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Objective To compare paired boxed gene 1(PAX1)methylation and p16/Ki-67 double staining alone and in combination in thinprep cytologic test(TCT)for distinguishing atypical squamous cells of undetermined significance(ASC-US)and low-grade squamous intraepithelial lesion(LSIL)population.Methods A total of 247 patients with TCT results of ASC-US and LSIL admitted in our hospital from January 2021 to December 2022 were enrolled in this study.Detection efficacy of PAX1 methylation and p16/Ki-67 double staining alone and in combination was evaluated with colposcopic pathologic results as the gold standard and the sensitivity,specificity,accuracy and area under the curve(AUC)as evaluation indexes.Results The positive rates of PAX1 methylation and p16/Ki-67 double staining were increased with the severity of pathological findings.Combined detection of PAX1 methylation and p16/Ki-67 assay had a sensitivity of 91.25％,specificity of 97.72％and accuracy of 95.51％in the women with TCT of ASC-US,and these values were statistically better than those of PAX1 methylation and p16/Ki-67 double staining alone(P＜0.01).Conclusion The combination of PAX1 methylation and p16/Ki-67 double-staining assay can further improve the diagnostic efficacy in patients with ASC-US on TCT results.
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Objective:To assess the impact of reducing the mesh density on the overall volume and trueness of single-crown restora-tions.Methods:15 single-crown restorations were included,and their mesh density in 3D software was simplified by 75％,50％,25％,10％and 5％respectively.The overal volume,file size and mesh edge length of the restorations with different reduction levels were compared.Deviation analysis was conducted by curving clipping the area of the shoulder,tissue surface(except for the shoulder)and occlusal surface of the restorations and compared with those of the corresponding regions in the non-simplified restorations.Trueness was assessed using the root mean square(RMS)values for the volume and trueness of different areas.Results:Reducing the mesh den-sity did not significantly affect the overal volume of the single-crown restorations(P＞0.05),but it had a significant impact on the file size(P＜0.001),mesh edge length(P＜0.001)and the trueness of the shoulder(P＜0.001),tissue surface(except for the shoulder)(P＜0.001)and occlusal surface(P＜0.001)areas.Conclusion:Reducing the mesh density had little impact on the overall volume of the restorations but significantly affected their trueness.
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Znic (Zn) alloys with good cytocompatibility and suitable degradation rate have been a kind of biodegradable metal with great potential for clinical applications. This paper summarizes the biological role of degradable Zn alloy as bone implant materials, discusses the mechanical properties of different Zn alloys and their advantages and disadvantages as bone implant materials, and analyzes the influence of different processing strategies (such as alloying and additive manufacturing) on the mechanical properties of Zn alloys. This paper provides systematic design approaches for biodegradable Zn alloys as bone implant materials in terms of the material selection, product processing, structural topology optimization, and assesses their application prospects with a view to better serve the clinic.
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Orthopedics , Zinc , Alloys , Dental Materials , Prostheses and ImplantsABSTRACT
Objective To explore the expression profile of the JAK/STAT pathway in patients with acute myeloid leukemia(AML)and to analyze its impact on the survival prognosis of patients.Methods This study compared differentially expressed genes between AML patients and healthy controls in 2 independent cohorts(n=64,n=121),and these genes were enriched by pathways.The expression levels of JAKs and STATs genes were compared between AML patients and healthy controls.The clinical values of JAK/STAT genes were analyzed using gene expression data,patients'clinical and prognostic information from 2 AML cohorts(n=163,n=403).Results Gene microarray expression results in 26 AML patients and 38 healthy controls showed 1266 genes with significantly differential expression(Padj≤0.05,| log2FC| ≥0.5),of which 426 genes were significantly upregulated in AML patients and 840 genes were significantly downregulated in AML patients.Pathway enrichment of these genes was performed in the JAK/STAT pathway,which was found to be active in AML patients(P＜0.05).Comparison of mi-croarray data from the GSE1159 cohort(n=121)showed AML patients had higher levels of JAK1(P=0.019),J AK2(P=0.047)and STAT4(P＜0.001)gene expression than the healthy controls,and their STAT5A(P=0.028)and STAT6(P=0.022)gene expression levels were lower than those in the healthy controls.Univariate survival analysis identified shorter over-all survival(P=0.02,HR=1.463;P=0.041,HR=1.293)and event-free survival(P=0.01,HR=1.510)in patients with high STAT4 expression than in those with a lower STAT4 expression in the TCGA and GSE6891 cohorts(n=163;n=403).Univa-riate and multifactorial COX analyzes confirmed that high STAT4 expression was an independent prognostic risk factor for AML patients(EFS:P=0.002,HR=1.958;OS:P=0.036,HR=1.556).Conclusion In AML patients,the JAK/STAT path-way is activated,and the STAT4 expression level is higher than that of the healthy controls.High expression of STAT4 suggest poor prognosis,wihich is an independent risk factor for the prognosis of AML patients.
