of self-made Bushen Jiangu Decoction on bone transformation markers in elderly patients with osteoporotic vertebral compression fracture after operation, and to evaluate the clinical efficacy.Methods:Prospective cohort study. A total of 92 patients with osteoporotic vertebral compression fracture after operation in Fangshan Hospital of Beijing University of Chinese Medicine from April 2020 to December 2021 who met the inclusion criteria were divided into 2 groups by random drawing method, with 46 in each group. The control group was treated with routine western medicine after operation, and the observation group was treated with self-made Bushen Jiangu Decoction on the basis of the control group. Both groups were treated for 3 months. TCM symptom scores were performed before and after treatment, and the prognosis of the patients was evaluated with the Chinese Osteoporosis Quality of Life (COQOL), VAS scale, and the Oswestry Dysfunction Index (ODI). The levels of amino terminal propeptide (PINP), cross-linked terminal peptide β special sequence (β-CTX) and bone morphogenetic protein 6 (BMP6) of type Ⅰ procollagen were determined by contrast chromogenic method with o-benzaldehyde. The adverse reactions during treatment were recorded and the clinical efficacy was evaluated.Results:The total effective rate was 95.7% (44/46) in the observation group and 82.6% (38/46) in the control group, and there was a significant difference between the two groups ( χ 2=4.04 , P=0.044). After treatment, the scores of fracture nonunion, pain in back and loin, chilliness and lassitude, and pallor in the observation group were significantly lower than those in the control group ( t values were 4.84, 4.09, 4.87, 4.14, respectively, P<0.01). The scores of COQOL, VAS and ODI in the observation group were significantly lower than those in the control group ( t values were 6.26, 10.57 and 6.15, respectively, P<0.01). The levels of PINP [(44.93±5.86)μg/L vs. (49.76±6.02)μg/L, t=3.90] and β-CTX [(0.49±0.17) μg/L vs. (0.68±0.20) μg/L, t=4.91] in observation group were significantly lower than those in the control group after treatment ( P<0.05). The level of BMP6 [(81.23±9.14) μg/L vs. (75.14±8.25) μg/L, t=3.36] in observation group was significantly higher than that of the control group ( P<0.05). During the treatment,the incidence of adverse reactions in the observation group was 13.0% (6/46), while that in the control group was 8.7% (4/46), and there was no significant difference between the two groups ( χ 2=0.45, P=0.503). Conclusion:The self-made Bushen Jiangu Decoction combined with conventional western medicine therapy can adjust the level of bone transformation markers in elderly patients with osteoporotic vertebral compression fractures, improve the lumbar function and quality of life, and improve the clinical efficacy.

Effect of hyperbaric oxygen therapy combined with repetitive peripheral magnetic stimulation on ankle motor function and balance of stroke patients / 中国康复理论与实践

ObjectiveTo observe the effect of hyperbaric oxygen therapy (HBOT) combined with repetitive peripheral magnetic stimulation (rPMS) on ankle motor function and balance of stroke patients. MethodsFrom April, 2022 to March, 2023, 96 patients in the First Affiliated Hospital of Bengbu Medical College were randomly divided into control group (n = 32), rPMS group (n = 32) and combined group (n = 32). The control group received conventional rehabilitation; rPMS group received rPMS on the basis of the control group; and the combined group received HBOT on the basis of rPMS group, for two weeks. Before and after treatment, the plantar weight-bearing ratio of the affected side, Berg Balance Scale (BBS), active range of motion (AROM) of ankle dorsiflexion of the affected side, and integrated electromyographic (iEMG) values during maximum isometric contraction of the tibialis anterior and gastrocnemius muscles were measured. ResultsTwo cases dropped out in each group, and 90 cases were finally included, and no adverse events occurred during treatment. Before treatment, there was no significant difference in plantar weight-bearing ratio of the affected side, BBS score, AROM of ankle dorsiflexion of the affected side, and iEMG of tibialis anterior and gastrocnemius among three groups (F < 2.070, P > 0.05). After treatment, all the indicators significantly improved in all the groups (|t| > 27.004, P < 0.001), and they were better in the combined group than in rPMS group and the control group (P < 0.001); except the proportion of plantar weight-bearing on the affected side, the other indicators were better in rPMS group than in the control group (P < 0.001). ConclusionrPMS can promote the recovery of ankle motor function and balance of stroke patients, and the effect combining with HBOT is better.

