Analysis of prognosis and influencing factors of No. 253 lymph node metastasis in descending colon, sigmoid colon, and rectal cancer: a multicenter study / 中华外科杂志

Objectives: To analyze the influencing factors of No. 253 lymph node metastasis in descending colon cancer, sigmoid colon cancer, and rectal cancer, and to investigate the prognosis of No. 253 lymph node-positive patients by propensity score matching analysis. Methods: A retrospective analysis was performed on clinical data from patients with descending colon cancer, sigmoid colon cancer, rectosigmoid junction cancer, and rectal cancer who underwent surgery between January 2015 and December 2019 from the Cancer Hospital of the Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Peking Union Medical College Hospital, General Hospital of the Chinese People's Liberation Army, and Peking University Cancer Hospital. A total of 3 016 patients were included according to inclusion and exclusion criteria, comprising 1 848 males and 1 168 females, with 1 675 patients aged≥60 years and 1 341 patients aged<60 years. Clinical and pathological factors from single center data were subjected to univariate analysis to determine influencing factors of No. 253 lymph node metastasis, using a binary Logistic regression model. Based on the results of the multivariate analysis, a nomogram was constructed. External validation was performed using data from other multicenter sources, evaluating the effectiveness through the area under the receiver operating characteristic curve and the calibration curve. Using data from a single center, the No. 253 lymph node-positive group was matched with the negative group in a 1∶2 ratio (caliper value=0.05). Survival analysis was performed using the Kaplan-Meier method and Log-rank test. The Cox proportional hazards model was used to determine independent prognostic factors. Results: (1) The tumor diameter≥5 cm (OR=4.496,95%CI:1.344 to 15.035, P=0.015) T stage (T4 vs. T1: OR=11.284, 95%CI:7.122 to 15.646, P<0.01), N stage (N2 vs. N0: OR=60.554, 95%CI:7.813 to 469.055, P=0.043), tumor differentiation (moderate vs. well differentiated: OR=1.044, 95%CI:1.009 to 1.203, P=0.044; poor vs. well differentiated: OR=1.013, 95%CI:1.002 to 1.081, P=0.013), tumor location (sigmoid colon vs. descending colon: OR=9.307, 95%CI:2.236 to 38.740, P=0.002), pathological type (mucinous adenocarcinoma vs. adenocarcinoma: OR=79.923, 95%CI:15.113 to 422.654, P<0.01; signet ring cell carcinoma vs. adenocarcinoma: OR=27.309, 95%CI:4.191 to 177.944, P<0.01), and positive vascular invasion (OR=3.490, 95%CI:1.033 to 11.793, P=0.044) were independent influencing factors of No. 253 lymph node metastasis. (2) The area under the curve of the nomogram prediction model was 0.912 (95%CI: 0.869 to 0.955) for the training set and 0.921 (95%CI: 0.903 to 0.937) for the external validation set. The calibration curve demonstrated good consistency between the predicted outcomes and the actual observations. (3) After propensity score matching, the No. 253 lymph node-negative group did not reach the median overall survival time, while the positive group had a median overall survival of 20 months. The 1-, 3- and 5-year overall survival rates were 83.9%, 61.3% and 51.6% in the negative group, and 63.2%, 36.8% and 15.8% in the positive group, respectively. Multivariate Cox analysis revealed that the T4 stage (HR=3.067, 95%CI: 2.357 to 3.990, P<0.01), the N2 stage (HR=1.221, 95%CI: 0.979 to 1.523, P=0.043), and No. 253 lymph node positivity (HR=2.902, 95%CI:1.987 to 4.237, P<0.01) were independent adverse prognostic factors. Conclusions: Tumor diameter ≥5 cm, T4 stage, N2 stage, tumor location in the sigmoid colon, adverse pathological type, poor differentiation, and vascular invasion are influencing factors of No. 253 lymph node metastasis. No. 253 lymph node positivity indicates a poorer prognosis. Therefore, strict dissection for No. 253 lymph node should be performed for colorectal cancer patients with these high-risk factors.

Development and validation of a prognostic prediction model for patients with stage Ⅰ to Ⅲ colon cancer incorporating high-risk pathological features / 中华外科杂志

Objective: To examine a predictive model that incorporating high risk pathological factors for the prognosis of stage Ⅰ to Ⅲ colon cancer. Methods: This study retrospectively collected clinicopathological information and survival outcomes of stage Ⅰ~Ⅲ colon cancer patients who underwent curative surgery in 7 tertiary hospitals in China from January 1, 2016 to December 31, 2017. A total of 1 650 patients were enrolled, aged (M(IQR)) 62 (18)years (range: 14 to 100). There were 963 males and 687 females. The median follow-up period was 51 months. The Cox proportional hazardous regression model was utilized to select high-risk pathological factors, establish the nomogram and scoring system. The Bootstrap resampling method was utilized for internal validation of the model, the concordance index (C-index) was used to assess discrimination and calibration curves were presented to assess model calibration. The Kaplan-Meier method was used to plot survival curves after risk grouping, and Cox regression was used to compare disease-free survival between subgroups. Results: Age (HR=1.020, 95%CI: 1.008 to 1.033,P=0.001), T stage (T3:HR=1.995,95%CI:1.062 to 3.750,P=0.032;T4:HR=4.196, 95%CI: 2.188 to 8.045, P<0.01), N stage (N1: HR=1.834, 95%CI: 1.307 to 2.574, P<0.01; N2: HR=3.970, 95%CI: 2.724 to 5.787, P<0.01) and number of lymph nodes examined (≥36: HR=0.438, 95%CI: 0.242 to 0.790, P=0.006) were independently associated with disease-free survival. The C-index of the scoring model (model 1) based on age, T stage, N stage, and dichotomous variables of the lymph nodes examined (<12 and ≥12) was 0.723, and the C-index of the scoring model (model 2) based on age, T stage, N stage, and multi-categorical variables of the lymph nodes examined (<12, 12 to <24, 24 to <36, and ≥36) was 0.726. A scoring system was established based on age, T stage, N stage, and multi-categorical variables of lymph nodes examined, the 3-year DFS of the low-risk (≤1), middle-risk (2 to 4) and high-risk (≥5) group were 96.3%(n=711), 89.0%(n=626) and 71.4%(n=313), respectively. Statistically significant difference was observed among groups (P<0.01). Conclusions: The number of lymph nodes examined was an independent prognostic factor for disease-free survival after curative surgery in patients with stage Ⅰ to Ⅲ colon cancer. Incorporating the number of lymph nodes examined as a multi-categorical variable into the T and N staging system could improve prognostic predictive validity.

