Advances in Salmonella-mediated targeted tumor therapy / 药学学报

italic>Salmonella has emerged as a promising tumor-targeting strategy in recent years due to its good tumor targeting ability and certain safety. In order to further optimize its therapeutic effect, scientists have tried to modify Salmonella, including its attenuation and drug loading. This paper summarizes the mechanism and research progress of Salmonella-mediated targeted tumor therapy, and introduces the strategies and related progress of its modification and optimization. At the same time, the advantages, current challenges and future development directions of Salmonella-mediated tumor therapy are summarized.

The risk surveillance of schistosomiasis in Yunnan, 2021 / 中国热带医学

@#Abstract: Objective　To evaluate the potential transmission risk of schistosomiasis in Yunnan Province, and to provide strategic basis for the prevention and control. Methods　Based on the prevalence of schistosomiasis, the social and environmental factors that may lead to the epidemic, 1-3 villages from 3 provincial-level and 15 county-level counties (cities and districts) were selected as the evaluated villages in 2021. The risk of schistosomiasis spread was analyzed comprehensively by consulting, reviewing and collecting routine surveillance data of schistosomiasis in the villages, combined with snail and wild feces survey. The risk level was evaluated for the positive snails, positive wild feces, resident infection, average density of live snails and snail frame occurrence rate. Results　Totally 7 snail counties schistosomiasis transmission was blocked of 18 epidemic counties and the rest were eliminated counties. A total of 152 447 snail frames were investigated and 3 043 frames with snails, 15 895 snails were captured and included 15 727 live snails in the 32 evaluated villages. The total area of snail was 58.87 hm2 and the area of reoccurrence was 34.19 hm2 with snail frame occurrence rate of 2.00% and average density of live snails 0.103 2/0.11 m2, and no positive snails were found by loop-mediated isothermal amplification (LAMP) assay. A total of 1 374 wild feces were collected in 27 evaluated villages of 14 epidemic counties, mainly from cattle, dogs, sheep, equine animals, pigs and so on, all of which were negative. According to the risk assessment of epidemic spread, Yongle Village and Yongsheng Village in Eryuan County, Zhiming Village in Chuxiong City were Ⅱ risk, and the rest were Ⅲ risk. Conclusions　Although the risk of transmission is low in Yunnan Province, the risk of transmission and spread still exists. It is necessary to strengthen the risk monitoring, control of snail and effective management of livestock to prevent the rebound of the epidemic.

Death and life loss of malignant tumors in Xicheng District from 2014 to 2021 / 预防医学

Objective@#To investigate the mortality and life loss of malignant tumors among residents in Xicheng District, Beijing from 2014 to 2021, so as to provide the evidence for formulating the control strategy for malignant tumors.@*Methods@#Data pertaining to dead cases of malignant tumors in Xicheng District from 2014 to 2021 were collected from Beijing Integrated and Analysis Platform for Health and Disease Prevention Monitoring Information Resources. The crude mortality, standardized mortality, years of potential life lost (YPLL), years of potential life lost rate (YPLLR), rate of standardized years of potential life lost (SYPLLR), average years of life lost (AYLL) and annual percent change (APC) of malignant tumors were measured to analyze the trends in mortality of malignant tumors and life loss.@*Results@#A total of 23 202 residents died from malignant tumors in Xicheng District from 2014 to 2021, and the crude and standardized mortality rates of malignant tumors were 198.09/105 and 101.46/105, respectively. The standardized mortality of malignant tumors was 117.36/105 among men and 85.97/105 among women. The standard mortality of malignant tumors appeared a tendency towards a decline among all cases (APC=-1.515%, t=-4.289, P=0.005) and women (APC=-1.629%, t=-3.046, P=0.023), and the crude mortality of malignant tumors appeared a tendency towards a rise with age (χ2trend=49.324, P<0.001). The five most deadly malignant tumors included lung cancer, colorectal cancer, liver cancer, stomach cancer and pancreatic cancer, and lung cancer, liver cancer and colorectal cancer were the three malignant tumors with the three highest life loss, with YPLL of 18 054 person-years, 9 446 person-years and 8 179 person-years, respectively. Leukemia had the highest AYLL (15.95 years per person).@*Conclusions@#The standardized mortality of malignant tumors appeared a tendency towards a decline among residents in Xicheng District from 2014 to 2021, and men and the elderly people were at high risk of malignant tumors. Lung cancer, colorectal cancer and liver cancer were leading causes of death, leukemia was the major cause of life loss.