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Objective:To investigate the surgical treatment of mesh infection after lapa-roscopic inguinal hernia repair.Methods:The retrospective and descriptive study was conducted. The clinical data of 32 patients with mesh infection after laparoscopic inguinal hernia repair who were admitted to the Affiliated Beijing Chaoyang Hospital of Capital Medical University from January 2018 to December 2020 were collected. There were 30 males and 2 females, aged 59(range, 19-81)years. All patients underwent debridement. Observation indicators: (1) surgical and postopera-tive situations; (2) follow-up. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers or percentages, and comparison between was conducted using Fisher exact probability. Results:(1) Surgical and postoperative situations. All 32 patients underwent debridement success-fully, with the operation time and volume of intraoperative blood loss as 110(range, 45-220)minutes and 24(range, 5-200)mL. Of the 32 patients, there were 6 cases undergoing open debridement, 26 cases undergoing laparoscopic exploration with 12 cases clarified the cause of infection, in which 4 cases had intestinal fistula by mesh infection breaking through the peritoneum and invading the intestinal tract and underwent laparoscopic intestinal fistula repair, 3 cases had significant amount of residual medical glue, 3 cases had mesh wrinkling and curling, 2 cases underwent peritoneum suturing with black silk thread. There were 18 cases undergoing complete removal of infected mesh and 14 cases undergoing partial mesh removal. There were 18 cases undergoing removal of infected mesh by laparoscopic posterior approach and 14 cases undergoing removal of infected mesh by open anterior approach. Twenty-nine of the 32 patients had bacterial culture and drug allergy testing, including 24 cases with positive cultures, while 5 cases with negative cultures. The duration of hospital stay of the 32 patients was 27.0(range, 9.0-85.0)days. (2) Follow-up. All 32 patients were followed up for 37.9(range, 18.7-52.5)months. There were 5 cases and 2 cases with postoperative incision infection in the 18 patients undergoing complete removal of infected mesh and 14 cases undergoing partial mesh removal, respectively, showing no significant difference between them ( P>0.05). There were 7 cases, 4 cases with seroma, recurrent sinus in the 18 patients undergoing complete removal of infected mesh and 5 cases, 6 cases in the 14 cases undergoing partial mesh removal, respectively, showing no significant difference between them ( P>0.05). None of patient in the two groups had hematoma, recurrent inguinal hernia or chronic pain. The 7 patients with incision infec-tion recovered effectively after symptomatic treatment. The 12 patients with seroma received no special treatment. The 10 patients with recurrent sinus underwent debridement, in which 9 cases did not experience any further abdominal wall infections and 1 case underwent the third debride-ment. Conclusion:The management of mesh infection following laparoscopic inguinal hernia repair necessitates the expertise of hernia specialists to complete remove the infected mesh or partial remove the infected mesh based on the specific clinical scenario.
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Boron neutron capture therapy(BNCT), a promising radiotherapy, belongs to precision treatment for cancers. BNCT can accurately kill cancer cells and protect normal cells at the same time relying on 10B compounds with high efficacy. The research about developing new 10B compounds is in progress, and novel and efficient 10B compounds are emerging, which greatly facilitate broadening the advantages and efficacy of BNCT. Considering the mixed rays generated from the BNCT process, its biological effects on tumor cells are relatively complex, and related studies are still lacking. The molecular mechanisms underlying BNCT need to be elucidated further. BNCT has been applied in the treatment of malignant brain tumors, head and neck cancers, and malignant melanoma with favorable curative effects. This review mainly focuses on the development of 10B compounds, biological mechanisms, potential advantages, and clinical applications.
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Objective: To observe the effects of electroacupuncture (EA) at Neiguan (PC6) on arrhythmia during acute myocardial ischemia-reperfusion and the expression of connexin 43 (Cx43) in rats. Methods: A total of 40 Sprague-Dawley male rats were used. Ten rats were randomly selected as the blank group, and the remaining 30 rats were randomly divided into a model group and an EA group, with 15 rats in each group. Before modeling, rats in the EA group received one session of EA intervention at bilateral Neiguan (PC6) for 30 min; the other groups were treated with the same grasping and anesthesia for 30 min without intervention. PowerLab physiological recorder was used to record electrocardiograph within 30 min of infarction. After the experiment, cardiac tissue and serum were collected from rats. Hematoxylin-eosin (HE) staining was used to observe the morphological changes of myocardial tissue in the ventricular infarction area of rats in each group. The expression of Cx43 protein in the myocardium of each group was detected by Western blotting (WB). Enzyme-linked immunosorbent assay (ELISA) was used to determine the activity of Na+-K+-ATPase in myocardial tissue and the serum content of endogenous digitalis-like factor (EDLF) in rats. Results: There was no statistical difference in arrhythmia score between the EA group and the model group, but the total duration and average duration of arrhythmia in the EA group were decreased (P<0.01). HE staining showed that compared with the blank group, myocardial cells in the model group were disorganized and seriously damaged. The pathological changes in the EA group were similar to those in the model group, but the damage was relatively minor. The results of WB showed that compared with the blank group, the Cx43 expression in myocardial tissue of the model group was decreased (P<0.01); compared with the model group, the Cx43 expression in the EA group was increased (P<0.01); compared with the blank group, the Na+-K+-ATPase activity in myocardial tissue of the model group was significantly decreased (P<0.01); compared with the model group, the Na+-K+-ATPase activity in the EA group was increased (P<0.01). ELISA results showed that compared with the blank group, the serum EDLF content in the model group was significantly increased (P<0.01); compared with the model group, the EDLF content in the EA group was decreased (P<0.01). Conclusion: EA at Neiguan (PC6) can delay and reduce the onset of arrhythmia during myocardial infarction in the rat model of myocardial ischemia-reperfusion. Its mechanism of action may be related to the regulation of the Cx43 expression in myocardial tissue, improvement of the activity of Na+-K+-ATPase in myocardial tissue, and increase in the content of serum EDLF.
