Clinical effects and mid-term follow-up analysis of para-split laminotomy for lumbar spinal canal tumors / 国际外科学杂志

Objective:To investigate the surgical outcome and prognostic factors of para-split laminotomy for removal of lumbar spinal canal tumors.Methods:Retrospectively review the clinical data of 35 patients suffering lumbar spinal canal tumors, who underwent the para-split laminotomy for tumor resection in Department of Neurosurgery, Clinical Medical College of Yangzhou University from October 2016 to August 2019, including 16 males and 19 females, and the age was(40.1±10.6)years. Intraoperative blood loss, operation time, tumor resection, tumor pathological results, perioperative complications were observed. Follow-up situations, including tumor recurrence, bony fusion of laminae and spinal stability. Follow-up using outpatient examination and telephone interview was performed by the end of August 2022. The JOA back pain scoring system was used to evaluate the neurological function of the spinal cord, and paired t-test were performed to compare the overall preoperative and postoperative spinal cord neurological function scores. Linear regression and multiple linear regression were used to analyze the prognostic factors. Measurement data of normal distribution were expressed as mean±standard deviation ( ± s), and the comparison before and after operation was performed by paired t-test. Mearsurement data of skewed distribution were expressed as M( Q1, Q3). Count data were expressed as cases. Results:The tumors of 35 patients were resected completely. The median blood loss was 100(75, 140)mL and the average operative duration was (181.1±42.7) min. The postoperative pathological results were as follows: 24 neurilemmomas, 6 meningiomas, 4 ependymomas and 1 neurofibroma. There were no surgery-related complications occurred. The postoperative follow-up ranged from 36 to 69 months, with no tumor recurrence or spinal instability, and bony fusion of laminae seen in some patients on CT imaging. The overall spinal cord neurological function scores of pre and post operation were(19.5±3.4)versus(25.4±2.2), Paired t-test analysis revealed a significant difference between the overall postoperative spinal cord neurological function scores and the preoperative scores, and the postoperative scores were better than the preoperative scores( P<0.05). Multiple linear regression analysis showed a positive correlation between preoperative JOA scores and postoperative JOA scores, and postoperative JOA scores has negative correlation with tumor volume and the age at the time of operation ( P<0.05). Conclusion:Para-split laminotomy with less damage to the posterior spinal structures can effectively improve the neurological function of the spinal cord and protect the stability of the lumbar spine in patients with lumbar spinal canal tumors, and the better the preoperative neurological function of the spinal cord, the better the prognosis of patients, and the smaller the tumor volume, the better the prognosis.

Application of PET-LINAC in Biology-guided Radiotherapy / 中国医疗器械杂志

Biology-guided radiotherapy (BgRT) is a novel technique of external beam radiotherapy, combining positron emission tomography-computed tomography (PET-CT) with a linear accelerator (LINAC). The key innovation is to utilize PET signals from tracers in tumor tissues for real-time tracking and guiding beamlets. Compared with a traditional LINAC system, a BgRT system is more complex in hardware design, software algorithm, system integration and clinical workflow. RefleXion Medical has developed the world's first BgRT system. Nevertheless, its actively advertised function, PET-guided radiotherapy, is still in the research and development phase. In this review study, we presented a number of issues related to BgRT, including its technical advantages and potential challenges.

开放科学(资源服务)标识码(OSID) Effect of Tanshinone ⅡA on abnormal integration of granule cells in the dentate gyrus of mice with chronic epilepsy / 西安交通大学学报(医学版)

【Objective】 To clarify the role and molecular mechanism of Tanshinone ⅡA (TanⅡA) in the pathological integration of granule cells in the dentate gyrus (DG) by using the mouse model of temporal lobe epilepsy (TLE). 【Methods】 Status epilepticus (SE) was induced in the mice with pilocarpine and treated with TanⅡA 5 mg/kg. After two months, Morris water maze was used to examine the spatial learning and memory ability and video surveillance was used to monitor spontaneous seizures. The DG was removed for staining of Timm, Prox-1, DCX and SynⅠ. PTEN, p-AKT, and p-S6 expressions were observed by Western blotting. 【Results】 TanⅡA decreased Timm score, SynⅠ, PSD-95 and pS6 levels, and increased the level of PTEN in the DG, and attenuated the formation of mossy fiber sproutings and basal dendrites of the granule cells. Video surveillance showed that TanⅡA reduced the frequency of Racine’ grade 5 seizures. 【Conclusion】 TanⅡA can effectively attenuate the abnormal integration of the granule cells in the DG by regulating PTEN/AKT/mTOR pathway and thus plays an anti-epileptic role.