Differential diagnosis and surgical management in chondrosarcoma of the jugular foramen / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the diagnosis, surgical management and outcome of jugular foramen chondrosarcoma (CSA). Methods: Fifteen patients with jugular foramen CSA hospitalized in the Department of Otorhinolaryngology Head and Neck Surgery of Chinese PLA General Hospital from December 2002 to February 2020 were retrospectively collected,of whom 2 were male and 13 were female, aging from 22 to 61 years old. The clinical symptoms and signs, imaging features, differential diagnosis, surgical approaches, function of facial nerve and cranial nerves IX to XII, and surgical outcomes were analyzed. Results: Patients with jugular foramen CSA mainly presented with facial paralysis, hearing loss, hoarseness, cough, tinnitus and local mass. Computed tomography (CT) and magnetic resonance (MR) could provide important information for diagnosis. CT showed irregular destruction on bone margin of the jugular foramen. MR demonstrated iso or hypointense on T1WI, hyperintense on T2WI and heterogeneous contrast-enhancement. Surgical approaches were chosen upon the sizes and scopes of the tumors. Inferior temporal fossa A approach was adopted in 12 cases, inferior temporal fossa B approach in 2 cases and mastoid combined parotid approach in 1 case. Five patients with facial nerve involved received great auricular nerve graft. The House Brackmann (H-B) grading scale was used to evaluate the facial nerve function. Preoperative facial nerve function ranked grade Ⅴ in 4 cases and grade Ⅵ in 1 case. Postoperative facial nerve function improved to grade Ⅲ in 2 cases and grade Ⅵ in 3 cases. Five patients presented with cranial nerves Ⅸ and Ⅹ palsies. Hoarseness and cough of 2 cases improved after operation, while the other 3 cases did not. All the patients were diagnosed CSA by histopathology and immunohistochemistry, with immunohistochemical staining showing vimentin and S-100 positive, but cytokeratin negative in tumor cells. All patients survived during 28 to 234 months' follow-up. Two patients suffered from tumor recurrence 7 years after surgery and received revision surgery. No complications such as cerebrospinal fluid leakage and intracranial infection occurred after operation. Conclusions: Jugular foramen CSA lacks characteristic symptoms or signs. Imaging is helpful to differential diagnosis. Surgery is the primary treatment of jugular foramen CSA. Patients with facial paralysis should receive surgery in time as to restore the facial nerve. Long-term follow-up is necessary after surgery in case of recurrence.

Efficacy of polyetheretherketone rod hybrid surgery in preventing proximal junctional failure after adult spinal deformity surgery / 中华外科杂志

Objective: To investigate the clinical outcome and preventive effect of polyetheretherketone(PEEK) rod hybrid surgery on proximal junction failure(PJF) after long-segment fusion of adult spinal deformity. Methods: A retrospective study was conducted to analyze patients with degenerative scoliosis/kyphosis who underwent long-segment decompression and fusion surgery at Department of Orthopedics, Peking University First Hospital from January 2017 to December 2021. A total of 75 patients were included in the study, including 14 males and 61 females, aged (67.2±6.8)years (range:55 to 84 years). According to the operation method chosen by the patients, the patients were divided into PEEK rod hybrid group (20 cases) and traditional titanium rod group (55 cases). The general information of the patients was collected, and the coronal and sagittal parameters of the spine were measured before operation, at 1 month after operation, and at the last follow-up. The clinical effect of surgery was judged by the visual analogue scale (VAS) and Oswestry disability index (ODI). Whether proximal junctional kyphosis (PJK) and PJF occurred during the follow-up and the time of occurrence were recorded. Comparisons between groups were performed using independent sample t test, Mann-Whitney U test, χ2 test and Fisher's exact probability method. The data before and after surgery in the same group were compared using the paired sample t test and the Wilcoxon test. Results: There were no significant differences in age, gender, body mass index, bone mineral density, distal instrumented vertebrae, surgical segments, osteotomy method, operation time, and intraoperative bleeding between the two groups (all P>0.05). The follow-up time of the PEEK rod group was shorter(M(IQR)16.5(4.8) vs. 25.0(12.0),Z=-4.230,t<0.01). There were no significant differences in coronal, sagittal parameters, VAS, and ODI between the two groups before operation (all P>0.05). Postoperative coronal Cobb angle, pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, thoracic kyphosis, sagittal vertical axis (SVA), VAS, and ODI were significantly improved in both groups(all P<0.05). At the last follow-up, the SVA of the PEEK rod hybrid group was(3.74±2.40)cm, which was significantly lower than that of the titanium rod group (6.28±4.06)cm (t'=-3.318, P=0.002). At the last follow-up, the ODI of the PEEK rod hybrid group was 30.7±6.1, significantly better than the titanium rod group 39.3±17.2. PJK occurred in 2 patients (10.0%) in the PEEK rod hybrid group, and no PJF phenomenon was observed. In the titanium rod group, 18 patients (32.7%) developed PJK, and 11 patients (20.0%) developed PJF. There was a statistically significant difference in the incidence of PJF between the PEEK rod hybrid group and the titanium rod group (P=0.031). Conclusions: PEEK rod hybrid surgery can achieve good clinical results in the treatment of adult spinal deformities. Compared with traditional titanium rod surgery, it can significantly reduce the incidence of postoperative PJF and improve the clinical function of patients.