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Infectious diarrhea is an important public health problem, which has a significant impact on global disease burden. Under the background of climate change, rainstorms increase and floods occur frequently. Most studies show that the incidences of infectious diarrhea disease increase significantly after rainstorm and flood events. However, there is a lack of systematic summary on the path of rainstorm and flood events affecting the incidence of infectious diarrhea, including the key links and mechanisms underlying environmental-social interaction. This study comprehensively combed the literature from environmental factors, socio-economic and cultural factors, and population and individual susceptibility factors. The potential mechanisms of infectious diarrhea caused by rainstorm and flood events were discussed from the aspects of spreading of pathogens, affecting sanitation facilities and (or) drinking water treatment infrastructure, the regulatory role of individual and behavioral factors, and long-term effects. Based on the "pressure-state-response" model, a social driving process model of rainstorm and flood leading to incidence of infectious diarrhea was constructed. This model could provide reference for future quantitative modeling and other research directions. It is helpful to guide the public health departments to accurately identify factors affecting the incidence of infectious diarrhea after rainstorm and flood, so as to take targeted intervention measures.
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Background Climate change leads to frequent heavy rainfall events, and higher incidences of bacillary dysentery after heavy rainfall have been observed. The impacts of heavy rainfall and its antecedent rainfall conditions on the disease are worth paying attention to. Objective To quantitatively analyze how the relationship between heavy rainfall events and bacillary dysentery occurrence is modified by antecedent rainfall conditions in Anhui Province and explore the different moderation effects in urban and rural contexts. Methods CN05.1 meteorological data of Anhui Province and cases of bacillary dysentery of the same area were collected from January 1, 2006 to August 31, 2017. An exposure-response Poisson regression model of heavy rainfall events and the number of daily cases was constructed to explore the moderation effect of antecedent rainfall conditions on the incidence of bacillary dysentery, and further stratified by urban and rural areas. Results This study included 129 459 cases of bacillary dysentery, with a daily average of 30.39. Compared with dry antecedent conditions without heavy rainfall, dry antecedent conditions with heavy rainfall had no obvious different effect on the incidence of bacillary dysentery for the whole province (P>0.05). But wet antecedent conditions significantly increased the risk of bacillary dysentery for the whole province after heavy rainfall (wet antecedent conditions without heavy rainfall: RR=1.281, 95%CI: 1.264-1.298; wet antecedent conditions with heavy rainfall: RR=1.267, 95%CI: 1.167-1.376). After urban and rural stratification, antecedent rainfall conditions also showed a significant moderation effect on the incidence of bacillary dysentery following heavy rainfall events. Compared with dry antecedent conditions without heavy rainfall, dry antecedent conditions with heavy rainfall had no obvious effect on the incidence of bacillary dysentery for the urban and the rural populations (P > 0.05). However, wet antecedent conditions without heavy rainfall (urban: RR=1.391, 95%CI: 1.362-1.421; rural: RR=1.222, 95%CI: 1.201-1.243) and wet antecedent conditions with heavy rainfall (urban: RR=1.364, 95%CI: 1.193-1.559; rural: RR=1.218, 95%CI: 1.098-1.352) significantly increased the risk of bacillary dysentery in both rural and urban areas. Conclusion In the influence of heavy rainfall on the incidence of bacillary dysentery in Anhui Province, antecedent rainfall conditions have a certain moderation effect in the whole province and in both urban and rural areas, and the risk of bacillary dysentery is increased under wet antecedent conditions.
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Background Climate change has resulted in long-term impacts on human health. Implementing efficient adaptation strategies among primary healthcare facilities is well determined by whether staff of different genders recognize the health risks related to climate change and are willing to take active measures. Objective To investigate gender differences on perceptions of health risks and attitude towards adaptation strategies among primary healthcare workers in China, and provide relevant suggestions. Methods By adopting a multi-stage cluster sampling method, we selected 21 urban and 10 rural healthcare facilities in Guangdong Province to collect information with a questionnaire. Then chi-square test, Wilcoxon rank sum test, and logistic regression analysis were used to explore the gender differences in climate change-related health risk cognition, knowledge acquisition channels, attitudes towards adaptation strategies, main obstacles, and resource requirements among the healthcare workers. Results Of 733 participants, 38.47% (282 participants) were male and 61.53% (451 participants) were female. The percentages of male healthcare workers who agreed that climate change is happening and recognized the causes of climate change (70.21%, 60.99%) were higher than the percentages of female counterparts (59.87%, 49.00%) (both Ps＜0.05), but no obvious gender differences existed in recognizing health risks of heatwaves and infectious diseases as well as sensitive population identification (all Ps＞0.05). Most of the participants (92.50%) received climate change and health-related information from mass media like TV, radio, and newspapers. Meanwhile less men chose new media channels than women (OR=0.62, 95%CI∶ 0.41-0.94). Only 30.56% of the participants (33.69% of men and 28.60% of women) reported involvement of relevant training and lectures. Most of them (90.96%) agreed to take active measures to deal with the health threats associated with climate change without gender differences for various measures (all Ps＞0.05). The leading obstacles were hard to integrate health adaptation to climate change into main work of institutions (most female agreed, 72.28%) and the lack of funds (most male agreed, 77.66%). Increasing funding for primary health care was regarded as the most needed resource by male (86.88%) and female (89.14%). After controlling the influence of other social factors, more men agreed with the lack of funds than women (OR=1.57, 95%CI∶ 1.10-2.24). Conclusion There are some gender differences in the perceptions of health risks and adaptation strategies of climate change among primary healthcare workers: Male staff are more likely to agree with climate change and regard the lack of funds as the main obstacle, while women prefer to choose new media channels to obtain information. It’s suggested that the government and relevant institutions focus on the learning and training of climate change and health-related knowledge and expand diversified information access, and promote capacity building to cope with health threats at grass-root level, in the light of recognized gender differences among primary healthcare workers.
