A Study on Environmental Factors for Nonsyndromic Cleft Lip and/or Palate.

The aim of the study was to investigate the association between environmental factors and nonsyndromic cleft of the lip and/or palate (NSCL/P) in Yantai District, China. A retrospective case-control study was carried out. A total of 236 NSCL/P children were selected from Department of Oral and Maxillofacial Surgery of Yantai Stomatological Hospital between September 2013 and December 2016 as cases; 209 controls were chosen from other diagnosis in the same department during the same period. The 2 groups matched age and sex. The parents of participants were inquired regarding the risk factors, and the answers were filled in a questionnaire by physicians. Chi-square and multivariate logistic regression analysis were used to analysis the data. There was significantly increased NSCL/P risk with high maternal age (P =0.002), family history (P = 0.001), abortion history (P = 0.033), poor parental education level (P = 0.008), maternal smoking (P = 0.044), maternal alcohol (P = 0.039), common cold or fever (P = 0.035), drug use (P = 0.006), and maternal stress (P = 0.049). Reduced NSCL/P risk was found with folic acid supplementation (P = 0.005), adequate maternal age (P = 0.002), and high parental education (P = 0.001). The proper amount of folic acid, the appropriate age of childbearing, and the high education were the protective factors of NSCL/P, whereas family history, abortion history, drug use during pregnancy, maternal tobacco and alcohol, and maternal stress were the risk factors for NSCL/P in Yantai District, China.

Smartphone-Based Patients' Activity Recognition by Using a Self-Learning Scheme for Medical Monitoring.

Smartphone based activity recognition has recently received remarkable attention in various applications of mobile health such as safety monitoring, fitness tracking, and disease prediction. To achieve more accurate and simplified medical monitoring, this paper proposes a self-learning scheme for patients' activity recognition, in which a patient only needs to carry an ordinary smartphone that contains common motion sensors. After the real-time data collection though this smartphone, we preprocess the data using coordinate system transformation to eliminate phone orientation influence. A set of robust and effective features are then extracted from the preprocessed data. Because a patient may inevitably perform various unpredictable activities that have no apriori knowledge in the training dataset, we propose a self-learning activity recognition scheme. The scheme determines whether there are apriori training samples and labeled categories in training pools that well match with unpredictable activity data. If not, it automatically assembles these unpredictable samples into different clusters and gives them new category labels. These clustered samples combined with the acquired new category labels are then merged into the training dataset to reinforce recognition ability of the self-learning model. In experiments, we evaluate our scheme using the data collected from two postoperative patient volunteers, including six labeled daily activities as the initial apriori categories in the training pool. Experimental results demonstrate that the proposed self-learning scheme for activity recognition works very well for most cases. When there exist several types of unseen activities without any apriori information, the accuracy reaches above 80 % after the self-learning process converges.

Effects of water-nitrogen coupling on water and salt environment and root distribution in Suaeda salsa.

Understanding the spatial distribution of crop roots is crucial for effectively managing crop water and fertilizer. We investigate the effects of water-nitrogen coupling on the water-salt environment and root distribution in the root zone of S. salsa. Three irrigation levels were established, calculated according to 0.35 (W1), 0.50 (W2), and 0.65 (W3) of local ET0. The three nitrogen levels were 150 (N1), 250 (N2), and 350 (N3) kg·hm-2 in a complete combination design. With the augmentation of irrigation water and nitrogen application, the total root weight density of the root system of Suaeda salsa increased from 17.18×10-3 g·cm-3 to 27.91×10-3 g·cm-3. The distribution of soil water suction significantly influences the root distribution of Suaeda salsa in saline soil, causing a transition from a narrow deep type to a wide shallow type. Under the W2 irrigation level, soil water suction ranges from 1485.60 to 1726.59 KPa, which can provide water for S. salsa.it becomes feasible to attain the necessary water and salt environment for the growth and development of S. salsa, resulting in the attainment of maximum biomass, ash content, and salt uptake. No significant differences in the biomass, ash content, and salt uptake of S. salsa was noted between N2 and N3 nitrogen application levels (p > 0.05).The optimal irrigation volume and nitrogen application level were 0.50 ET0 and 250 kg·hm-2, respectively. The results of this study provide a scientific basis for the large-scale planting of S. salsa in extreme arid areas to improve and utilize saline wastelands.