Traditional Chinese medicine therapy for rheumatoid arthritis: a review / 中国中药杂志

Rheumatoid arthritis(RA) is an autoimmune disease that seriously affects the physical and mental health of patients, but its pathogenesis is still unclear. At present, clinical treatment drugs include conventional synthetic disease modifing anti-rheumatic drugs(csDMARDs), nonsteroid anti-inflammtory drugs(NSAIDs), hormones, small molecule targeted drugs, biological agents, etc. These drugs can relieve the clinical symptoms of most patients with RA to a certain extent, but there are still many limitations, such as drug adverse reactions and individual differences in drug efficacy. Therefore, the research on drug treatment targets and the development of low-toxicity drugs helps further improve the precise prevention, diagnosis, and treatment of RA. There is an urgent need for efficient and low-toxic treatments to delay the clinical progress of RA. As a treasure of Chinese culture, traditional Chinese medicine(TCM) is widely used as an alternative therapy in the treatment of various diseases, and has a significant clinical efficacy. TCM therapy(including monomer traditional Chinese medicine, classical compounds, and non-drug therapies) has a significant curative effect on RA. Based on the literature research in recent years, this paper reviewed the clinical and mechanism research of TCM therapy in the treatment of RA, and provided more in-depth thinking for the wide application of TCM therapy in clinical practice.

Factors Influencing and Adverse Reactions of Voriconazole Clearance in Patients with Hematological Diseases / 中国实验血液学杂志

OBJECTIVE@#To monitor the changes of voriconazole minimum concentration(Cmin) in patients with hematological diseases, and evaluate the factors influencing and adverse reactions of voriconazole clearance in patients with hematological diseases, so as to provide a theoretical basis for reasonable clinical use of voriconazole.@*METHODS@#136 patients with hematological diseases who used voriconazole in Wuhan NO.1 Hospital from May 2018 to December 2019 were selected. The correlation between C-reactive protein, albumin, creatinine and voriconazole Cmin were analyzed, and the changes of voriconazole Cmin after glucocorticoid treatment was also detected. In addition, stratified analysis was used to explore the adverse events of voriconazole.@*RESULTS@#Among 136 patients, 77 were male (56.62%) and 59 were female (43.38%). There were positive correlations between voriconazole Cmin and C-reactive protein and creatinine levels (r=0.277, r=0.208), while voriconazole Cmin was negatively correlated with albumin level (r=-2.673). Voriconazole Cmin in patients treated with glucocorticoid was decreased significantly (P<0.05). In addition, sratified analysis of voriconazole Cmin showed that compared with voriconazole Cmin 1.0-5.0 mg/L group, the incidence of adverse reactions of visual impairment in voriconazole Cmin> 5.0 mg/L group was increased (χ2=4.318, P=0.038).@*CONCLUSION@#The levels of C-reactive protein, albumin and creatinine are closely related to the voriconazole Cmin, which indicate that inflammation and hyponutrition may prevent the clearance of voriconazole in patients with hematological diseases. It is necessary to monitor the voriconazole Cmin of patients with hematological diseases, and adjust the dosage in time to reduce adverse reactions.