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Objective:To compare the efficacy of 2 fixation modes [dynamic hip screw (DHS) plus anti-rotation screw versus 3 cannulated compression screws (CCS)] in the treatment of femoral neck fractures complicated with comminuted posterior wall.Methods:The data were analyzed retrospectively of the 109 patients who had been treated for femoral neck fractures complicated with comminuted posterior wall at Department of Orthopaedics, Shenzhen Hospital, University of Chinese Academy of Sciences from February 2017 to December 2019. They were divided into 2 groups according to 2 fixation modes. There were 42 males and 16 females with an age of 48.5 (40.0, 55.3) years in CCS group of 58 cases subjected to fixation with 3 CCSs; there were 31 males and 20 females with an age of 47.0 (38.0, 53.0) years in DHS group of 51 cases subjected to fixation with DHS plus anti-rotation screw. The length of incision, operation time, intraoperative bleeding, weight-bearing time for the affected limb, visual analog scale (VAS), hip Harris score, and incidence of postoperative complications were compared between the 2 groups.Results:The comparison of preoperative general data between the 2 groups was not statistically significant, showing comparability between groups ( P>0.05). In the CCS group, the incision length [3.0 (2.9, 4.5) cm] and operation time [90.0 (73.8, 125.0) min] were significantly shorter than those in the DHS group [10.0 (9.0, 12.0) cm and 135.0 (110.0, 165.0) min], the intraoperative bleeding [40.0 (10.0, 100.0) mL] was significantly less than that in the DHS group [200.0 (150.0, 300.0) mL], the partial and complete weight-bearing durations of the affected limb [12.0 (12.0, 13.0) weeks and 24.0 (21.0, 25.0) weeks] were significantly longer than those in the DHS group [11.0 (10.0, 12.0) weeks and 19.0 (18.0, 20.0) weeks], and the perioperative VAS pain score [2.0 (2.0, 3.0) points] was significantly lower than that in the DHS group [5.0 (4.0, 6.0) points], but the incidence of follow-up complications [56.9% (33/58)] was significantly higher than that in the DHS group [33.3% (17/51)] (all P<0.05). There was no significant difference between the DHS group and the CCS group in the excellent and good rate of Harris hip score at one year after operation [94.1% (48/51) versus 91.4% (53/58)] ( P>0.05). Conclusions:In the treatment of femoral neck fractures complicated with comminuted posterior wall, DHS plus anti-rotation screw and 3 CCSs can both result in fine therapeutic outcomes but a relatively high incidence of complications at late follow-up. However, the former fixation mode can shorten the weight-bearing time for the affected limb and reduce complications but is more invasive than the latter fixation mode.
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Objective:To investigate the effects of compression treatment on occurrence of venous thromboembolism (VTE) after tension-free inguinal hernia repair.Methods:The retrospective cohort study was conducted. The clinical data of 13 263 patients with inguinal hernia who were admitted to 58 medical centers from January to December in 2017 were collected, including 1 668 in Beijing Chaoyang Hospital of Capital Medical University, 782 in East Hospital Affiliated to Tongji University, 558 in Huadong Hospital of Fudan University, 525 in Sir Run Run Shaw Hospital of Zhejiang University School of Medicine, 488 in Ruijin Hospital of Shanghai Jiaotong University School of Medicine, 382 in Tianjin People's Hospital, 378 in Peking University Third Hospital, 364 in Beijing Hospital, 356 in Shengjing Hospital of China Medical University, 348 in Huashan Hospital of Fudan University, 348 in Sichuan Provincial People's Hospital, 328 in Affiliated Hospital of Zunyi Medical University, 304 in Beijing Luhe Hospital of Capital Medical University, 296 in People's Hospital of Changshou District in Chongqing, 290 in Anhui Provincial Hospital, 281 in the First Affiliated Hospital of Dalian Medical University, 281 in Xinjiang Uygur Autonomous People's Hospital, 247 in Qilu Hospital of Shandong University, 220 in Wuhan NO.1 Hospital, 214 in the First Hospital of China Medical University, 213 in West China Hospital of Sichuan University, 206 in the Second Affiliated Hospital of Chongqing Medical University, 202 in Taiyuan Central Hospital of Shanxi Medical University, 197 in the First Affiliated Hospital of Wenzhou University, 191 in Zhongda Hospital of Southeast University, 190 in Tianjin Medical University General Hospital, 189 in Xuzhou Central Hospital, 188 in the First Affiliated Hospital of Harbin Medical University, 187 in the Second