Establishment of basic principles and methods of acupuncture standardization in traditional Chinese medicine / 数字中医药（英文）

@#Standardization is the universal language of the world, and standardization of traditional Chinese medicine (TCM) is essential for its communication in China and globally. However, the principles and methods of TCM acupuncture standardization have been unclear and inadequate in the early stages. Based on an investigative approach to understanding the current status, identifying problems, and finding solutions, our team has established basic principles of TCM acupuncture that embody Chinese wisdom, evaluated the international strategic environment systematically, proposed the principle of “importance of harmony and exercise of impartiality”, and established basic working principles. A series of methods for TCM acupuncture standard development and evaluation have been constructed, including general standards for the revision of TCM acupuncture standards, the first TCM acupuncture clinical research management specification, a shared full chain technology platform, a data center, and an evaluation research base for TCM acupuncture clinical research. Evaluation criteria for ancient literature and expert experience, a recommendation method for the “three main and three auxiliaries” TCM guideline for prevention were established, and quantifiable assessment methods of TCM standard applicability were proposed. These findings provide methodological guidance for TCM acupuncture standardization.

Comparación de biometría ocular entre adultos jóvenes chinos y cubanos / Comparison of ocular biometry between chinese and cuban young adults

Objetivo: Comparar la biometría ocular entre adultos jóvenes chinos y cubanos pertenecientes al sector salud. Métodos: Estudio observacional descriptivo de corte transversal en 30 chinos y 30 cubanos, residentes de las diferentes especialidades médicas, que acudieron al Instituto Cubano de Oftalmología "Ramón Pando Ferrer" entre septiembre de 2016 y septiembre de 2017. Las variables estudiadas fueron: longitud axial, profundidad de cámara anterior, y diámetro corneal horizontal. Se realizó biometría de no contacto con IOLMaster 500 (Carl Zeiss) en ambos ojos. Resultados: La edad media fue 24,9 años y 25,9 años en cubanos y chinos respetivamente. Los resultados biométricos promedio de ambos ojos para cubanos/chinos fueron: longitud axial 24,10 mm/24,60 mm; amplitud de cámara anterior 3,56 mm/3,46 mm; y diámetro corneal horizontal 11,80 mm/11,60 mm, sin diferencias estadísticamente significativas. El 60 de los ojos chinos fueron largos mientras que en los cubanos fue el 45 . Se reportaron dos ojos chinos con cámara anterior estrecha y el diámetro corneal horizontal fue normal en el 100 por ciento. Conclusiones: Los chinos exhibieron ojos de mayor longitud axial, menor amplitud de cámara anterior y menor diámetro corneal horizontal que los cubanos aunque las diferencias no fueron estadísticamente significativas.(AU)

Objective: To compare ocular biometry between Chinese and Cuban young adults belonging to the health sector. Methods: Descriptive observational cross-sectional study in 30 Chinese and 30 Cubans, residents of different medical specialties, who attended the Cuban Institute of Ophthalmology "Ramón Pando Ferrer" between September 2016 and September 2017. The variables studied were: axial length, anterior chamber depth, and horizontal corneal diameter. Non-contact biometry was performed with IOLMaster 500 (Carl Zeiss) in both eyes. Results: The average age was 24.9 years and 25.9 years in Cuban and Chinese patients respectively. The average biometric results of both eyes for Cuban/Chinese eyes were: axial length 24.10 mm/24.60 mm; anterior chamber width 3.56 mm/3.46 mm; and horizontal corneal diameter 11.80 mm/11.60 mm, with no statistically significant differences. Sixty percent of the Chinese eyes were long, while 45 percent of the Cuban eyes were long. Two Chinese eyes were reported with narrow anterior chamber and horizontal corneal diameter was normal in a 100 percent of them. Conclusions: Chinese exhibited eyes of greater axial length, smaller anterior chamber width and smaller horizontal corneal diameter than Cubans although the differences were not statistically significant(AU)

Feasibility of corneal epithelial transplantation with polyethylene glycol hydrogel membrane as a carrier for limbal stem cell deficiency / 中华实验眼科杂志