Association between Polymorphisms in IL-16 Genes and Coronary Heart Disease risk.

OBJECTIVE: We aimed to investigate the role of polymorphisms in IL-16 genes on the susceptibility of Coronary Artery Disease (CAD). METHODS: A total of 260 CAD cases and 281 health controls were collected between January 2008 and November 2011. Genotyping of IL-16 rs8034928, rs3848180, rs1131445, rs4778889 and rs11556218 was conducted by polymerase chain reaction (PCR) and matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry technologies. RESULTS: The frequencies of rs8034928 C allele and rs3848180 G allele in the CAD cases in CAD group were significantly higher than in controls. Compared with rs8034928 T/T genotype, a significant higher risk of CAD was found in C/C genotype (OR=1.87, 95%CI=1.17-3.03), and variant of rs8034928 showed a significant increased risk of CAD in dominant (OR=1.48, 95%CI=1.04-2.10) and recessive model (OR=1.70, 95%CI=1.10-2.67). The rs3848180 G/G was found to be associated with risk of CAD(OR=1.79, 95%CI=1.16-2.75), and G allele carries had a significant risk of CAD (OR=1.47, 95%CI=1.02-2.13). CONCLUSIONS: Our study indicated that rs8034928 and rs11556218 polymorphisms are associated with CAD risk in a Chinese population, and IL-16 gene polymorphisms may be used as a predictor to the susceptibility of CAD.

Inhibition of platelet-derived growth factor signaling attenuates pulmonary fibrosis.

Pulmonary fibrosis is the consequence of a variety of diseases with no satisfying treatment option. Therapy-induced fibrosis also limits the efficacy of chemotherapy and radiotherapy in numerous cancers. Here, we studied the potential of platelet-derived growth factor (PDGF) receptor tyrosine kinase inhibitors (RTKIs) to attenuate radiation-induced pulmonary fibrosis. Thoraces of C57BL/6 mice were irradiated (20 Gy), and mice were treated with three distinct PDGF RTKIs (SU9518, SU11657, or Imatinib). Irradiation was found to induce severe lung fibrosis resulting in dramatically reduced mouse survival. Treatment with PDGF RTKIs markedly attenuated the development of pulmonary fibrosis in excellent correlation with clinical, histological, and computed tomography results. Importantly, RTKIs also prolonged the life span of irradiated mice. We found that radiation up-regulated expression of PDGF (A-D) isoforms leading to phosphorylation of PDGF receptor, which was strongly inhibited by RTKIs. Our findings suggest a pivotal role of PDGF signaling in the pathogenesis of pulmonary fibrosis and indicate that inhibition of fibrogenesis, rather than inflammation, is critical to antifibrotic treatment. This study points the way to a potential new approach for treating idiopathic or therapy-related forms of lung fibrosis.

Antifouling properties of hydrogels.

Marine sessile organisms easily adhere to submerged solids such as rocks, metals and plastics, but not to seaweeds and fishes, which are covered with soft and wet 'hydrogel'. Inspired by this fact, we have studied long-term antifouling properties of hydrogels against marine sessile organisms. Hydrogels, especially those containing hydroxy group and sulfonic group, show excellent antifouling activity against barnacles both in laboratory assays and in the marine environment. The extreme low settlement on hydrogels in vitro and in vivo is mainly caused by antifouling properties against the barnacle cypris.

Research progress of circadian clock genes regulating stem cell differentiation / 实用口腔医学杂志

Circadian clock exists widely in all kinds of organisms and regulates various physiological activities of organisms,which mainly depends on the rhythmic expression of circadian clock genes.Circadian clock genes play an important role in many physiologi-cal processes,which has been shown to be closely related to tissue regeneration.Stem cells are the focus of regenerative medicine,and the regulation of stem cells directed differentiation can achieve tissue repair and regeneration.Studies have shown that circadian clock genes are the key factors regulating stem cell differentiation,so targeting circadian clock genes shows certain therapeutic prospects.In this review,the research progress of the regulation of circadian clock genes in the differentiation of stem cells and their related mecha-nisms is introduced and analyzed to provide possible ideas for the future application of regenerative medicine.