Hospital Affiliated to Naval Medical University, 175 in Chengdu Fifth People's Hospital, 173 in Tianjin Nankai Hospital, 172 in the Fourth Affiliated Hospital of China Medical University, 172 in Zhangjiakou First Hospital, 161 in Henan Provincial People's Hospital, 153 in the First Affiliated Hospital of Xi'an Jiaotong University, 149 in Shandong Provincial Hospital, 142 in the Second Hospital of Shandong University, 137 in the First Affiliated Hospital of Hunan University of Medicine, 136 in the Fourth Hospital of Harbin Medical University, 127 in Pingjiang District of the First Affiliated Hospital of Soochow University, 102 in the Central Hospital of Wuhan, 100 in the First Affiliated Hospital of Soochow University, 98 in Peking Union Medical College Hospital of Chinese Academy of Medical Sciences, 97 in the First Affiliated Hospital of Chongqing Medical University, 96 in Xijing Hospital Affiliated to Air Force Medical University, 90 in the Fourth Medical Center of Chinese PLA General Hospital, 81 in Hunan Provincial Hospital of Traditional Medicine, 80 in the First Hospital of Tsinghua University, 80 in Xinhua Hospital of Hubei Province, 61 in the First Affiliated Hospital of Zhengzhou University, 57 in Peking University International Hospital, 50 in Peking University First Hospital, 39 in Zhongnan Hospital of Wuhan University, 38 in Jilin Yan'an Hospital, 37 in China-Japan Union Hospital of Jilin University, 20 in Taikang Xianlin Drum Hospital, 16 in Chinese PLA General Hospital, 3 in the First Affiliated Hospital of Fujian Medical University. There were 11 852 males and 1 411 females, aged from 18 to 102 years, with a median age of 64 years. Of 13 263 patients, 9 995 with compression treatment after tension-free inguinal hernia repair were divided into compression group and 3 268 without compression treatment after tension-free inguinal hernia repair were divided into non-compression group. Observation indicators: (1) compression treatment of patients in the compression group; (2) occurrence of VTE after tension-free inguinal hernia repair in the two groups; (3) analysis of influencing factors for VTE after tension-free inguinal hernia repair. Follow-up using telephone interview was performed to detect history of patient's thrombosis, medical history of patient's family and the incidence of postoperative VTE up to February 2018. Measurement data with skewed distribution were represented as M ( P25, P75) or M (range), and comparison between groups was analyzed using the Wilcoxon rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Univariate analysis and multivariate analysis were conducted using the Logistic regression model. Results:(1) Compression treatment of patients in the compression group: of the 9 995 patients in the compression group, 6 086 underwent compression treatment with 0.5 kg of sandbag or 500 mL of packed 0.9% sodium chloride solution, 1 881 underwent compression treatment with trusses, 745 underwent compression treatment with girdles, 675 underwent compression treatment with elastic underwear combined with 0.5 kg of sandbag, and 608 underwent compression treatment with elastic underwear. (2) Occurrence of VTE after tension-free inguinal hernia repair in the two groups: patients of the two groups after matching were followed up. Occurrence of VTE after matching were 15 and 1 in the compression group and non-compression group, respectively, showing no significant difference between the two groups ( χ2=2.010, P>0.05). (3) Analysis of influencing factors for VTE after tension-free inguinal hernia repair: results of univariate analysis showed that cases with varix of lower limb, cases with oral contracep-tives or hormone replacement therapy history, cases with VTE history, clinical classification, clinical typing, surgical method, cases with anticoagulant drugs history, cases undergoing oral antiplatelet drugs, cases undergoing postoperative VTE prevention with medication were related factors for occurrence of VTE after tension-free inguinal hernia repair ( odds ratio=13.98, 37.71, 19.21, 4.43, 4.21, 0.07, 0.08, 0.10, 31.04, 95% confidence interval: 3.15?62.11, 8.35?170.24, 6.15?60.00, 1.43?13.76, 1.20?14.82, 0.01?0.49, 0.02?0.27, 0.04?0.29, 8.53?112.93, P<0.05). Results of multivariate analysis showed that cases with VTE history and surgical method were independent influencing factors for occurrence of VTE after tension-free inguinal hernia repair ( odds ratio=7.78, 11.19, 95% confidence interval: 2.06?29.42, 1.45?86.55, P<0.05). Conclusion:Cases with VTE history and surgical method are independent influencing factors for occurrence of VTE after tension-free inguinal hernia repair.