Constructing the educational quality evaluation system for the master of public health / 中华医学教育探索杂志

Objective:To construct a practical education training quality evaluation system that can monitor the entire training process for the master of public health, and to provide a basis for improving the public health education system.Methods:Based on the survey of the current status of the master of public health, combined with the literature survey, the focus group discussion and the expert forum, an evaluation system was established, and the weight coefficient of each index was determined by the analytic hierarchy process (AHP). All data were entered by Excel double-person, and matlabR2018a was used to calculate the weight, and determine the maximum characteristic root of the matrix, consistency index and consistency ratio.Results:The evaluation index system consisted of 7 first-level indicators and 24 second-level indicators. The average authority coefficient of 32 experts was 0.791. The top three items with the highest weight in the first-level indicators were mentor guidance (0.213), professional practice (0.157) and scientific research topics (0.149). The weight coefficient consistency ratio ( CR) was 0.040, showing that the consistency test passed ( CR<0.1). Conclusion:The educational quality evaluation system of the master of public health constructed by the institute is scientific, and the weight of the evaluation index reflects the focus of the postgraduate training process of the master of public health, which can provide a reference for improving the quality of public health professionals.

Network Meta-analysis of efficacy and safety of Chinese patent medicines in treatment of ankylosing spondylitis / 中国中药杂志

To evaluate the efficacy and safety of Chinese patent medicines in the treatment of ankylosing spondylitis(AS) by frequency network Meta-analysis. Randomized controlled trials(RCTs)of Chinese patent medicines for AS were retrieved from CNKI, Wanfang, VIP, CBM, PubMed, EMbase and Cochrane Library databases from the time of database establishment to January 2021. The quality of the included RCTs was evaluated according to the Cochrane bias risk standard, and the data was analyzed by RevMan 5.3 and Stata/MP 15.1. A total of 12 kinds of Chinese patent medicines in 55 RCTs were included. According to Meta-analysis, in term of the effectiveness, the top three optimal medication regimens were Biqi Capsules, Yishen Juanbi Pills and Yaobitong Capsules combined with western medicine. The top three interventions to reduce the erythrocyte sedimentation rate(ESR)were Yishen Juanbi Pills, Xianling Gubao Capsules and Fufang Xuanju Capsules combined with western medicine. The top three interventions to reduce the C-reactive protein(CRP)were Biqi Capsules, Xianling Gubao Capsules and Fufang Xuanju Capsules combined with western medicine. In terms of the safety, top three optimal medication regimens were Total Glucosides of Paeony Capsules, Yishen Juanbi Pills, and Wangbi Tablets combined with western medicine. This network Meta-analysis suggests that Chinese patent medicines combined with conventional western medicine can effectively improve the joint pain symptoms of AS patients and reduce the acute inflammatory indicators, with high safety. However, the literature included in this study is generally of low methodological quality, and the conclusion needs to be verified by high-quality research.

Review of the Reasons in Cases Requiring Varus/Valgus Constrained Prosthesis in Primary Total Knee Arthroplasty / 대한정형외과학회잡지