A decade's review for membrane anatomy: the setting,events in it, order formed by primary fascia and serous membrane / 中华胃肠外科杂志

The successful report of total mesorectal excision (TME)/complete mesocolic excision (CME) has encouraged people to apply this concept beyond colorectal surgery. However, the negative results of the JCOG1001 trial denied the effect of complete resection of the "mesogastrium" including the greater omentum on the oncological survival of gastric cancer patients. People even believe that the mesentery is unique in the intestine, because they have a vague understanding of the structure of the mesentery. The discovery of proximal segment of the dorsal mesogastrium (PSDM) proved that the greater omentum is not the mesogastrium, and further revised the structure (definition) of the mesentery and revealed its container characteristics, i.e. the mesentery is an envelope-like structure, which is formed by the primary fascia (and serosa) that enclose the tissue/organ/system and its feeding structures, leading to and suspended on the posterior wall of the body. Breakdown of this structure leads to the simultaneous reduction of surgical and oncological effects of surgery. People quickly realized the universality of this structure and causality which cannot be matched by the existing theories of organ anatomy and vascular anatomy, so a new theory and surgical map- membrane anatomy began to form, which led to radical surgery upgraded from histological en bloc resection to anatomic en bloc resection.

Development of membrane anatomy theory in gastric cancer surgery / 中华胃肠外科杂志

In the past decade, the concept of membrane anatomy has been gradually applied in gastric cancer surgery. Based on this theory, D2 lymphadenectomy plus complete mesogastric excision (D2+CME) has been proposed, which has been demonstrated to significantly reduce intraoperative bleeding and intraperitoneal free cancer cells during surgery, decrease surgical complications, and improve survival. These results indicate that membrane anatomy is feasible and efficacious in gastric cancer surgery. In this review, we will describe the important contents of membrane anatomy, including "Metastasis V"(2013, 2015), proximal segmentation of dorsal mesogastrium (2015), D2+CME procedure (2016), "cancer leak"(2018), and surgical outcomes of D2+CME (2022).

Biomechanopharmacology of Chinese Medicine Based on Mechano-ion Channel Piezo1： A Review / 中国实验方剂学杂志

Ischemic stroke is one of the leading causes of death and disability worldwide. In Han dynasty， HUA Tuo proposed the original preventive medicine idea that "with good blood circulation， the disease cannot be born"， which opened a broad space for the cross-research of blood-related mechanical factors and pharmacology. In the pathogenesis of ischemic stroke， mechanical factors comprehensively affect the function and crosstalk of platelets and endothelial cells. In recent years， as the well-known effects on thrombosis and stroke， more attention has been paid to hemodynamic factors as the participants involved in pathological mechanisms and potential therapeutic targets of ischemic stroke. The mechanical force ion channel Piezo1 widely exists on the surface of many types of cells. Besides being regulated by chemical and endogenous substances， Piezo1 responds to different mechanical conditions， regulates the opening and closing of channels， and activates different downstream signaling pathways. Piezo1 is now regarded as an important connection between mechanical and biochemical signals. A variety of Chinese medicine can affect the activity of Piezo1 protein， which may prevent and treat thrombotic diseases such as ischemic stroke through Piezo1 protein. In this paper， the effects of Piezo1 protein on the physiological and pathological functions of endothelial cells and platelet under different mechanical conditions and the role of Piezo1 in the process of thrombosis were reviewed， as well as the effects of Chinese medicine， chemical medicine， and endogenous substances targeting Piezo1 channel. These could provide new ideas for further exploring the mechanisms of Chinese medicines in activating blood circulation， developing new drugs， and deepening biomechanical-pharmacology research.