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Objective:To investigate the effects of compression treatment on occurrence of seroma after tension-free inguinal hernia repair.Methods:The propensity score matching and retrospective cohort study was conducted. The clinical data of 6 600 patients with unilateral inguinal hernia who were admitted to 51 medical centers from January to December in 2017 were collected, including 917 in Beijing Chaoyang Hospital of Capital Medical University, 451 in East Hospital Affiliated to Tongji University, 363 in Huadong Hospital of Fudan University, 307 in Ruijin Hospital of Shanghai Jiaotong University School of Medicine, 254 in Sir Run Run Shan Hospital of Zhejiang University School of Medicine, 222 in Sichuan Provincial People′s Hospital, 221 in Beijing Luhe Hospital of Capital Medical University, 202 in Shengjing Hospital of China Medical University, 191 in Anhui Provincial Hospital, 181 in Affiliated Hospital of Zunyi Medical University, 174 in Tianjin People′s Hospital, 169 in the First Affiliated Hospital of Dalian Medical University, 155 in People′s Hospital of Changshou in Chongqing, 152 in Qilu Hospital of Shandong University, 146 in the First Affiliated Hospital of Fujian Medical University, 136 in Taiyuan Central Hospital of Shanxi Medical University, 134 in First Hospital of Wuhan, 122 in Xinjiang Uygur Autonomous People′s Hospital, 122 in the Second Affiliated Hospital of Chongqing Medical University, 118 in the Second Hospital Affiliated to Naval Medical University, 113 in Xuzhou Central Hospital, 112 in the First Affiliated Hospital of Harbin Medical University, 112 in the First Affiliated Hospital of Wenzhou Medical University, 102 in the Second Hospital of Shandong University, 100 in Tianjin Hospital of Itcwm Nankai Hospital, 99 in Shandong Provincial Hospital, 90 in Huashan Hospital of Fudan University, 88 in Henan Provincial People′s Hospital, 87 in West China Hospital of Sichuan University, 86 in Zhangjiakou First Hospital, 86 in the First Affiliated Hospital Soochow University, 77 in the Fourth Affiliated Hospital of China Medical University, 75 in Tianjin Medical University General Hospital, 72 in the First Affiliated Hospital of Hunan University of Medicine, 67 in First Affiliated Hospital of Xi′an Jiaotong University, 49 in the First Hospital of China Medical University, 49 in Hunan Provincial Hospital of Traditional Medicine, 48 in Xijing Hospital Affiliated to Air Force Medical University, 47 in Xinhua Hospital of Hubei Province, 46 in the First Hospital of Tsinghua University, 45 in the First Affiliated Hospital of Chongqing Medical University, 34 in the First Affiliated Hospital of Zhengzhou University, 29 in Peking University International Hospital, 28 in Jilin Yan′an Hospital, 25 in China-Japan Union Hospital of Jilin University, 22 in Peking University Third Hospital, 22 in Peking University First Hospital, 20 in the Fourth Affiliated Hospital of Harbin Medical University, 19 in Chengdu Fifth People′s Hospital, 8 in Chinese PLA General Hospital, 6 in Taikang Xianlin Drum Hospital. There were 5 850 males and 750 females, aged (57±16)years, with the range from 18 to 92 years. Of the 6 600 patients, 4 939 with compression treatment after tension-free inguinal hernia repair were divided into compression group and 1 661 without compression treatment after tension-free inguinal hernia repair were divided into non-compression group. Observation indicators: (1) the propensity score matching conditions and comparison of general data between the two groups after matching; (2) compression treatment of patients in the compression group after matching; (3) occurrence of seroma after tension-free inguinal hernia repair in the two groups after matching; (4) analysis of influencing factors for seroma after tension-free inguinal hernia repair. Follow-up using outpatient examination was performed at postoperative 14 days and 30 days to detect occurrence of seroma after tension-free inguinal hernia repair of patients up to January 2018. The propensity score matching was realized using the nearest neighbor method with 1∶1 ratio and caliper setting as 0.01. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analysed using the t test. Measurement data with skewed distribution were represented as M ( P25, P75) or M (range), and comparison between groups was analysed using the Wilcoxon rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was analysed using the chi-square test. Univariate analysis and multivariate analysis were conducted using the Logistic regression model. Results:(1) The propensity score matching conditions and comparison of general data between the two groups after matching: 3 322 of 6 600 patients had successful matching, including 1 661 in each group. Cases with smoking history, cases with coronary heart disease, cases with diabetes, cases with reducible hernia, irreducible hernia, incarcerated hernia, strangulated hernia (hernia grading), cases with Lichtenstein repair, cases with transabdominal preperitoneal patch repair, totally extraperitoneal repair(surgical methods), operation time, cases with emergency operation before propensity score matching were 1 110, 273, 333, 4 606, 63, 262, 8, 1 636, 2 515, 788, 60 minutes(50 minutes, 90 minutes), 155 in the compression group, and 233, 55, 87, 1 572, 28, 57, 4, 478, 941, 242, 60 minutes(45 minutes, 80 minutes), 29 in the non-compression group, respectively, showing significant differences in the above indicators between the two groups ( χ2=54.713, 12.927, 4.721, 11.218, 16.656, Z=-7.598, χ2=8.891, P<0.05). After propensity score matching, the above indicators were 231, 63, 82, 1 579, 20, 61, 1, 526, 826, 309, 60 minutes(45 minutes, 81 minutes), 34 in the compression group, and 233, 55, 87, 1 572, 28, 57, 4, 478, 941, 242, 60 minutes(45 minutes, 80 minutes), 29 in the non-compression group, respectively, showing no significant difference in the above indicators between the two groups ( χ2=0.018, 0.624, 0.157, 0.159, 0.240, Z=0.001, χ2=0.468, P>0.05). (2) Compression treatment of patients in the compression group after matching: of the 1 661 patients in the compression group after matching, 968 underwent compression treatment with 0.5 kg of sandbag or 500 mL of packed 0.9% sodium chloride solution, 109 underwent compression treatment with trusses, 112 underwent compression treatment with girdles, 311 underwent compression treatment with elastic underwear and 161 underwent compression treatment with elastic underwear combined with 0.5 kg of sandbag. (3) Occurrence of seroma after tension-free inguinal hernia repair in the two groups after matching: patients of the two groups after matching were followed up at postoperative 14 days and 30 days. Occurrence of seroma after matching were 44 and 15 in the compression group and non-compression group, respectively, showing a significant difference between the two groups ( χ2=13.299, P<0.05). (4) Analysis of influencing factors for seroma after tension-free inguinal hernia repair. Results of univariate analysis showed that cases with direct inguinal hernia, cases undergoing compression treatment with 0.5 kg of sandbag or 500 mL of packed 0.9% sodium chloride solution were related factors for occurrence of seroma after tension-free inguinal hernia repair ( odds ratio=0.518, 4.689, 95% confidence interval: 0.271-0.989, 2.730-8.055, P<0.05). Results of multivariate analysis showed that compared with no compression treatment, cases undergoing compression treatment with 0.5kg sandbag or 500 mL pack of 0.9% sodium chloride solution was an independent risk factor for occurrence of seroma after tension-free inguinal hernia repair ( odds ratio=4.698, 95% confidence interval: 2.734-8.073, P<0.05). Conclusion:Compared with no compression treatment, cases undergoing compression treatment with 0.5 kg of sandbag or 500 mL of packed 0.9% sodium chloride solution is an independent risk factor for occurrence of seroma after tension-free inguinal hernia repair.