Purpose@#The least constrained prosthesis is generally recommended in primary total knee arthroplasty (TKA). Nevertheless, a varus/valgus constrained (VVC) prosthesis should be implanted when a semi-constrained prosthesis is not good for adequate stability, especially in the coronal plane. In domestic situations, however, the VVC prosthesis could not always be prepared for every primary TKA case. Therefore, it is sometimes impractical to use a VVC prosthesis for unsual unstable situations. This study provides information for preparing VVC prostheses in the preoperative planning of primary TKA through an analysis of primary VVC TKA cases. @*Materials and Methods@#This study reviewed 1,797 primary TKAs, performed between May 2003 and February 2016. The reasons for requiring VVC prosthesis and the preoperative conditions in 29 TKAs that underwent primary TKA with a VVC prosthesis were analyzed retrospectively. @*Results@#In primary TKA, 29 cases (1.6%) in 27 patients (6 male and 21 female) used VVC prosthesis. Two patients underwent a VVC prosthesis on both knees. The mean age of the patients was 63.4 years old (34–79 years). The mean flexion contracture was 16.2° (-20°–90°), and the mean angle of great flexion was 111.7° (35°–145°). The situations requiring a VVC prosthesis were severe valgus deformity in 10 knees, knee stiffness requiring extensive soft tissue release in 10 knees, previously injured collateral ligaments in five knees, and distal femoral bone defect due to avascular necrosis in four knees. The mean tibiofemoral angle was 25.7° (21°–43°) in 10 cases with a valgus deformity. The mean flexion contracture was 37.5° (20°–90°), and the mean range of motion was 48.5° (10°–70°) in 10 cases with knee stiffness. @*Conclusion@#The preparation of VVC prosthesis is recommended, even for primary TKA in cases of severe valgus deformity (tibiofemoral angle>20°), stiff knee (the range of motion: less than 70° with more than 20° flexion contracture), and the cases with a previous collateral ligament injury. This information will help in the preparation of adequate TKA prostheses for unusual unstable situations.

Transpyloric optic navigation of tumor using a laparoscope during totally laparoscopic distal gastrectomy for gastric cancer

Purpose@#The purpose of this study was to describe the technique of intraoperative transpyloric optic navigation (TPON) and determine its efficacy and feasibility during totally laparoscopic distal gastrectomy (TLDG) in patients with gastric cancer. @*Methods@#Seventy-nine patients who underwent laparoscopic gastrectomy with transpyloric optic localization of the tumor from January 2016 through December 2018 were enrolled in this study. After resecting the first portion of the duodenum, the distal part of the stomach was exteriorized through an extended supraumbilical trocar site, and a balloon trocar was introduced from the pylorus to determine the location of tumor and determine its resection margin. The clinicopathologic and surgical outcomes were analyzed. @*Results@#The tumor was located in the lower third of the stomach in 39 cases, the middle third in 34 cases, and the upper-third in six cases. Tumor localization was successful in 67 patients. The mean proximal margin was 41.7 ± 26.8 mm. There was no morbidity related to the technique. By the fifth postoperative day, the average white blood cell count was within the normal range and the average level of C-reactive protein showed a decreasing pattern. @*Conclusion@#TPON of the tumor during TLDG is an effective and feasible method to determine the tumor location and to obtain an adequate resection margin.

Transpyloric optic navigation of tumor using a laparoscope during totally laparoscopic distal gastrectomy for gastric cancer

Purpose@#The purpose of this study was to describe the technique of intraoperative transpyloric optic navigation (TPON) and determine its efficacy and feasibility during totally laparoscopic distal gastrectomy (TLDG) in patients with gastric cancer. @*Methods@#Seventy-nine patients who underwent laparoscopic gastrectomy with transpyloric optic localization of the tumor from January 2016 through December 2018 were enrolled in this study. After resecting the first portion of the duodenum, the distal part of the stomach was exteriorized through an extended supraumbilical trocar site, and a balloon trocar was introduced from the pylorus to determine the location of tumor and determine its resection margin. The clinicopathologic and surgical outcomes were analyzed. @*Results@#The tumor was located in the lower third of the stomach in 39 cases, the middle third in 34 cases, and the upper-third in six cases. Tumor localization was successful in 67 patients. The mean proximal margin was 41.7 ± 26.8 mm. There was no morbidity related to the technique. By the fifth postoperative day, the average white blood cell count was within the normal range and the average level of C-reactive protein showed a decreasing pattern. @*Conclusion@#TPON of the tumor during TLDG is an effective and feasible method to determine the tumor location and to obtain an adequate resection margin.