Objective:To investigate whether polyethylene glycol hydrogel films (PHFs) can be used as a carrier for the expansion of corneal epithelial cells (CECs) in vitro and whether PHFs can be used in the treatment of limbal stem cell deficiency (LSCD). Methods:Sebacoyl chloride, dihydroxyl PCL and glycerol ethoxylate were used to synthesize PHFs.The thickness, transmittance and mechanical tensile properties of PHFs were measured.Four clean-grade New Zealand white rabbits were selected to culture primary limbal epithelial cells.The expression of keratin marker AE1/AE3 and stem cell marker p63 in the cultured cells were observed under a fluorescence microscope.The cells were divided into negative control group cultured with common cell culture solution, positive control group cultured with cell culture solution containing 100 μmol/L H 2O 2, and PHFs+ CECs group lined with PHFs cultured with common cell culture solution for 24 hours.The proliferation and apoptosis of cells in the three groups were observed by MTT and TUNEL staining, respectively.Fifteen clean-grade New Zealand white rabbits were divided into control group, PHFs group and PHFs+ CECs group by random number table method, with 5 rabbits in each group.LSCD model was constructed in the three groups.The control group was not given any treatment after modeling.In PHFs group, empty PHFs were placed on the corneal surface of rabbits.In PHFs+ CECs group, tissue-engineered grafts constructed with CECs after passage implanted on PHFs were placed on the corneal surface of rabbits.The corneal defect area of rabbits was detected and scored by fluorescein sodium staining.The histological characteristics of rabbits corneal epithelium was observed by hematoxylin-eosin staining.The use and care of animals complied with Guide for the Care and Use of Laboratory Animals by the U. S.National Research Council.The experimental protocol was approved by the Research and Clinical Trial Ethics Committee of The First Affiliated Hospital of Harbin Medical University (No.2021006). Results:The synthetic PHFs were with a thickness ≤150 μm, a tensile strength about 6 MPa, and a transmittance over than 99% in the range of 400-700 nm.Most of the cells from primary culture of limbal tissue were positive for AE1/AE3 and p63.MTT test results showed that the A490 value of PHFs+ CECs group, negative control group and positive control group was 0.59±0.01, 0.65±0.07 and 0.06±0.04, respectively, showing a statistically significant overall difference ( F=12.25, P<0.05). The A490 values of PHFs+ CECs group and negative control group were significantly higher than that of positive control group, and the differences were statistically significant (both at P<0.05). TUNEL test results showed that there was a significant difference in the TUNEL-positive cell rate among the three groups ( F=13.45, P<0.05), and the rates of TUNEL-positive cells in PHFs+ CECs group and negative control group were significantly lower than that in positive control group (both at P<0.05). Fluorescein sodium staining results showed that with the extension of postoperative period, the corneal fluorescein sodium staining score of the three groups decreased, which decreased successively in control group, PHFs group and PHFs+ CECs group.Hematoxylin-eosin staining showed fewer irregularly shaped corneal epithelial cells in the control group, and sparse single layer of corneal epithelial cells in some areas of the PHFs group.In PHFs+ CECs group, the corneal epithelium coverage was the largest, and the cell layers increased to 3-5, and the cells were with regular morphology and in close arrangement. Conclusions:PHFs have enough toughness, high transmittance and can expand corneal epithelium in vitro.PHFs are suitable for corneal epithelial transplantation and can promote the repair of corneal epithelium in rabbit model of LSCD.

Research advances on antitumor mechanism of NK cells and its application in cancer targeted therapy / 药学学报

Natural killer (NK) cells, as an essential part of innate immunity, can directly identify and kill tumor cells after being activated by the synergistic action of surface inhibitory receptors and activated receptors. It can secrete cytokines to recruit dendritic cells (DCs), induce DCs maturation and enhance adaptive immune response. It can target cancer stem cells (CSCs) and circulating tumor cells (CTCs) to inhibit cancer metastasis. NK cells have a unique inflammatory tendency, which can respond to cytokines and chemokines released from tumor sites and migrate to tumor sites, making them occupy an important advantage in cancer targeted therapy. The research on cancer targeted therapy of NK cells as drug delivery carriers, NK cell membrane-coated biomimetic nanoparticles, and NK cell extracellular vesicles (NKEVs) has attracted more and more attention. The article will focus on the mechanism of NK cells inhibiting cancer, and summarize the research progress of cancer targeted therapy of NK cells.

Calidad visual en la cirugía bilateral del cristalino por facoemulsificación / Visual quality in bilateral crystalline lens surgery by phacoemulsification

Objetivo: Analizar la recuperación y la calidad visual posoperatoria en la cirugía bilateral del cristalino por facoemulsificación. Métodos: Se realizó un estudio prospectivo y analítico de serie de casos en 40 pacientes con el diagnóstico de catarata bilateral, operados por cirugía bilateral simultánea del cristalino, atendidos en el Centro de Microcirugía Ocular del Instituto Cubano de Oftalmología "Ramón Pando Ferrer", durante el periodo comprendido desde noviembre del año 2018 hasta marzo de 2020. Se analizaron las variables edad, sexo, dureza nuclear según LOCS III, mejor agudeza visual con y sin corrección, astigmatismo medio inducido, visión de colores, sensibilidad al contraste, velocidad de lectura y estudio de la calidad de vida por la encuesta FV-14. Se emplearon los porcentajes y los números absolutos para resumir las variables cualitativas. En el caso de las cuantitativas se usó la media con su desviación estándar y el intervalo de confianza del 95 por ciento. Resultados: Fue más frecuente el sexo femenino en el 65 por ciento; la edad media fue de 69,1 ± 8,1 años. El 55,11 por ciento de los pacientes tuvo dureza NO3. La media de la mejor agudeza visual sin corrección mejoró a 0,89 ± 0,25; la mejor agudeza visual con corrección mejoró a 0,96 ± 0,03; el resto de las variables estudiadas mostró mejoría significativa. Conclusiones: La cirugía bilateral simultánea del cristalino personalizada contribuye de manera significativa a la mejoría de la visión en cantidad y calidad, lo que permite recuperar la calidad de vida de los pacientes(AU)