Effects of rhGLP-1 (7-36) on Akt/GSK3 signaling pathway in hepatocytes / 中华内分泌外科杂志

Objective:To observe the effect of rhGLP-1 (7-36) on Akt/GSK3 signaling pathway in hepatocytes.Methods:Human HL7702 cell line was cultured to the logarithmic growth stage and divided into experimental group and blank control group. The cultures were incubated with 100nM medium containing rhglp-1 (7-36) and without rhglp-1 (7-36) for 90min. The levels of Akt, Glycogen synthase Kinase 3 (GSK3) and Glycogen synthase (GS) in the two groups were detected by Western Blot.Results:Compared with blank control group, the protein expression of p-Akt (Thr308) in experimental group (1.81±0.28) was significantly increased ( P=0.01), but the protein expression of Akt and p-Akt (Ser473) was not significantly changed. The protein expression levels of p-GSK3α (Ser21) (1.27±0.09) and p-GSK3β (Ser9) (1.24±0.09) in the experimental group were significantly increased ( P=0.003, 0.002), while the protein expression levels of GSK3α and GSK3β were not significantly changed. The protein expression level of p-GS (Ser641) (0.70±0.16) was decreased in the experimental group ( P=0.03), but the protein expression level of GS did not change significantly. Conclusion:Glp-1 can inhibit GSK3/GS signaling pathway, activate GS activity and promote glycogen synthesis.

Clinical efficacy and prognosis analysis of different treatment regimens in patients with uncomplicated brucellosis / 中华传染病杂志

Objective:To analyze the efficacy and prognosis of different treatment regimens in patients with uncomplicated brucellosis, and to provide guidance for clinical treatment.Methods:The patients diagnosed with brucellosis in the Sixth People′s Hospital of Shenyang from September 2014 to June 2019 were enrolled. The clinical data of patients with uncomplicated brucellosis were collected. The two most frequent treatment regimens were screened, after conducting propensity score matching with 1∶4, and the clinical characteristics, prognosis, and adverse reactions in patients with two regimens were retrospectively analyzed. The primary outcome was clinical cure. The secondary outcomes were disease progression and relapse. Statistical analysis was performed using chi-square test, Wilcoxon rank sum test and log-rank method.Results:A total of 1 570 patients clinically diagnosed with brucellosis were included, and 939(59.8%) showed uncomplicated infection. There were 608(38.7%) patients who received doxycycline and rifampicin treatment, and 65(4.1%) received doxycycline and levofloxacin treatment. By propensity score matching, 223 patients (DR group) who used doxycycline and rifampicin were included, while 65 patients (DL group) who used doxycycline and levofloxacin were included. The cure rate, progression rate, symptom persistence rate and recurrence rate of DR group were 94.6%(211/223), 1.8%(4/223), 2.2%(5/223) and 1.3%(3/223), respectively. In DL group, those were 95.4%(62/65), 3.1%(2/65), 1.5%(1/65) and 0(0/65), respectively. And there was no significant difference between the two groups ( χ2=0.18, P=0.632). No significant difference of symptom durations between the two groups was observed (29.0(28.0, 30.0) d vs 28.0(26.1, 29.9) d, hazard ratio ( HR)=0.966, 95% confidence interval ( CI) 0.723 to 1.290, χ2=1.01, P=0.315), while treatment course of DR group was statistically longer than DL group (90.0(84.1, 95.9) d vs 44.0(37.3, 50.7) d, HR=0.489, 95% CI 0.361 to 0.662, χ2=14.18, P<0.001). Procalcitonin (0.02(0.02, 0.05) μg/L and 0.02(0.02, 0.04) μg/L) and C-reactive protein (8(3, 17) mg/L and 18(7, 55) mg/L) levels in DR group and DL group had decreased significantly after treatment than before treatment (0.09(0.04, 0.16) μg/L and 0.19(0.08, 0.25) μg/L, 106(19, 274) mg/L and 255(50, 494) mg/L), and the differences were statistically significant ( W=2.55, 2.04, 3.66 and 2.19, respectively, all P<0.05). The adverse reaction (ADR) rate in DR group was 4.2%(8/191), and five patients showed liver function injury. The ADR rate in DL group was 2.0%(1/51), which showed liver function injury. There was no significant difference of ADR between the two groups ( P>0.05). Conclusions:Doxycycline combined with rifampicin and doxycycline combined with levofloxacin have similar efficacy and adverse reaction rates for treating uncomplicated brucellosis.