Clinical and epidemiological analysis of 18 cases of Japanese spotted fever in Zigui County / 中华检验医学杂志

Objective:The epidemiological and clinical characteristics of 18 cases of Japanese spotted fever (JSF) in Zigui County were analyzed in order to improve the prevention and treatment of JSF.Methods:This is a case series analysis. The epidemiological and clinical data, laboratory tests and imaging characteristics of 18 JSF cases with median age of 60 years (54, 68) identified by The People′s Hospital of Zigui from April 2021 to August 2022 were collected and analyzed retrospectively.Results:Most (17/18) of the patients were farmers and all had a field exposure history. The patient′s onset was from April to October. Spring and autumn were the seasons with the highest incidence of JSF. The first symptoms of patients were high fever, headache, and fatigue. Of the 18 cases, 15 had a rash and 12 presented an eschar and 3 had neither rash nor eschar. In addition, 10 of 18 cases experienced edema of both lower extremities, and 3 got disturbance of consciousness. Laboratory tests found that 15 patients had abnormal white blood cells and 11 patients had decreased platelets. C-reactive protein, procalcitonin, D-dimer, lactate dehydrogenase, and alpha-hydroxybutyrate dehydrogenase were elevated in all patients; 13 patients with elevated alanine aminotransferase, 14 patients with elevated aspartate transamination. Kidney damage caused by Rickettsia japonica infection showed by abnormal proteinuria in 11 of the patients. Conclusions:The most common clinical manifestations of JSF are non-specific indications such as high fever, chills, fatigue, headache. The eschar and rash, which are the main features of Rickettsia infection, are not present in all patients, resulting delay of diagnosis or misdiagnosis. Medical workers should be more alert to rickettsial infections in patients with fever of unknown origin, especially in seasons of high incidence of spotted fever. Early diagnosis and correct antibiotic treatment shall be given according to the patient′s clinical manifestations, laboratory results and imaging test to control disease progression.

Clinical characteristics and prognosis of patients with therapy-related myelodysplastic syndrome and acute myeloid leukemia arising from malignant tumors / 中华血液学杂志

Objective: To investigate the clinical characteristics, cytogenetics, molecular biology, treatment, and prognosis of patients with therapy-related myelodysplastic syndrome and acute myeloid leukemia (t-MDS/AML) secondary to malignancies. Methods: The clinical data of 86 patients with t-MDS/AML in West China Hospital of Sichuan University between January 2010 and April 2023 were retrospectively analyzed. The clinical characteristics, primary tumor types, and tumor-related therapies were analyzed. Results: The study enrolled a total of 86 patients with t-MDS/AML, including 67 patients with t-AML, including 1 patient with M(0), 6 with M(1), 27 with M(2), 9 with M(3), 12 with M(4), 10 with M(5), 1 with M(6), and 1 with M(7). Sixty-two patients could be genetically stratified, with a median overall survival (OS) of 36 (95% CI 22-52) months for 20 (29.9%) patients in the low-risk group and 6 (95% CI 3-9) months for 10 (14.9%) in the intermediate-risk group. The median OS time was 8 (95% CI 1-15) months in 32 (47.8%) patients in the high-risk group. For patients with non-acute promyelocytic leukemia (APL) and AML, the median OS of the low-risk group was 27 (95% CI 18-36) months, which was significantly longer than that of the non-low-risk group (χ(2)=5.534, P=0.019). All 9 APL cases were treated according to the initial treatment, and the median OS was not reached, and the 1-, 2-, and 3-year OS rates were 100.0%, (75.0±6.2) %, and (75.0±6.2) % respectively. Of the 58 patients with non-APL t-AML (89.7%), 52 received chemotherapy, and 16 achieved complete remission (30.8%) after the first induction chemotherapy. The 1-, 2-, and 3-year OS rates of the non-APL t-AML group were (42.0 ± 6.6) %, (22.9±5.7) %, and (13.4±4.7) %, respectively. The median OS of patients who achieved remission was 24 (95% CI 18-30) months, and the median OS of those who did not achieve remission was 6 (95% CI 3-9) months (χ(2)=10.170, P=0.001). Bone marrow CR was achieved in 7 (53.8%) of 13 patients treated with vineclar-containing chemotherapy, with a median OS of 12 (95% CI 9-15) months, which was not significantly different from that of vineclar-containing chemotherapy (χ(2)=0.600, P=0.437). In 19 patients with t-MDS, the 1-, 2-, and 3-year OS rates were (46.8±11.6) %, (17.5±9.1) %, and (11.7±9.1) % with a median OS of 12 (95% CI 7-17) months, which was not significantly different from that in t-AML (χ(2)=0.232, P=0.630) . Conclusions: Breast cancer, bowel cancer, and other primary tumors are common in patients with t-MDS/AML, which have a higher risk of adverse genetics. Patients with APL had a high induction remission rate and a good long-term prognosis, whereas patients without APL had a low remission rate and a poor long-term prognosis.