Objective: Analyze postoperative recovery and visual quality in bilateral crystalline lens surgery by phacoemulsification. Methods: An analytical prospective study was conducted of a case series of 40 bilateral cataract patients undergoing simultaneous bilateral crystalline lens surgery at the Center for Ocular Microsurgery of Ramón Pando Ferrer Cuban Institute of Ophthalmology from November 2018 to March 2020. The variables analyzed were age, sex, nuclear hardness by LOCS III, best visual acuity with and without correction, induced medial astigmatism, color vision, contrast sensitivity, reading speed and quality of life by the VF-14 survey. Percentages and absolute numbers were used to summarize qualitative variables, whereas mean and standard deviation were used for quantitative variables, with a 95 percent confidence interval. Results: Female sex prevailed with 65 percent; mean age was 69.1 ± 8.1 years. Hardness was NO3 in 55.11 percent of the patients examined. Mean best visual acuity without correction improved to 0.89 ± 0.25; best corrected visual acuity improved to 0.96 ± 0.03; the remaining variables studied showed significant improvement. Conclusion: Simultaneous personalized bilateral crystalline lens surgery significantly contributes to visual improvement both quantitatively and qualitatively, making it possible for patients to recover their quality of life(AU)

Criofacoemulsificación en la cirugía de catarata / Cryophacoemulsification in cataract surgery

Objetivo: Demostrar los resultados de la criofacoemulsificación en la cirugía de catarata, como una mejora en la calidad visual y de vida de los pacientes. Métodos: Se realizó un estudio prospectivo y analítico de serie de casos en 43 ojos con catarata. Se utilizaron técnicas estadísticas descriptivas como media y desviación estándar. En los resultados no comparados la prueba de chi cuadrado, con significación del 95 por ciento y un valor de p < 0,05 se consideró estadísticamente significativa. Resultados: El 67,44 por ciento de los pacientes no sintieron dolor y lo refirieron muy leve en la colocación del blefaróstato, en la incisión por córnea clara y durante la colocación del lente intraocular; el 62,79 por ciento fueron féminas, mayores de 70 años; el 51,16 por ciento tenía dureza nuclear NO3 por LOCSIII; la visión de colores mejoró en el 90,70 por ciento; la sensibilidad al contraste mejoró en el 58,14 por ciento; el cilindro refractivo en el 72,09 por ciento fue menor de 0,5 dioptrías; la agudeza visual mejor corregida en el 93,02 por ciento fue de 0,8 a 1,0; la paquimetría demostró diferencias significativas al final; la pérdida celular endotelial media fue de 274,16 cel. /mm2; la hexagonalidad media se redujo en un 3,42 por ciento y la encuesta FV-14 fue muy buena en el 100 por ciento de los pacientes al mes de operado. Conclusiones: La criofacoemulsificación es segura y efectiva, que disminuye los efectos inflamatorios de la cirugía sobre la córnea, con alto grado de satisfacción de los pacientes(AU)

ABSTRACT Objective: Demonstrate the effect of cryophacoemulsification in cataract surgery as a way to improve patient visual quality and quality of life. Methods: An analytical prospective study was conducted of a case series of 43 eyes with cataract. Statistical analysis was based on mean and standard deviation descriptive techniques. In results not compared, a chi-square test with 95 percent significance and p < 0.05 was considered to be statistically significant. Results: Of the patients studied, 67.44 percent did not feel any pain and reported very mild pain during blepharostat placement, clear corneal incision and intraocular lens placement; 62.79 percent were females aged over 70 years; 51.16 percent had NO3 nuclear hardness by LOCSIII; color vision improved in 90.70 percent; contrast sensitivity improved in 58.14 percent; in 72.09 percent the refractive cylinder was smaller than 0.5 diopters; in 93.02 percent best corrected visual acuity was 0.8-1.0; pachymetry showed significant differences at the end; mean endothelial cell loss was 274.16 cel/mm2; mean hexagonality was reduced 3.42 percent, and the VF-14 index was very good in 100 percent of the patients one month after surgery. Conclusions: Cryophacoemulsification is safe and effective, reduces the inflammatory effects of surgery on the cornea and achieves a high level of patient satisfaction(AU)

Control de la progresión del astigmatismo en la facoemulsificación / Control of the progression of astigmatism in phacoemulsification

Objetivo: Determinar cómo controlar la progresión del astigmatismo en la facoemulsificación para mejorar sus resultados. Métodos: Se realizó un estudio descriptivo, prospectivo, de serie de casos en 43 ojos de pacientes con diagnóstico de catarata, operados por la técnica de facoemulsificación por prechop con implante de lente intraocular plegable, en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" desde noviembre del año 2018 hasta abril de 2020. Se emplearon los porcentajes y números absolutos para las variables cualitativas, las cuantitativas, la media y la desviación estándar, con un intervalo de confianza del 95 por ciento. Resultados: La edad media fue de 69,4 ± 8,3 años (51,16 por ciento); la dureza NO3; la mejor agudeza visual sin corrección mejoró en el 76,75 por ciento entre 0,8 a 1,0; la queratometría media pre- vs. posoperatoria no mostró diferencias estadísticamente significativas; el cilindro refractivo posoperatorio fue menor de 0,5 dioptrías en el 72,09 por ciento; el 51,17 por ciento de los ojos en el preoperatorio tenían astigmatismo refractivo contra la regla, lo cual mejoró según esta al mes de operado en el 60,47 por ciento de los pacientes. La calidad de vida en el 100 por ciento de los casos fue muy buena al mes de operados, según FV-14. Conclusiones: La corrección del astigmatismo con las incisiones personalizadas en la facoemulsificación ofrece buena predictibilidad y mejora su calidad visual y de vida(AU)