Aspirin suppresses neuronal apoptosis, reduces tissue inflammation, and restrains astrocyte activation by activating the Nrf2/HO-1 signaling pathway.

The nuclear factor E2-related factor 2 (Nrf2)/antioxidant response element signaling pathway plays a substantial role in preventing oxidative stress-related diseases. Aspirin has been shown to exert several pharmacological effects by inducing the expression of the heme oxygenase-1 (HO-1) protein. However, the effects of aspirin on spinal cord injury (SCI) have rarely been studied. Therefore, we sought to investigate the neuroprotective effects of aspirin after SCI. We employed a spinal cord contusion model in Sprague-Dawley rats, and aspirin was administered intraperitoneally for 7 days. Nissl staining showed that the aspirin treatment significantly reduced the loss of motor neurons after SCI compared with vehicle-treated animals. The expression of Nrf2, quinine oxidoreductase 1, and HO-1 proteins was increased in aspirin-treated animals after SCI compared with the vehicle group. In addition, aspirin simultaneously decreased the expression of inflammation-related proteins, such as tumor necrosis factor-α and interleukin-6 after SCI. Moreover, the ratio of apoptotic neurons in the anterior horn and the levels of the apoptosis-related proteins caspase-3, cleaved caspase-3, and Bax were significantly decreased in the aspirin group compared with the vehicle group. Immunofluorescence staining was used to detect the colocalization of NeuN and HO-1, and the results showed that aspirin significantly increased expression of the HO-1 protein in neurons. In addition, western blots and immunofluorescence staining showed aspirin restrained astrocyte activation. In conclusion, aspirin induces neuroprotective effects by inhibiting astrocyte activation and apoptosis after SCI through the activation of the Nrf2/HO-1 signaling pathway.

Comparison of efficacy of different volume of ropivacaine for subomohyiod anterior suprascapular nerve block in patients undergoing arthroscopic shoulder surgery with general anesthesia / 中华麻醉学杂志

Objective:To compare the efficacy of different volume of ropivacaine for subomohyiod anterior suprascapular nerve block (aSSNB) in the patients undergoing arthroscopic shoulder surgery with general anesthesia.Methods:One hundred and thirty-five patients of either sex, aged 18-64 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, scheduled for elective arthroscopic shoulder surgery, were divided into 3 groups ( n=45 each) using a random number table method: 0.5% ropivacaine 5 ml group (L group), 10 ml group (M group), and 15 ml group (H group). Before induction, aSSNB was performed with 0.5% ropivacaine 5, 10 and 15 ml in L, M and H groups, respectively.Diaphragmatic excursion, occurrence and degree of diaphragmatic paralysis, decrease in SpO 2, dyspnea and Horner syndrome were recorded at 30 min after injection.The intraoperative consumption of remifentanil and cardiovascular events were recorded.The extubation time, length of post-anesthesia care unit stay, and duration of sensory block were recorded.Quality of Recovery-15 scale score and score for patient′s satisfaction with analgesia were recorded.The first pressing time of analgesic pump, effective pressing frequency of analgesic pump, requirement for rescue analgesia, nausea, vomiting and nerve block-related complications within 24 h after surgery were recorded. Results:Compared with group L, the incidence of diaphragmatic paralysis was significantly increased, the degree of diaphragmatic paralysis was aggravated, the first pressing time of analgesic pump and duration of sensory block were prolonged, the effective pressing times of analgesic pump was reduced, and the requirement for rescue analgesia was decreased in M and H groups, and the decrease in SpO 2 was significantly increased, and the introperative consumption of remifentanil was decreased in group H ( P<0.05). Compared with group M, the decrease in SpO 2 and incidence of diaphragmatic paralysis were significantly increased, the degree of diaphragmatic paralysis was aggravated, the first pressing time of analgesic pump and duration of sensory block were prolonged ( P<0.05), and no significant change was found in the introperative consumption of remifentanil, the effective pressing times of analgesic pump or requirement for rescue analgesia in group H ( P>0.05). There was no significant difference in the incidence of cardiovascular events, score for patient′s satisfaction with analgesia, incidence of dyspnea and extubation time, length of post-anesthesia care unit stay, Quality of Recovery-15 sacle score, and the incidence of nausea and vomiting among three groups ( P>0.05). There were no Horner syndrome and nerve block-related complications in the three groups. Conclusions:Subomohyoid aSSNB with 0.5% ropivacaine hydrochloride 10 ml provides optimal efficacy when used for subomohyiod anterior suprascapular nerve block in patients undergoing arthroscopic shoulder surgery with general anesthesia.