Ultrafast Synthetic Transmit Aperture Imaging Using Hadamard-Encoded Virtual Sources With Overlapping Sub-Apertures.

The development of ultrafast ultrasound imaging offers great opportunities to improve imaging technologies, such as shear wave elastography and ultrafast Doppler imaging. In ultrafast imaging, there are tradeoffs among image signal-to-noise ratio (SNR), resolution, and post-compounded frame rate. Various approaches have been proposed to solve this tradeoff, such as multiplane wave imaging or the attempts of implementing synthetic transmit aperture imaging. In this paper, we propose an ultrafast synthetic transmit aperture (USTA) imaging technique using Hadamard-encoded virtual sources with overlapping sub-apertures to enhance both image SNR and resolution without sacrificing frame rate. This method includes three steps: 1) create virtual sources using sub-apertures; 2) encode virtual sources using Hadamard matrix; and 3) add short time intervals (a few microseconds) between transmissions of different virtual sources to allow overlapping sub-apertures. The USTA was tested experimentally with a point target, a B-mode phantom, and in vivo human kidney micro-vessel imaging. Compared with standard coherent diverging wave compounding with the same frame rate, improvements on image SNR, lateral resolution (+33%, with B-mode phantom imaging), and contrast ratio (+3.8 dB, with in vivo human kidney micro-vessel imaging) have been achieved. The f-number of virtual sources, the number of virtual sources used, and the number of elements used in each sub-aperture can be flexibly adjusted to enhance resolution and SNR. This allows very flexible optimization of USTA for different applications.

Analysis on mortality and premature death rates of 4 major chronic diseases in Ji'nan, 2015-2020 / 中华流行病学杂志

Objective: To understand the characteristics and trend of the premature death rate of 4 major chronic diseases in Ji'nan from 2015 to 2020. Methods: The death cause surveillance data and population data during 2015-2020 in Ji'nan were collected, and abbreviated life table, Joinpoint regression analysis and other methods were used to analyze the characteristics and change trends of the premature death rates of 4 major chronic diseases. Results: The crude mortality rate and age standardized mortality rate changes for the 4 major chronic diseases from 2015 to 2020 range from 568.65/100 000 to 604.06/100 000 and 366.77/100 000 to 432.48/100 000, respectively. The annual premature death rate of 4 major chronic diseases declined by 3.33% averagely from 2015 to 2020 (95%CI: -6.25%--0.32%), which might be explained by the declines of the premature death rates of cardiovascular and cerebrovascular diseases [average annual percentage change (AAPC)=-3.23%, 95%CI: -6.32%--0.05%] and cancer (AAPC=-3.58%,95%CI:-6.83%--0.21%). The average decline rate in women (AAPC=-4.19%,95%CI:-7.56%- -0.70%) was higher than that in men (AAPC=-2.92%,95%CI: -5.65%--0.11%). Conclusions: The premature death rate of 4 major chronic diseases showed a downward trend in Ji'nan from 2015 to 2020. Men should be considered as a key population in the prevention and control of 4 major chronic diseases, and attention should also be paid to the non-significant declines in the premature death rates of chronic respiratory diseases and diabetes.

[Evaluation of simulated mandibular models in skill training of implantology for dental undergraduates].

PURPOSE: To explore the effects of simulated mandibular models in skill training of implantology for dental undergraduate. METHODS: Pre-clinical teaching of oral implantology was implemented on simulation models for 51 undergraduates of grade 2013. Each undergraduate inserted a dental implant and took an impression in the simulation model under the teacher＇s guidance. After the training course, the scores were evaluated both objectively and subjectively. RESULTS: An average score of 91.6 was obtained in the course of oral implantology on simulated mandibular models. All students appreciated the teaching methods. They believed that training on simulation models could improve their learning interest and arouse their learning motivation. CONCLUSIONS: Simulated mandibular models are good tools in training of oral implantology for dental undergraduates education, which is worthy of wide application.