Objective: Determine how to control the progression of astigmatism in phacoemulsification to improve its results. Methods: A descriptive prospective study was conducted of a case series of 43 eyes of cataract patients undergoing prechop phacoemulsification with foldable intraocular lens implantation at Ramón Pando Ferrer Cuban Institute of Ophthalmology from November 2018 to April 2020. Percentages and absolute numbers were used for qualitative variables, and mean and standard deviation for quantitative variables, with a confidence interval of 95 percent. Results: Mean age was 69.4 ± 8.3 years (51.16 percent); hardness was NO3; in 76.75 percent best uncorrected visual acuity improved 0.8-1.0; pre- vs. postoperative mean keratometry did not show any statistically significant differences; in 72.09 percent the postoperative refractive cylinder was smaller than 0.5 diopters; 51.17 percent of the eyes had preoperative refractive against-the-rule astigmatism, improving at one month postoperative in 60.47 percent. Quality of life by the VF-14 survey was very good in 100 percent of the patients one month after surgery. Conclusions: Correction of astigmatism with personalized incisions in phacoemulsification provides good predictability and improves visual quality and quality of life(AU)

Comparison on efficacy between fascia-oriented versus vascular-oriented lateral lymph node dissection in patients with rectal cancer / 中华胃肠外科杂志

Objective: To compare the postoperative function, the short-term and long-term outcomes between fascia-oriented and vascular-oriented lateral lymph node dissection (LLND) in patients with rectal cancer. Methods: A retrospective cohort study was performed. Clinical data of patients who received total mesorectal excision (TME) with LLND at National Cancer Center, Cancer Hospital of Chinese Academy of Medical Science from January 2014 to December 2019 were retrospectively collected. Inclusion criteria were as follows: (1) rectal cancer was pathologically diagnosed, and the lower margin was below the peritoneal reflection. (2) resectable advanced rectal cancer with suspected lateral lymph node metastasis was evaluated based on rectal MRI assessment. (3) preoperative MRI showed lateral lymph node short diameter ≥5 mm and/or lymph node morphology (spike, blur, irregular) as well as heterogenous signal intensity. Lymph node shrinkage was less than 60% after receiving neoadjuvant therapy based on the reassessment of rectal MRI. (4) TME+LLND surgery was performed synchronously. Exclusion criteria were as follows: (1) previous history of pelvic surgery; (2) preoperative cystitis, urethritis, moderate and severe prostatic hyperplasia and other diseases resulting in abnormal urination function; (3) preoperative sexual dysfunction or loss of function; (4) patients receiving LLND due to lateral recurrence after TME; (5) distant metastasis of the tumor at initial diagnosis; (6) Incomplete collection of clinical data. A total of 73 consecutive patients were enrolled in this study. Based on the surgical approaches in performing LLND, patients were divided into fascia-oriented group (n=30) and vascular-oriented group (n=43). There were no significant differences in baseline data between the two groups (all P>0.05). The main outcome indicators of this study were the incidence of postoperative urinary and male sexual dysfunction, the efficacy, the number of lateral lymph nodes harvested and the detection rate of positive lymph nodes. Overall survival (OS) rates and progression free survival (PFS) rates were calculated by the Kaplan-Meier method and compared by log-rank test. Results: All patients in both groups completed surgery successfully. There were no significant differences in operation time, intraoperative blood loss, postoperative complications, and the length of hospital stay between the two groups (all P>0.05). In the whole group, the incidence of postoperative urinary dysfunction and male sexual dysfunction was 43.8% (32/73) and 62.5% (25/40), respectively. The median number of lateral lymph nodes harvested was 8.0(4.0,11.0) with a positive rate of 20.5%(15/73). Compared to the vascular-oriented group, the fascia-oriented group demonstrated a decreased rate of urinary dysfunction [26.7% (8/30) vs. 55.8% (24/43), χ(2)=6.098, P=0.014], lower rate of sexual dysfunction in males [6/15 vs. 76% (19/25), χ(2)=5.184, P=0.023], more harvested lateral lymph nodes [M (P25, P75): 9.5 (6.8, 15.3) vs. 6.0 (3.0, 9.0), Z=-2.849, P=0.004]. There was no significant difference in the positvie rate of lateral lymph nodes between the two groups [20% (6/30) versus 20.9% (9/43), χ(2)=0.009, P=0.923]. Three(4.1%) patients were lost during a median follow-up of 34 (1-66) months. The 3-year PFS and OS of the whole cohort were 69.5% and 88.3%, respectively. No significant difference in 3-year PFS rates (79.6% vs. 62.0%, P=0.172) and 3-year OS rates (91.2% vs. 85.9%, P=0.333) were observed between the fascia-oriented group and the vascular-oriented group (both P>0.05). Conclusion: Fascia-oriented LLND is associated with lower risk of postoperative urinary and male sexual dysfunction in patients with rectal carcinoma, and harvest of more lymph nodes, but no significant advantage in long-term survival.

IL-27 in combination with IL-15 regulates anti-tumor effect of NK92 cells by phosphorylating the STATs pathway / 中国肿瘤生物治疗杂志

@#[Abstract] Objective: To investigate the effect of IL-27 in combination with IL-15 on the anti-tumor effects of NK92 cells and the possible molecular and signaling mechanisms. Methods: NK92 cells with high IL-15 expression (IL-15-NK92 cells) were cultured in different mass concentrations of IL-27 (0, 10, 20, 30 and 60 ng/ml) for 24 h. The effects of IL-27 on IL-15 secretion, migration and proliferation of IL-15-NK92 cells were detected by ELISA, Transwell and CCK-8 assay, respectively. Flow cytometry was used to detect the expression levels of IL-15-NK92 cell surface receptors NKG2D, NKp30 and NKp46, as well as the secretion levels of perforin and granzyme B. LDH method was used to detect the cytotoxic effect of IL-15-NK92 cells on hematologic tumor cells and solid tumor cells, and WB was used to detect the expressions and phosphorylation level of STATs pathway-related proteins. Results: IL-27 at the concentration of 30 ng/ml promoted IL-15-NK92 cells secreting IL-15 (P<0.01), significantly enhanced the cell migration (P<0.05) but inhibited the proliferation of IL-15-NK92 cells (P<0.05). 30 ng/ml IL-27 could significantly promote the expressions of NKG2D, NKp30 and NKp46 on surface of IL-15-NK 92 cells, as well as elevate the secretion of perforin (all P<0.05), but didn’t affect the secretion of granzyme B (P>0.05); moreover, it also significantly enhanced the cytotoxicity of IL-15-NK92 cells against hematologic malignancies and solid tumor cells (P<0.05 or P<0.01), and up-regulated the phosphorylation levels of STAT1, STAT3 and STAT5 (all P<0.01). Conclusion: IL-27 can enhance the cytotoxicity of IL-15-NK92 cells against hematologic tumor cells and solid tumor cells, which might be related with its upregulation of phosphorylation level of STAT1, STAT3 and STAT5 in JAK-STAT pathway and multiple activating receptors in IL-15-NK92 cells.