A double-blind, double-dummy, randomized controlled, multicenter trial of 99Tc-methylene diphosphonate in patients with moderate to severe rheumatoid arthritis / 中华医学杂志(英文版)

BACKGROUND@#Clinical observational studies revealed that 99Tc-methylene diphosphonate (99Tc-MDP) could reduce joint pain and swollenness in rheumatoid arthritis (RA) patients. This multicenter, randomized, double-blind, double-dummy study aimed to evaluate the effects of 99Tc-MDP plus methotrexate (MTX) vs. MTX alone or 99Tc-MDP alone on disease activity and structural damage in MTX-naïve Chinese patients with moderate to severe RA.@*METHODS@#Eligible patients with moderate to severely active RA were randomized to receive 99Tc-MDP plus MTX (n = 59) vs. MTX (n = 59) alone or 99Tc-MDP (n = 59) alone for 48 weeks from six study sites across four provinces in China. The primary outcomes were the American College of Rheumatology 20% improvement (ACR20) response rates at week 24 and changes in modified total Sharp score at week 48.@*RESULTS@#At week 24, the proportion of participants achieving ACR20 was significantly higher in the MTX + 99Tc-MDP combination group (69.5%) than that in the MTX group (50.8%) or 99Tc-MDP group (47.5%) (P = 0.03 for MTX + 99Tc-MDP vs. MTX, and MTX + 99Tc-MDP vs.99Tc-MDP, respectively). The participants in the MTX + 99Tc-MDP group and the 99Tc-MDP group had significantly less important radiographic progression than the participants in the MTX group over the 48 weeks (MTX + 99Tc-MDP vs. MTX: P = 0.03, 99Tc-MDP vs. MTX: P = 0.03, respectively). There was no significant difference in terms of adverse events (AEs) among the groups. No serious AEs were observed.@*CONCLUSIONS@#This study demonstrated that the combination of 99Tc-MDP with MTX inhibited structural damage and improved disease activity in RA patients compared with MTX and 99Tc-MDP monotherapies, without increasing the rate of AEs. Additional clinical studies of 99Tc-MDP therapy in patients with RA are warranted.@*TRIAL REGISTRATION@#Chictr.org, ChiCTR-IPR-14005684; http://www.chictr.org.cn/showproj.aspx?proj=10088.

Analysis of COL1A1 gene variation and clinical prevention and treatment in patients with Van der Hoeve syndrome / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the clinical phenotype, treatment and prevention of Van der Hoeve syndrome, and analyze the variation characteristics of its related gene COL1A1. Methods: Hearing and sequencing data of syndromic deafness patients who had undergone genetic testing for deafness at the Chinese People's Liberation Army General Hospital since January 2008 to October 2020 were retrospectively reviewed. The variation of the COL1A1 gene and return visits to traceable patients and families were summarized, the disease progress and clinical treatment effects were analyzed, and the prevention strategies were discussed. Results: A total of 7 patients with COL1A1 gene mutation underwent clinical intervention. The mutation sites were c.1342A>T (p.Lys448*), c.124C>T (p.Gln42*), c.249insG(p.Ala84*), c.668insC(p.Gly224*), c.2829+1G>C, c.1081C>T (p.Arg361*), c.1792C>T (p.Arg598*), of which c.1081C>T and c.1792C>T had been previously reported, and the remaining 5 were novo mutations that have not been reported. All the 7 probands underwent stapes implantation and received genetic counseling and prevention guidance. Conclusions: Van der Hoeve syndrome belongs to osteogenesis imperfecta type Ⅰ. The disease has high penetrance. Timely surgical intervention for hearing loss can improve the life quality in patients. Accurate genetic counseling and preimplantation genetic diagnosis can achieve the primary prevention for the disease.

Treatment effect of hemifacial dysplasia by injecting transplantation of autologous tissue in the second stage surgery for total auricle reconstruction / 中华耳鼻咽喉头颈外科杂志