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Primary liver cancer is one of the most common cancer worldwide. Hepatocellular carcinoma (HCC) in particular, is the second leading cause of cancer deaths in the world. The Hippo signaling pathway has emerged as a major oncosuppressive pathway that plays critical roles inhibiting hepatocyte proliferation, survival, and HCC formation. A key component of the Hippo pathway is the inhibition of yes-associated protein (YAP)/transcriptional co-activator with PDZ-binding motif (TAZ) transcription factors by the Hippo kinase cascade. Aberrant activation of YAP or TAZ has been found in several human cancers including HCC. It is also well established that YAP/TAZ activation in hepatocytes causes HCC in mouse models, indicating that YAP/TAZ are potential therapeutic targets for human liver cancer. In this review, we summarize the recent findings regarding the multifarious roles of Hippo/YAP/TAZ in HCC development, and focus on their cell autonomous roles in controlling hepatocyte proliferation, differentiation, survival and metabolism as well as their non-cell autonomous in shaping the tumor microenvironment.
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Objective To evaluate treatment experience for mesh infection after inguinal hernia repair.Methods 392 cases underwent surgery for mesh infection after inguinal hernia repair in Beijing Chaoyang Hospital from Jan 2007 to Jun 2018.For mesh infection after open inguinal hernia repair,infected mesh and tissue were removed by open operation,while laparoscopic operation was adopted for mesh infection after laparoscopic inguinal hernia repair.Time of infection,type of bacteria,and hernia recurrence were evaluated.Results 369 cases suffered mesh infection after open inguinal hernia repair and 23 cases were after laparoscopic inguinal hernia repair.61 cases suffered mesh infection within 3 months,258 cases were from 3 months to 1 year and 73 cases were after one year.During follow up of 6 to 36 months after operation,29 cases suffered hernia recurrence in 24 to 34 months after removal of mesh.Bacterial culture were positive in 193 cases,including 126 cases of staphylococcus aureus,18 cases of escherichia coli and 15 cases of pseudomonas aeruginosa.Conclusion Individualized treatment policy based on original mesh placement is safe and effective for mesh infection after inguinal hemiorrhaphy.
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Objective To investigate the clinical value of biological mesh in repairing abdominal wall defect after tumor resection.Methods 15 patients with abdominal wall defect left over by radial resection of abdominal wall tumor were treated with primary biological mesh herniorrhaphy from Sep 2015 to Sep 2017 at the Department of Hernia and Abdominal Wall Surgery of Beijing Chaoyang Hospital.Results The operation was successful in all 15 patients.The operation time was 95 (65-145)main.The hospital stay was 17 (9-22) d.The patients were followed up for 18 (17-32) months.postoperative seroma occurred in 8 cases,postoperative fever occurred in 1 case.One case died of multiple systemic metastases of advanced gastric cancer.All the other patients were followed up without complaining about local pain,foreign body sensation,intestinal obstruction,intestinal fistula.Conclusions Biological mesh is safe and feasible for the treatment of abdominal wall defect after tumor resection.
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Objective@#To investigate the clinical value of biological mesh in repairing abdominal wall defect after tumor resection.@*Methods@#15 patients with abdominal wall defect left over by radial resection of abdominal wall tumor were treated with primary biological mesh herniorrhaphy from Sep 2015 to Sep 2017 at the Department of Hernia and Abdominal Wall Surgery of Beijing Chaoyang Hospital.@*Results@#The operation was successful in all 15 patients. The operation time was 95(65-145)min. The hospital stay was 17(9-22)d. The patients were followed up for 18(17-32) months. postoperative seroma occurred in 8 cases, postoperative fever occurred in 1 case. One case died of multiple systemic metastases of advanced gastric cancer. All the other patients were followed up without complaining about local pain, foreign body sensation, intestinal obstruction, intestinal fistula.@*Conclusions@#Biological mesh is safe and feasible for the treatment of abdominal wall defect after tumor resection.