Focused extracorporeal shock wave therapy with centrifugal exercise for the treatment of greater trochanteric pain syndrome / 中国骨伤

OBJECTIVE@#To explore the clinical efficacy of focused extracorporeal shock wave therapy with centrifugal exercise in the treatment of greater trochanteric pain syndrome.@*METHODS@#From September 2017 to June 2019, 53 eligible cases of greater trochanteric pain syndrome were randomly divided into observation group (29 cases) and control group (24 cases). In observation group, there were 8 males and 21 females, aged from 38 to 62 years old with an average of (49.96±6.39) years old; the course of disease ranged from 6 to 13 months with an average of (8.58±1.99) months;treated with focused extracorporeal shock wave therapy with centrifugal exercise. In control group, there were 5 males and 19 females, aged from 39 to 62 years old with an average of (52.79±5.86) years old;the course of disease ranged from 6 to 14 months with an average of (9.04±2.51) months;treated with centrifugal exercise alone. Visual analogue scale (VAS) and hip Harris score were measured before ESWT treatment and at 1, 2, and 6 months to evaluate relieve degree of pain and functional recovery of hip joint, respectively.@*RESULTS@#At 1 month after treatment, there were no significant differences in VAS, hip Harris score and treatment success rate (all @*CONCLUSION@#In treatment of greater trochanteric pain syndrome, focused extracorporeal shock wave therapy with centrifugal exercise could significantly relieve symptoms of lateral hip pain, improve functional recovery of hip joint with good safety. This treatment strategy is worthy of application and promotion in clinical practice.

Efficacy and safety of COVID-19 vaccines: a systematic review / 中国当代儿科杂志

OBJECTIVE@#To evaluate systematically the efficacy and safety of COVID-19 vaccines.@*METHODS@#PubMed, Embase, Cochrane Library, Clinicaltrial.gov, CNKI, Wanfang Data, China Biomedical Literature Service System, and China Clinical Trial Registry were searched for randomized controlled trials of COVID-19 vaccines published up to December 31, 2020. The Cochrane bias risk assessment tool was used to assess the quality of studies. A qualitative analysis was performed on the results of clinical trials.@*RESULTS@#Thirteen randomized, blinded, controlled trials, which involved the safety and efficacy of 11 COVID-19 vaccines, were included. In 10 studies, the 28-day seroconversion rate of subjects exceeded 80%. In two 10 000-scale clinical trials, the vaccines were effective in 95% and 70.4% of the subjects, respectively. The seroconversion rate was lower than 60% in only one study. In six studies, the proportion of subjects who had an adverse reaction within 28 days after vaccination was lower than 30%. This proportion was 30%-50% in two studies and > 50% in the other two studies. Most of the adverse reactions were mild to moderate and resolved within 24 hours after vaccination. The most common local adverse reaction was pain or tenderness at the injection site, and the most common systemic adverse reaction was fatigue, fever, or bodily pain. The immune response and incidence of adverse reactions to the vaccines were positively correlated with the dose given to the subjects. The immune response to the vaccines was worse in the elderly than in the younger population. In 6 studies that compared single-dose and double-dose vaccination, 4 studies showed that double-dose vaccination produced a stronger immune response than single-dose vaccination.@*CONCLUSIONS@#Most of the COVID-19 vaccines appear to be effective and safe. Double-dose vaccination is recommended. However, more research is needed to investigate the long-term efficacy and safety of the vaccines and the influence of dose, age, and production process on the protective efficacy.

Treatment of degenerative lumbar spondylolisthesis with minimally invasive transforaminal lumbar interbody fusion by microscope-assisted Zista channel / 中国骨伤

OBJECTIVE@#To investigate the clinical efficacy and advantage of minimally invasive transforaminal lumbar interbody fusion under microscope-assisted Zista channel in the treatment of degreeⅠandⅡdegenerative lumbar spondylolisthesis.@*METHODS@#The clinical data of 18 patients with degenerative lumbar spondylolisthesis treated by microscope-assisted Zista channel MIS-TLIF operation from January 2017 to March 2018 were analyzed retrospectively. There were 10 males and 8 females with an average age of 59 years (48 to 70). The course of spondylolisthesis ranged from 6 months to 5 years with an average of 33 months. The segment of spondylolisthesis was L@*RESULTS@#All the patients completed the operation successfully and were followed up more than 12 months after operation. Operation time was(160.45±34.98) min, intraoperative blood loss was (88.32±21.12) ml, postoperative drainage volume was (50.34 ±18.22)ml, and walking time after operation was (20.65±6.25) h. Preoperative and postoperative at 7 days, 3 months, 12 months, VAS score of low back pain was 7.81±2.16, 4.19±1.17, 2.25±0.62 and 1.53±0.58 respectively, VAS score of leg pain was 8.47± 2.21, 3.45±0.86, 2.31±0.73 and 1.43±0.47, JOA score was 12.01±2.33, 18.56±3.12, 23.54±3.31 and 26.34±2.65. There were significant differences in VAS and JOA scores between preoperative and postoperative (@*CONCLUSION@#MIS-TLIF under microscope-assisted Zista channel has obvious minimally invasive advantages in the treatment of degreeⅠandⅡdegenerative lumbar spondylolisthesis, and it is a safe and effective method.