Objective: To observe the treatment effect of hemifacial dysplasia by injecting transplantation of autologous dermis and fat granules in the second stage surgery for total auricle reconstruction. Methods: From March 2013 to March 2018, 57 patients with unilateral microtia and mild-to-moderate hemifacial dysplasia were divided into concurrent treatment group (32 cases, including 13 females and 19 males and aged 6-33 years old with an average age of 12.5 years) and traditional treatment group (25 cases, including 10 females and 15 males and aged 6-21 years old with an average age of 11.3 years) according to the different surgical methods. Modified Nagata method of auricular reconstruction was chosen, in the second stage surgery (cranial ear angle plasty), patients in concurrent treatment group received the treatment of hemifacial dysplasia with autologous dermal and fat injection transplantation at the same time; Patients in traditional treatment group only received cranial ear angle plasty. Statistical analysis of the two groups of patients was carried out for the average operation time, the average length of hospital stay, the incidence of common complications and postoperative satisfaction rate. SPSS 21.0 software was used for statistical analysis. Results: The mean operation time of the concurrent treatment group (282.0±3.4)min was longer than that of the traditional treatment group (243.0±3.1)min, and the difference was statistically significant (t=9.884, P<0.05). There were no statistically significant differences in the average length of stay between the the concurrent treatment group (9.4±0.3)d and the traditional treatment group(9.5±0.2)d, t=0.256, P>0.05. There were no statistically significant differences in the incidence of common surgical complications between the concurrent treatment group (12.5%, 4/32) and the traditional treatment group(12.0%, 3/25), χ2=0, P>0.05. Postoperative satisfaction rate of the concurrent treatment group(90.6%, 29/32) was significantly higher than that of the traditional treatment group(56.0%, 14/25), the difference was statistically significant (χ2=9.081, P<0.05). Conclusions: Auricular reconstruction with treatment of hemifacial dysplasia should not significantly increase the average length of stay and the incidence of common complications compared with auricular reconstruction alone. Although the operation time is slightly extended, the scheme of concurrent treatment can reduce the times of operations, save medical resources and increase the satisfaction rate of patients.

Comparison between ultrasound-guided percutaneous radiofrequency and microwave ablation in benign thyroid nodules

Objective: The purpose of this study was to compare the efficacy and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) for the treatment of benign thyroid nodules (BTNs). Methods: Patients with BTNs were treated in our hospital, including 72 patients treated with RFA and 100 patients treated with MWA from June 2016 to March 2019. The volume reduction rates (VRRs), thyroid function, clinical status, and complications were compared at each postoperative duration to evaluate the efficacy and safety of the two modalities. Results: The mean VRRs of the RFA group vs. the MWA group at 1, 3, 6, and 12 months were 22.7±13.4% vs. 24.0±16.1% (P = 0.681), 56.1±19.5% vs. 54.8±22.8% (P = 0.788), 77.9±21.0% vs. 68.7±19.1% (P = 0.038), and 85.4±18.9% vs. 75.8±19.4% (P = 0.029), respectively. There was no significant difference in the VRRs between the two treatments at 1 and 3 months and the RFA group achieved higher VRRs than MWA group at 6 and 12 months. Moreover, the symptom and cosmetic scores decreased significantly in both groups and all patients succeeded in preserving thyroid function. Of the total patients, 2.8% in the RFA group and 4% in the MWA group experienced voice changes after undergoing thyroid ablation, and one patient in the RFA group had intraoperative hemorrhage of about 10 mL. Conclusions: RFA and MWA are both effective and safe techniques for treating BTNs. Higher VRRs were observed at the 6- and 12-month follow-ups in the RFA group

Low-intensity pulsed ultrasound for regenerating peripheral nerves: Potential for penile nerve / 亚洲男科学杂志(英文版)

Peripheral nerve damage, such as that found after surgery or trauma, is a substantial clinical challenge. Much research continues in attempts to improve outcomes after peripheral nerve damage and to promote nerve repair after injury. In recent years, low-intensity pulsed ultrasound (LIPUS) has been studied as a potential method of stimulating peripheral nerve regeneration. In this review, the physiology of peripheral nerve regeneration is reviewed, and the experiments employing LIPUS to improve peripheral nerve regeneration are discussed. Application of LIPUS following nerve surgery may promote nerve regeneration and improve functional outcomes through a variety of proposed mechanisms. These include an increase of neurotrophic factors, Schwann cell (SC) activation, cellular signaling activations, and induction of mitosis. We searched PubMed for articles related to these topics in both in vitro and in vivo animal research models. We found numerous studies, suggesting that LIPUS following nerve surgery promotes nerve regeneration and improves functional outcomes. Based on these findings, LIPUS could be a novel and valuable treatment for nerve injury-induced erectile dysfunction.