Application of endovascular balloon occlusion in complex aortic surgery / 中华胸心血管外科杂志

Objective:To summarize the experience of 15 cases of balloon endovascular occlusion assisted aortic replacement.Methods:15 patients who needed reoperation after aortic surgery underwent endovascular balloon occlusion assisted aortic replacement by DSA guidance in the hybrid OR. Main inclusion criteria: The target vessel to be blocked cannot be directly blocked. Based on the last CTA before the operation, the diameter of the target vessel was measured, and the appropriate diameter balloon and the appropriate diameter balloon and the amount of contrast agent were selected. The vascular approach was selected according to the CTA.During the operation, the balloon was filled and fixed well, the distal invasive blood pressure waveform showed advection, and the pressure close to hydrostatic pressure as the complete blocking standard.Results:All 15 cases of balloon endovascular occlusion assisted aortic surgery were successful. After the operation, 14 target vessels normally without damage, and there was no vascular complication. One case after surgical three-branch stent surgery underwent the second thoracoabdominal aortic replacement operation. After the stent was blocked by the balloon, the new tissue in the stent fell off, and the celiac trunk and superior mesenteric artery were embolized for reoperation.Conclusion:Balloon endovascular occlusion technology expands the indications of aortic surgery and simplifies the operation, that is a safe and effective occlusion method. Whether the target vessel is suitable for balloon occlusion should be judged before the operation to avoid related complications.

Proton FLASH radiotherapy / 中华放射肿瘤学杂志

FLASH radiotherapy (FLASH-RT) is a treatment modality that delivers ultra-high dose rate and ultra-fast radiation for cancer treatment. Compared to conventional dose rate radiotherapy, FLASH-RT can yield similar efficacy for tumors and achieve normal tissue protection, translating to an increased therapeutic window. Due to this unique feature, FLASH-RT is attracting increasing attention from the radiotherapy community, both academia and industry. Due to its unique Bragg peak as well as intrinsic high dose rate, application of FLASH has more value and profound significance in proton therapy while achieving highly conformal dose deposition simultaneously. This article reviews research progress on FLASH-RT, relevant cell and animal studies, experimental conditions and results. Moreover, this article also investigates the potential biological mechanisms, technical challenges for implementation and potential clinical applications of FLASH-RT.

Mechanism of Sinomenii caulis in the treatment of rheumatoid arthritis based on network pharmacology / 药学实践杂志

Objective To explore the molecular targets and associated potential pathways of Sinomenii caulis in the treatment of rheumatoid arthritis (RA) based on network pharmacology. Methods The constituents of Sinomenii caulis were searched by Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). The potential active ingredients were screened based on oral bioavailability (OB) and drug like index (DL) in TCMSP database. The potential targets of active ingrediens were explored based on DRAR-CPI docking server. RA related gene targets were retrieved through GeneCards and OMIM database. Venn online software was used to obtain the common target of drugs and diseases. The "herbs-compound-target-disease" network diagram was constructed by using Cytoscape software. String database was used to draw the protein interaction (PPI) network. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of the intersection network were conducted by Bioconductor Database. Results 6 active ingredients and 176 targets were identified. 305 target genes directly related to RA were obtained from the GeneCards and OMIM databases. 15 genes were obtained from the intersection of component-target and disease-target. The GO function analysis found 500 items on biological process (BP), 18 items on cellular component (CC), and 28 items on molecular function (MF). KEGG pathway enrichment analysis revealed 77 pathways. Conclusion This study identified six active ingredients from Sinomenii caulis and revealed the key targets of the anti-RA treatment with Sinomenii caulis being IL10、IL4、INS、MAPK8、ELANE、MAPK1 and MAPK14. The important biological processes and signaling pathways including infection, inflammation and immunity were explored. It has laid the foundation for further molecular biology experiments.

The reduction of coagulation factor activity R before surgery increases the risk of postoperative neurological complications in patients with acute type A aortic dissection / 中国胸心血管外科临床杂志

@#Objective    To analyze the risk factors for neurological complications after emergency surgery of acute type A aortic dissection. Methods    The clinical data of 51 patients with acute Stanford type A aortic dissection who were admitted to Shanghai Delta Hospital from October 2018 to May 2019 were retrospectively analyzed. There were 37 males (72.5%) and 14 females (27.5%), aged 29-85 (55.1±12.3) years. The patients were divided into two groups, including a N1 group (n=12, patients with postoperative neurological insufficiency) and a N0 group (n=39, patients without postoperative neurological insufficiency). The clinical data of the two groups were compared and analyzed. Results    There were statistical differences in age (62.6±11.2 years vs. 51.7±11.4 years, P=0.003), preoperative D-dimer (21.7±9.2 μg/L vs.10.8±10.7 μg/L, P=0.001), tracheal intubation time (78.7±104.0 min vs. 19.6±31.8 min, P=0.003), ICU stay time (204.1±154.8 min vs. 110.8±139.9 min, P=0.037) and preoperative coagulation factor activity R (4.0±1.5 vs. 5.1±1.6, P=0.022). Preoperative coagulation factor activity R was the independent risk factor for neurological insufficiency after emergency (OR=2.013, 95%CI 1.008-4.021, P=0.047). Conclusion    For patients with pre-emergent acute aortic dissection who are older (over 62.6-64.5 years), with reduced coagulation factor R (less than 4.0), it is recommended to take more active brain protection measures to reduce the occurrence of postoperative neurological complications in patients with acute aortic dissection, and further improve the quality of life.