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Objective@#To evaluate treatment experience for mesh infection after inguinal hernia repair.@*Methods@#392 cases underwent surgery for mesh infection after inguinal hernia repair in Beijing Chaoyang Hospital from Jan 2007 to Jun 2018. For mesh infection after open inguinal hernia repair, infected mesh and tissue were removed by open operation, while laparoscopic operation was adopted for mesh infection after laparoscopic inguinal hernia repair. Time of infection, type of bacteria, and hernia recurrence were evaluated.@*Results@#369 cases suffered mesh infection after open inguinal hernia repair and 23 cases were after laparoscopic inguinal hernia repair. 61 cases suffered mesh infection within 3 months, 258 cases were from 3 months to 1 year and 73 cases were after one year. During follow up of 6 to 36 months after operation, 29 cases suffered hernia recurrence in 24 to 34 months after removal of mesh. Bacterial culture were positive in 193 cases, including 126 cases of staphylococcus aureus, 18 cases of escherichia coli and 15 cases of pseudomonas aeruginosa.@*Conclusion@#Individualized treatment policy based on original mesh placement is safe and effective for mesh infection after inguinal hemiorrhaphy.
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OBJECTIVE： To study the effects of ethyl acetate part form the ethanol extract of Periploca forrestii on cardiac function of isolated frog heart， and to primarily investigate its potential mechanism. METHODS： The isolated frog heart samples were prepared by using the intube method of steinmann. The Ren’s solution （blank control）， 1.70 mg/mL and 3.48 mg/mL ethyl acetate part from ethanol extract of P. forrestii were used to perfuse the sample. The BL-420 biological function experimental system was used to record the changes in heart rate and myocardial contractility. The effects of ethyl acetate part from ethanol extract of P. forrestii on cardiac function of isolated frog heart were investigated. After perfused with 10 mg/L atropine， 20 μL isoproterenol， 1 μL low calcium （per 1 000 mL pure water contain 0.06 g CaCl2）， high calcium Ren’s solution （per 1 000 mL pure water contain 0.24 g CaCl2）， adding 1.74 mg/mL ethyl acetate part from ethanol extract of P. forrestii， the changes of myocardial contractility in isolated hearts were recorded by BL-420 biological function experimental system. Myocardial tissue was collected after perfused with Ren’s solution （blank control） and ethyl acetate part from ethanol extract of P. forrestii with 1.74 and 3.48 mg/mL. The activity of Na+-K+-ATPase， Ca2+-Mg2+-ATPase and AChE were detected to investigate the potential mechanism of the effects of ethyl acetate extract from ethanol extract of P. forrestii on cardiac function. RESULTS： Compared with blank control， mean myocardial contractility was significantly decreased （P＜0.001） after adding 1.74， 3.48 mg/mL ethyl acetate part form ethanol extract of P. forrestii， but had no significant on heart rate （P＞0.05）. With the increase of extracellular Ca2+ concentration， the inhibitory effect of ethyl acetate part from ethanol extract of P. forrestii on isolated frog heart contraction also increased gradually. After adding atropine and isoproterenol， the inhibitory effect of the ethyl acetate part form ethanol extract of P. forrestii on isolated frog heart contraction decreased to some certain. The activity of Na+-K+-ATPase in cardiac tissue was not significantly changed （P＞0.05）， the activity of Ca2+-Mg2+-ATPase was significantly increased （P＜0.05）， and the activity of AChE was significantly decreased （P＜0.05） after perfused with 1.74， 3.48 mg/mL ethyl acetate part form ethanol extract of P. forrestii. CONCLUSIONS： The ethyl acetate part from the ethanol extract of P. forrestii can inhibit the contractile activity of the isolated frog heart and has a certain negative inotropic effect. The mechanism may be related to the increase of Ca2+-Mg2+-ATPase activity， inhibition of AChE activity， blocking of calcium channel in the cell membrane， the activation of M receptor and blocking of β receptor.
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OBJECTIVE： To optimize the extraction technology of the flavonoids from Glycyrrhiza uralensis. METHODS： Using total contents of four flavonoids， liquiritinapioside， glycyrrhizin， isoliquiritin apioside and formononetin as indexes， types and volume fractions of extraction solvents （water， ethanol）， volume of addition and extraction time as factors， based on single factor experiment， Box-Behnken design-response surface method was used to optimize the extraction technology of flavonoids from G. uralensis. Validation test was also conducted. RESULTS： The optimal extraction technology was 50 mL 50％ ethanol as extraction solvent， 0.200 g G. uralensis， ultrasonic extraction for 50 min. In validation test， the extraction amounts of liquiritinapioside， glycyrrhizin， isoliquiritin apioside and formononetin were 10.733 0， 27.784 9， 3.441 9， 0.429 1 mg/g， respectively （all RSDs＜3.0％， n＝3）. The average total extraction amount of four flavonoids was obtained was 42.388 9 mg/g， the relative error of which to predicted value （42.173 2 mg/g） was 0.52％ （n＝3）. CONCLUSIONS： The optimized extraction technology is simple， rapid and stable， and can be used for the extraction of flavonoids from G. uralensis.