Anti-cyclic citrullinated peptide antibody predicts the development of rheumatoid arthritis in patients with undifferentiated arthritis / 中华医学杂志(英文版)

BACKGROUND@#Clinical outcomes of undifferentiated arthritis (UA) are diverse, and only 40% of patients with UA develop rheumatoid arthritis (RA) after 3 years. Discovering predictive markers at disease onset for further intervention is critical. Therefore, our objective was to analyze the clinical outcomes of UA and ascertain the predictors for RA development.@*METHODS@#We performed a prospective, multi-center study from January 2013 to October 2016 among Chinese patients diagnosed with UA in 22 tertiary-care hospitals. Clinical and serological parameters were obtained at recruitment. Follow-up was undertaken in all patients every 12 weeks for 2 years. Predictive factors of disease progression were identified using multivariate Cox proportional hazards regression.@*RESULTS@#A total of 234 patients were recruited in this study, and 17 (7.3%) patients failed to follow up during the study. Among the 217 patients who completed the study, 83 (38.2%) patients went into remission. UA patients who developed RA had a higher rheumatoid factor (RF)-positivity (42.9% vs. 16.8%, χ = 8.228, P = 0.008), anti-cyclic citrullinated peptide (CCP) antibody-positivity (66.7% vs. 10.7%, χ = 43.897, P < 0.001), and double-positivity rate of RF and anti-CCP antibody (38.1% vs. 4.1%, χ = 32.131, P < 0.001) than those who did not. Anti-CCP antibody but not RF was an independent predictor for RA development (hazard ratio 18.017, 95% confidence interval: 5.803-55.938; P < 0.001).@*CONCLUSION@#As an independent predictor of RA, anti-CCP antibody should be tested at disease onset in all patients with UA.

The Benefits of Resection for Gastric Carcinoma Patients with Non-curative Factors / 전남의대학술지

The benefits of resection for gastric carcinoma patients with non-curative factors remain controversial. Thus, we evaluated the survival benefits of resection in these gastric carcinoma patients. We reviewed the hospital records of 467 gastric carcinoma patients with non-curative factors who had resection (n=305) and compared their clinicopathological findings with individuals (n=162) who underwent bypass or exploration from 1996 to 2010. The 3-year survival rate of patients who had resection was higher than was that of patients who did not (13.2 vs. 7.2%, respectively p < 0.001). Cox's proportional hazard regression analysis revealed that only one factor was an independent, statistically significant prognostic parameter: the presence of peritoneal dissemination (risk ratio, 1.37; 95% confidence interval, 1.04–1.79; p < 0.05). The 3-year survival rate of patients with peritoneal dissemination was higher in individuals who underwent resection compared with those who did not (9.5 vs. 4.7%, respectively; p < 0.001). The current results highlight the improved survival rates of gastric carcinoma patients with non-curative factors who underwent surgery compared with those who did not. Although resection is not curative in this group of patients, we still recommend performing the procedure.

Mid-Term Results of Fixed Bearing Unicompartmental Knee Arthroplasty: Minimum 5-Year Follow-Up / 대한정형외과학회잡지

PURPOSE: To evaluate the clinical and radiological outcomes, and the complications of unicompartmental knee arthroplasty (UKA) using a fixed bearing prosthesis after 5-year follow-up. MATERIALS AND METHODS: Twenty-six knees (25 patients) that underwent fixed bearing UKA between May 2003 and August 2011 were included. The subjects were 3 males (3 knees) and 22 females (23 knees), and the average age was 63.5 years. The preoperative diagnosis was osteoarthritis (23 knees) and osteonecrosis (3 knees). The mean follow-up duration was 67 months (from 60 to 149 months). The clinical evaluation included pre- and postoperative American knee society knee and function score, and range of motion. The radiology evaluation included standing antero-posterior, lateral view, and fluoroscopic film to analyze the postoperative alignment and osteolysis. RESULTS: The mean American Knee Society knee score and function score were improved from 42.0 and 57.5 to 87.9 and 85.0, respectively (p < 0.001). The mean preoperative and postoperative range of motion was 132.9° and 132.5°, respectively. The mean femorotibial angle were varus 0.5° preoperatively and valgus 2.2° postoperatively. A radiolucent line was observed in 2 knees; one knee had a stable implant, while in the other knee, patellofemoral arthritis was identified during UKA. Diffuse pain of the knee joint with tenderness of the medial joint line was identified at the follow-up, so conversion to total knee arthroplasty was recommended. No other complications, such as osteolysis, infections, postoperative stiffness, and dislocation, were encountered. CONCLUSION: The midterm results of fixed bearing UKA were clinically and radiologically satisfactory.