Astigmatismo y cirugía de catarata / Astigmatism and cataract surgery

RESUMEN La catarata es la primera causa de ceguera curable en el mundo y se produce por la opacidad del cristalino, con una disminución gradual, lenta y progresiva de la agudeza visual. La cirugía para extraer el cristalino es la única forma de curar esta discapacidad visual. La facoemulsificación ha evolucionado con el fin de lograr su perfección y el objetivo de restablecer la visión de los pacientes con la mayor calidad y cantidad en el menor tiempo posible. El desarrollo científico ha estado encaminado a controlar o eliminar el astigmatismo preoperatorio o inducido por la cirugía, y para esto se ha incluido en la actualidad el empleo de los lentes intraoculares trifocales flexibles tóricos y las incisiones menores a dos milímetros en la córnea clara, así como las incisiones relajantes limbares, las incisiones opuestas en la córnea clara, la cirugía refractiva fotoablativa y el láser de femtosegundo. Para lograr un resultado refractivo en la cirugía de catarata es imprescindible minimizar al máximo el astigmatismo inducido por el procedimiento. Este éxito se logra con un estudio personalizado preoperatorio exhaustivo, que permita satisfacer las necesidades visuales del paciente y su reincorporación temprana a sus tareas. De ahí la motivación para realizar una búsqueda de los últimos diez años de diversos artículos publicados, con el objetivo de describir los principios para evaluar el astigmatismo medio inducido posterior a la cirugía del cristalino, y su repercusión en la calidad visual y de vida de los pacientes. Se utilizó la plataforma google, específicamente la Biblioteca Virtual de Salud, con todos sus buscadores(AU)

ABSTRACT Cataract is the leading cause of curable blindness worldwide. It results from opacity of the crystalline lens with gradual, slow and progressive visual acuity reduction. Surgery for removal of the crystalline lens is the only cure for this visual impairment. Phacoemulsification technique has evolved to achieve perfection and the aim of restoring patients' vision with the greatest quality and quantity in the shortest possible time. Scientific development has been aimed at either controlling or eliminating preoperative or surgically induced astigmatism. To achieve this aim, recent inclusion has been made of the use of flexible toric trifocal intraocular lenses and minor incisions at two millimeters in the clear cornea, as well as limbal relaxing incisions, opposite incisions in the clear cornea, photoablative refractive surgery and femtosecond laser. To obtain a good refractive result in cataract surgery it is indispensable to minimize the astigmatism induced by the procedure. Such success is accomplished through an exhaustive personalized preoperative study allowing to meet the visual needs of patients and their early reincorporation to daily activities. Hence the motivation to conduct a search of a variety of papers published in the last ten years with the purpose of describing the principles applied to evaluate mean induced astigmatism after crystalline lens surgery and its effect on the patients' visual acuity and quality of life. Use was made of the Google platform, particularly the Virtual Health Library with all its search engines(AU)

Desarrollo de la anestesia en Oftalmología / Development of anesthesia in Ophthalmology

RESUMEN Para el ser humano la información suministrada por sus ojos resulta esencial en su interacción con el entorno. Por esta razón todos consideramos la vista como nuestro sentido más valioso. Es fácil comprender, por tanto, que cualquier individuo sometido a una operación oftalmológica desarrollará un alto grado de ansiedad; de ahí la importancia de su cooperación para evitar las complicaciones quirúrgicas, donde en muchas ocasiones la cirugía se realiza con anestesia local. Es por eso que evitar el dolor y abolir los movimientos oculares va a ser un paso previo fundamental en la cirugía. Con el advenimiento del desarrollo tecnológico aplicado a la Oftalmología, nuevos procedimientos quirúrgicos persiguen una recuperación visual y social temprana de los pacientes. Dentro de ellos la cirugía de catarata por facoemulsificación exige métodos anestésicos que permitan lograr este propósito, y en la actualidad ya podemos mencionar la anestesia tópica y la crioanalgesia como avances en este sentido, las cuales se aplican en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer". Se realizó una búsqueda de diversos artículos publicados en la plataforma de PubMed, con el objetivo de conocer el desarrollo y las características de los anestésicos aplicados en la cirugía de catarata(AU)

ABSTRACT The information obtained by human beings through their eyes is essential for their interaction with the environment. This is the reason why we all consider our sight as our most valuable sense. It is thus easy to understand that any individual undergoing eye surgery will develop a high degree of anxiety. Hence the importance of their cooperation to prevent surgical complications, since on many occasions surgery is performed with local anesthesia. Preventing pain and stopping eye movement are therefore a crucial previous step in surgery. With the application of technological development to ophthalmology, new surgical procedures have emerged aimed at the patients' visual recovery and early social reincorporation. One of those procedures is phacoemulsification cataract surgery, which requires anesthetic methods that make it possible to achieve such an end. Examples of advances in this field are topical anesthesia and cryoanalgesia, both of which are applied at Ramón Pando Ferrer Cuban Institute of Ophthalmology. A search was conducted for papers published on the PubMed platform with the purpose of becoming acquainted with the development and characteristics of the anesthetics used in cataract surgery(AU)