Progress of microecological agent in the treatment of children with inflammatory bowel disease / 国际儿科学杂志

The incidence of childhood inflammatory bowel disease has gradually increased in recent years.The disease is a chronic intestinal inflammatory disease, and its susceptible age is school age, which seriously affects the growth and development of children and brings psychological and spiritual trauma.The etiology and pathogenesis of inflammatory bowel disease is unclear, but with the in-depth study of the intestinal flora in recent years, it has been shown that intestinal flora imbalance plays an important role in the occurrence and development of the disease, and it has also been widely confirmed in clinical practice.Therefore, people try to use probiotics in the treatment of children with inflammatory bowel disease.This article mainly reviews the progress of the application of probiotics, prebiotics, fecal bacteria transplantation and other microecological agent in children with inflammatory bowel disease, analyzes the therapeutic effects of probiotics on children with inflammatory bowel disease, and provides new ideas for clinical practice.

Effects of Pelvic Biomechanical Changes on Female Pelvic Floor Dysfunction / 医用生物力学

Pelvic floor dysfunction disease has a high incidence in women after pregnancy. During this special physiological period of women pregnancy, posture of woman pelvis will change, and the pelvic biomechanics will change as well. Such mechanical changes will bring corresponding diseases. The relationship between dynamic changes and occurrence of functional disorders were discussed, the influences of changes in abdominal pelvic mechanics on the pelvic floor after pregnancy were summarized, and the high risk factors of pelvic floor dysfunction （PFD） were investigated, so as to provide the optimal treatment plans and method for pelvic floor rehabilitation treatment.

Clinical efficacy of extracorporeal membrane oxygenation on severe acute respiratory distress syndrome caused by Pneumocystis jersima pneumonia after renal transplantation / 中华器官移植杂志

Objective:To explore the clinical efficacy of venovenous extracorporeal membrane oxygenation(V-V ECMO)in patients with severe acute respiratory distress syndrome(ARDS)caused by Pneumocystis pneumonitis(PJP)after kidney transplantation(KT).Methods:Cal data of 9 KT recipients on V-V ECMO were retrospectively analyzed. Timing of V-V ECMO support, complications during treatment and V-V ECMO performance were summarized.Results:All 9 patients with confirmed PJP adopted V-V ECMO with oxygenation index of 25~92 prior to V-V ECMO and average time from admission to initiating V-V ECMO was 5.56(1~17)days. Except for one death from hemorrhagic shock due to abdominal hemorrhage, the remainders were successfully weaned. Another recipient died from sepsis after weaning and there were 7 survivors. V-V ECMO support time was 215.5 h among 8 successfully weaned recipients. Among 7 survivors, 1 had premorbid deterioration of graft function and no fatal complications occurred.Conclusions:V-V ECMO is an effective treatment for severe ARDS caused by P. pneumoniae post-KT. And its early application is recommended for reducing complications and improving patient prognosis.

Excessive copper in feed not merely undermines animal health but affects food safety

Background@#Blackened intestines in slaughtered pigs have been commonly observed in China in recent years. However, no cause has been reported. @*Objectives@#We attempted to determine whether the blackening of the pig intestine was related to an excess of copper (Cu) in their feed. @*Methods@#In this study, we observed and collected porcine intestines in small- and large-scale pig slaughterhouses in Shandong province from May to October 2018. Twelve types of metal ions were detected in the black intestinal samples. @*Results@#The Cu level in the intestine samples was mostly higher than the Chinese national limit for food. Further study showed that Cu supplementation in most commercial porcine feed also exceeded the national standard. An animal model (mouse) that could mimic the intestinal blackening in pigs was established. Compared to control mice, Cu accumulated in the liver and intestines of mice fed an excessive Cu level, confirming the excessive Cu in the feed may be considered the major cause of blackened porcine intestines. Microscopic examination revealed that black intestines had many particles containing Cu in the lamina propria of the intestinal mucosa, and the intestinal mucosal epithelial cells showed degeneration and necrosis. @*Conclusions@#In conclusion, overuse of Cu in animal feed can lead to animal poisoning and Cu accumulation in animal products. Such overuse not only harms the health of livestock but can also affect public health.