Small molecule receptor tyrosine kinase inhibitor of platelet-derived growth factor signaling (SU9518) modifies radiation response in fibroblasts and endothelial cells.

BACKGROUND: Several small receptor tyrosine kinase inhibitors (RTKI) have entered clinical cancer trials alone and in combination with radiotherapy or chemotherapy. The inhibitory spectrum of these compounds is often not restricted to a single target. For example Imatinib/Gleevec (primarily a bcr/abl kinase inhibitor) or SU11248 (mainly a VEGFR inhibitor) are also potent inhibitors of PDGFR and other kinases. We showed previously that PDGF signaling inhibition attenuates radiation-induced lung fibrosis in a mouse model. Here we investigate effects of SU9518, a PDGFR inhibitor combined with ionizing radiation in human primary fibroblasts and endothelial cells in vitro, with a view on utilizing RTKI for antifibrotic therapy. METHODS: Protein levels of PDGFR-alpha/-beta and phosphorylated PDGFR in fibroblasts were analyzed using western and immunocytochemistry assays. Functional proliferation and clonogenic assays were performed (i) to assess PDGFR-mediated survival and proliferation in fibroblasts and endothelial cells after SU9518 (small molecule inhibitor of PDGF receptor tyrosine kinase); (ii) to test the potency und selectivity of the PDGF RTK inhibitor after stimulation with PDGF isoforms (-AB, -AA, -BB) and VEGF+bFGF. In order to simulate in vivo conditions and to understand the role of radiation-induced paracrine PDGF secretion, co-culture models consisting of fibroblasts and endothelial cells were employed. RESULTS: In fibroblasts, radiation markedly activated PDGF signaling as detected by enhanced PDGFR phosphorylation which was potently inhibited by SU9518. In fibroblast clonogenic assay, SU9518 reduced PDGF stimulated fibroblast survival by 57%. Likewise, SU9518 potently inhibited fibroblast and endothelial cell proliferation. In the co-culture model, radiation of endothelial cells and fibroblast cells substantially stimulated proliferation of non irradiated fibroblasts and vice versa. Importantly, the RTK inhibitor significantly inhibited this paracrine radiation-induced fibroblast and endothelial cell activation. CONCLUSION: Radiation-induced autocrine and paracrine PDGF signaling plays an important role in fibroblast and endothelial cell proliferation. SU9518, a PDGFR tyrosine kinase inhibitor, reduces radiation-induced fibroblast and endothelial cell activation. This may explain therapeutic anticancer effects of Imatinib/Gleevec, and at the same time it could open a way of attenuating radiation-induced fibrosis.

Scientific paradigm of membrane anatomy / 中华胃肠外科杂志

Anatomical plane and fascia have been described in medical behaviors for hundreds of years since the appearance of anatomy and operation. Generally, these descriptions can be sorted into three theories, i.e. plane surgery, fascia theory and mesentery anatomy. However, these theories are difficult to satisfy the scientific paradigm that includes consistency in description, independence in validation, potential to solve practical problems, and the interaction of the above-mentioned theries. Recently, membrane anatomy was proposed as the anatomy of mesentery and its beds in broad sense. Behind it lies fascia membrane/serous membrane structure, as well as inherent life events and general order. Mesentery in broad sense is described as the fascia membrane/serous membrane in serous cavity, which envelops and suspends the organ/tissue and its feeding structures to the posterior wall of the body. Anatomy is the setting/structure, in which life events/functions occur. In the research and discussion of membrane anatomy, abiding by the scientific paradigm and upholding the scientific spirit are the only way to obtain reliable knowledge and the criterion for in-depth scientific research.