Chemical constituents from Syneilesis aconitifolia (II) / 中草药

Objective: To study the chemical constituents from Syneilesis aconitifolia. Methods: The chemical constituents were isolated by silica gel column chromatography and HPLC, and its structure were identified by their spectral data and physicochemical properties analysis. Results: Eighteen compounds were isolated from methanol extract ethyl acetate extracts of S.aconitifolia with the structures identified as 3β-angeloyoxy-eremophil-6-en-8-oxo-12,15β-diacid (1), quercetin-3-O-α-L-rhamnoside (2), triacontanol (3), 8β-methoxyeremophil-3,7(11)-diene-8α,12(6α,15)-dilactone (4), 3,4-dihydroxybenzoic acid (5), 8-oxo-eremophil-6,9-dien-12-oic acid (6), 8βH-eremophil-3,7(11)-dien-12,8α(14,6α)-diolide (7), 8αH-6α,10β-dihydroxyeremophilenolide (8), pinoresinol (9), 6β,8β,10β-trihydroxyeremophil-7(11)-en-12,8-olide (10), 10α,15-dihydroxy-oplopan-4-one (11), 6α,15α-epoxy-1β,4β-dihydroxyeudesmane (12), caryolane-1,9β-diol (13), (-)-clovane-2,9-diol (14), cis-3-hexenyl-β-D-glucopyranoside (15), kaempferol-3-O-α-L-rhamnoside (16), quercetin-3-O-β-D-glucopyranoside(17) and (-)-oplopan-4-one-10-α-O-β-D-glucoside (18). Conclusion: Compound 1 is a new compound, named as syneilesis acid. Compounds 4-16 and 18are isolated from this plant for the first time.

Full endoscopic I See technique for the treatment of single-segment degenerative lumbar spinal stenosis / 中国骨伤

OBJECTIVE@#To investigate the clinical efficacy and advantages of the full endoscopic I See technique for the single-segment degenerative lumbar spinal stenosis.@*METHODS@#The clinical data of 38 patients with the single-segment degenerative lumbar spinal stenosis treated by full endoscopic I See technique from January 2017 to March 2018 were analyzed retrospectively. There were 16 males and 22 females, aged from 35 to 79 years with an average of(53.45±12.56) years. Five cases were L, 23 cases were L, 10 cases were LS. The clinical efficacy was evaluated by VAS, ODI and Macnab scores.@*RESULTS@#All the patients were followed up for more than 12 months after operation. The length of operation was from 55 to130 (86.0± 17.5) min. Intraoperative blood loss was ranging from 10 to 50 (17±6) ml, and the hospitalization length was from 3 to 7 days with an average of 4.6 days. The VAS scores of low back pain assessed before operation, and 3 d, 3 months, 12 months post operation were 6.67 ±1.25, 3.87 ±1.35, 2.55 ±1.21, 2.05 ±0.97, respectively, and the differences were statistically significant (P < 0.05);VAS scores of leg pain at these time points were 7.85±2.62, 3.31±1.42, 2.02±1.13, 1.85±0.86, respectively, and the differences were statistically significant (<0.05);ODI scores were 40.32±5.38, 25.76±4.81, 12.66±4.64, 9.32±2.91, respectively, and the differences were statistically significant (<0.05). Tevaluate the lumbar vertebrae function according to the Macnab criteria, 15 cases obtained excellent results, 19 cases were good, and 4 cases were fair.@*CONCLUSION@#Full endoscopic I See technique is effective in the treatment of single-segment degenerative lumbar spinal stenosis, with the advantages of less trauma, shorter hospital stay, and faster recovery.

Reversal of Social Recognition Deficit in Adult Mice with MECP2 Duplication via Normalization of MeCP2 in the Medial Prefrontal Cortex / 神经科学通报·英文版

Methyl-CpG binding protein 2 (MeCP2) is a basic nuclear protein involved in the regulation of gene expression and microRNA processing. Duplication of MECP2-containing genomic segments causes MECP2 duplication syndrome, a severe neurodevelopmental disorder characterized by intellectual disability, motor dysfunction, heightened anxiety, epilepsy, autistic phenotypes, and early death. Reversal of the abnormal phenotypes in adult mice with MECP2 duplication (MECP2-TG) by normalizing the MeCP2 levels across the whole brain has been demonstrated. However, whether different brain areas or neural circuits contribute to different aspects of the behavioral deficits is still unknown. Here, we found that MECP2-TG mice showed a significant social recognition deficit, and were prone to display aversive-like behaviors, including heightened anxiety-like behaviors and a fear generalization phenotype. In addition, reduced locomotor activity was observed in MECP2-TG mice. However, appetitive behaviors and learning and memory were comparable in MECP2-TG and wild-type mice. Functional magnetic resonance imaging illustrated that the differences between MECP2-TG and wild-type mice were mainly concentrated in brain areas regulating emotion and social behaviors. We used the CRISPR-Cas9 method to restore normal MeCP2 levels in the medial prefrontal cortex (mPFC) and bed nuclei of the stria terminalis (BST) of adult MECP2-TG mice, and found that normalization of MeCP2 levels in the mPFC but not in the BST reversed the social recognition deficit. These data indicate that the mPFC is responsible for the social recognition deficit in the transgenic mice, and provide new insight into potential therapies for MECP2 duplication syndrome.

Resveratrol inhibits hypoxia-induced oxidative stress and proliferation in pulmonary artery smooth muscle cells through the HIF-1α/NOX4/ROS signaling pathway / 生理学报

The purpose of the present study was to determine the effects of resveratrol on hypoxia-induced oxidative stress and proliferation in pulmonary artery smooth muscle cells (PASMCs) and the underlying mechanism. Primary rat PASMCs were isolated and cultured in vitro and pretreated with different concentrations of resveratrol (10, 20, and 40 µmol/L) or the NADPH oxidase (NOX) inhibitor VAS2870 (10 µmol/L) for 0.5 h. The cells were then cultured under normoxia (21% O