Excessive copper in feed not merely undermines animal health but affects food safety

Background@#Blackened intestines in slaughtered pigs have been commonly observed in China in recent years. However, no cause has been reported. @*Objectives@#We attempted to determine whether the blackening of the pig intestine was related to an excess of copper (Cu) in their feed. @*Methods@#In this study, we observed and collected porcine intestines in small- and large-scale pig slaughterhouses in Shandong province from May to October 2018. Twelve types of metal ions were detected in the black intestinal samples. @*Results@#The Cu level in the intestine samples was mostly higher than the Chinese national limit for food. Further study showed that Cu supplementation in most commercial porcine feed also exceeded the national standard. An animal model (mouse) that could mimic the intestinal blackening in pigs was established. Compared to control mice, Cu accumulated in the liver and intestines of mice fed an excessive Cu level, confirming the excessive Cu in the feed may be considered the major cause of blackened porcine intestines. Microscopic examination revealed that black intestines had many particles containing Cu in the lamina propria of the intestinal mucosa, and the intestinal mucosal epithelial cells showed degeneration and necrosis. @*Conclusions@#In conclusion, overuse of Cu in animal feed can lead to animal poisoning and Cu accumulation in animal products. Such overuse not only harms the health of livestock but can also affect public health.

Prevention and treatment strategy of cardiovascular diseases based on information construction and vascular health management in community / 中国医师杂志

In China, cardiovascular disease has become the main disease burden. To control cardiovascular diseases fundamentally, we should not only pay attention to treatment, but also control risk factors and vascular disease early.Vascular health management can detect subclinical vascular diseases.Through controlling risk factors, vascular function can be improved, and cardiovascular events can be prevented from the upstream.Peking University Shougang hospital is the first practitioner of vascular health management.In addition, it has explored the application of information technology and artificial intelligence in vascular health management.The life-long vascular health management and tertiary hospital-primary hospital-family service model carried out by Peking University Shougang hospital can better realize the prophylaxis of cardiovascular diseases. Prevention and control strategy of cardiovascular diseases based on information technology and vascular health management can help the implement of " healthy China 2030" .

Prognostic Value of TP53 Mutation for Transcatheter Arterial Chemoembolization Failure/Refractoriness in HBV-Related Advanced Hepatocellular Carcinoma / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#This study aimed to investigate the clinicopathologic features and mutational landscape of patients with hepatitis B virus (HBV)–related advanced hepatocellular carcinomas (HCC) undergoing transcatheter arterial chemoembolization (TACE). @*Materials and Methods@#From January 2017 to December 2018, 38 patients newly diagnosed with HBV-related advanced HCC were enrolled in the final analysis. Their pathological tissues and corresponding blood samples before TACE treatment were collected for whole-exome sequencing. Response to TACE was evaluated at 1-3 months after two consecutive use of TACE. Predictive factors were analyzed by univariate and multivariate analyses in a bivariate Logistic regression model. Enrichment of related pathways of all driver genes were acquired using the gene set enrichment analysis (GSEA). @*Results@#Among 38 patients, 23 (60.5%) exhibited TACE failure/refractoriness. Patients with TACE failure/refractoriness showed higher frequency of TP53 mutation than their counterparts (p=0.020). Univariate and multivariate analyses showed that only vascular invasion and TP53 mutation were significantly correlated with TACE failure/refractoriness in HBV-related advanced HCC. Of the 16 patients without vascular invasion, eight (50.0%) had TP53 mutations, and TP53 mutation was associated with TACE failure/refractoriness (p=0.041). Moreover, GSEA showed that mitogen-activated protein kinase and apoptosis pathways induced by TP53 mutation were possibly associated with TACE failure/refractoriness. @*Conclusion@#Our study suggested that TP53 mutation was independently related with TACE efficacy, which may work via mitogen-activated protein kinase and apoptosis pathways. These findings may provide evidence to help distinguish patients who will particularly benefit from TACE from those who require more personalized therapeutic regimens and rigorous surveillance in HBV-related advanced HCC.