Demonstration and significance on proximal segment of dorsal mesogastrium / 中华胃肠外科杂志

In radical gastrectomy, D2 systemic lymphadenectomy, which includes complete resection of the bursa sac and omentum, and D2 extended lymphadenectomy outside the bursa sac, is a standard procedure accepted by gastrointestinal surgeons generally. However, a series of clinical trials showed that both D2 extended lymphadenectomy and bursectomy could not improve oncologic benefit, but increase surgical risk. These findings showed a lot of conflicts in gastric cancer surgery, gastrointestinal surgery, even in oncological surgery. It was demonstrated that bursa sac and greater omentum were neither mesogastrium nor the proximal segment of dorsal mesogastrium (PSDM), which has been identified recently. Local physiological structures (such as blood vessels and lymphatic nodes) and pathological events (such as lymph nodes metastasis and metastasis V) only occur in mesentery in broad sense (i.e. PSDM). Broken PSDM during radical gastrectomy can result in cancer cell leakage into the operational field. Therefore, complete PSDM excision in the D2 field (D2+CME) is suggested as a better procedure for local advanced gastric cancer, which can get benefits not only in surgical hazard, but also in oncologic result. The results of PSDM research could lead to three changes: (1) resolving some long standing problems in gastric cancer surgery, gastrointestinal surgery, and even oncologic surgery; (2) opening an new era for finding and utilizing extra-intestinal mesentery in broad sense; (3) formulating the theory of membrane anatomy which may update, iterate and upgrade related information of classical anatomy, pathology, surgery and oncology.

Evaluation value of iron metabolism disorders in sepsis patients in an intensive care unit / 中华急诊医学杂志

Objective:To evaluate iron metabolism disorders in sepsis patients and explore the effect of iron deficiency on mortality.Methods:Patients ( n=130) who were admitted to the emergency intensive care unit (ICU) of the First Affiliated Hospital of Dalian Medical University from September 2016 to July 2018 and met the diagnostic criteria of Sepsis 3.0 were selected, and sex- and age-matched healthy volunteers ( n=20) were enrolled as a control group. Peripheral venous blood samples were collected in sepsis patients on day 1, 3 and 7 after admission, or in the healthy volunteers upon enrollment, to detect iron metabolism-related indicators and interleukin-6 (IL-6); the Sequential Organ Failure Assessment (SOFA) score was calculated upon hospital admission. Iron metabolism-related indicators were compared between the groups; the correlation of plasma iron with hemoglobin, hepcidin, ferritin, IL-6, sTFR/log ferritin and the ability of plasma iron to predict 28-day death of sepsis patients were analyzed. Results:Sepsis patients developed significant anemia on day 3 after admission; plasma iron, transferrin, iron saturation, total iron binding capacity and unsaturated iron binding capacity in the first week of admission were significantly lower than those in the control group; distribution width of red blood cells, ferritin, IL-6, hepcidin and soluble transferrin receptor were significantly higher than those in the control group. Distribution width of red blood cells, ferritin and hepcidin on day 3 and 7 after admission, and plasma iron and iron saturation on day 7 after admission were significantly higher than those on day 1. However, total iron binding capacity and unsaturated iron binding power on day 7, and sTFR/log ferritin on day 3 were significantly lower than those on day 1. Patients in the survival and non-survivor groups in the first week of admission had significant anemia on day 3 and 7, but the anemia was worse in the non-survivor group. Transferrin, total iron binding capacity, and unsaturated iron binding capacity in the non-survivor group in the first week of admission, and plasma iron in the non-survivor group on day 3 and 7, were significantly lower than those in the survival group. Ferritin, IL-6 and hepcidin in the non-survivor group in the first week of admission, and iron saturation on day 7 were significantly higher than those in the survival group. Spearman correlation analysis showed that plasma iron was negatively correlated with IL-6 ( r=-0.391, P<0.01), ferritin ( r=-0.293, P=0.001) and hepcidin ( r=-0.209, P=0.017), but not with hemoglobin ( r=0.005, P=0.958). The area under the operation curve (AUC) for plasma iron for predicting 28-day mortality in sepsis patients was 0.524 (95% CI: 0.416-0.631, P=0.656). Conclusions:Sepsis patients have significant anemia and iron metabolism disorders in the early stage, while non-survival patients are more severe. Reduced plasma iron level has no capacity to predict 28-day mortality of sepsis patients. In addition, decreased plasma iron level is not related to decreased hemoglobin, and thus iron supplementation should be cautious in sepsis patients.