Risk factors of delayed bleeding after endoscopic submucosal dissection treatment for duodenal mass lesions / 中华消化内镜杂志

Data of 55 patients with duodenal mass lesions treated by endoscopic submucosal dissection (ESD) were retrospectively analyzed. Risk factors of delayed bleeding after ESD were explored by univariate analysis and multivariate unconditional logistic regression analysis. Duodenal delayed bleeding occurred in 5 patients (9.09%). No closure treatment under endoscopy( P=0.035) was significantly different between the delayed bleeding group and the non-delayed bleeding group. Multivariate non-conditional logistic regression showed no closure treatment under endoscopy was an independent risk factor for delayed bleeding after ESD in duodenal mass lesions ( P=0.029, OR=0.079, 95% CI: 0.008-0.776). Patients older than 60 years and who did not take endoscopic closure treatment have higher incidences of delayed bleeding after ESD. No closure treatment under endoscopy is directly related to postoperative delayed bleeding.

Computed tomography-identified phenotypes of small airway obstructions in chronic obstructive pulmonary disease / 中华医学杂志(英文版)

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease characteristic of small airway inflammation, obstruction, and emphysema. It is well known that spirometry alone cannot differentiate each separate component. Computed tomography (CT) is widely used to determine the extent of emphysema and small airway involvement in COPD. Compared with the pulmonary function test, small airway CT phenotypes can accurately reflect disease severity in patients with COPD, which is conducive to improving the prognosis of this disease. CT measurement of central airway morphology has been applied in clinical, epidemiologic, and genetic investigations as an inference of the presence and severity of small airway disease. This review will focus on presenting the current knowledge and methodologies in chest CT that aid in identifying discrete COPD phenotypes.

Effect of delayed cord clamping and umbilical cord milking on cerebral hemodynamics in preterm infants: a randomized double-blind controlled trial / 中国当代儿科杂志

OBJECTIVE@#To compare the effect of delayed cord clamping (DCC) versus umbilical cord milking (UCM) on cerebral blood flow in preterm infants.@*METHODS@#This was a single-center, prospective, double-blind, randomized controlled trial. A total of 46 preterm infants, with a gestational age of 30-33@*RESULTS@#A total of 21 preterm infants in the DCC group and 23 in the UCM group were included in the statistical analysis. There was no significant difference in PSV, EDV, and RI between the two groups at all time points after birth (@*CONCLUSIONS@#DCC and UCM have a similar effect on cerebral hemodynamics in preterm infants with a gestational age of 30-33

Expression of Semaphorin 3A after spinal cord injury / 中国骨伤

OBJECTIVE@#To investigate expression of Semaphorin 3A in rats after spinal cord injury and explore possible mechanism of inhibiting of axonal regeneration after SCI.@*METHODS@#Forty healthy female SD rats, 8 weeks old, weighing (210.00±9.88) g, were randomly divided into control group(20 rats in group A) and model group(20 rats in group B). In control group, removal of T@*RESULTS@#After a simple spinal cord transection injury, hemorrhagic necrosis, localized edema, neurodegeneration, necrosis, and cyst formation occurred in the injured area, and glial scar formation occurred in glial cells. Semaphorin 3A expression levels in control group was low in the gray matter area. There was no expression of Semaphorin 3A in the injured area of spinal cord injury in model group 3 days after operation. On the 14th day, the expression of Semaphorin 3A in the injured area of spinal cord injury increased significantly and was at a high level. On the 28th day, the expression of Semaphorin 3A was moderate. On the 42th day, the positive expression of Semaphorin 3A returned to normal level.@*CONCLUSION@#The increased expression of Semaphorin 3A after spinal cord injury may be one of the mechanisms that inhibit axonal regeneration.

A case-control study of cervical spine Key-hole technique and anterior cervical Zero-P system in the treatment of cervical spondylotic radiculopathy / 中国骨伤

OBJECTIVE@#To explore the short-term clinical efficacy of single-stage cervical spondylotic radiculopathy (CSR) between the minimally invasive Key-hole technique and anterior cervical Zero profile intervertebral fusion system (Zero-P).@*METHODS@#A retrospective analysis was performed on 45 patients who underwent surgical treatment for CSR from January 2017 to January 2020, including 21 in Key hole group (12 males and 9 females), followed up for 10-22(13.2±2.3) months;24 cases in Zero-P group (14 males and 10 females), and the follow up period was 10 to 23(12.7±1.9) months. Perioperative conditions (incision length, intraoperative blood loss, operation time, length of hospital stay, and complications) were compared between two groups, and X-rays of cervical spine before and after surgery and at the final follow-up were taken to analyzed curvature of the cervical spine, visual analogue scale(VAS) of pain before and after surgery, Oswestry Disability Index(ODI) and Japanese Orthopaedic Association (JOA) score of cervical spine were recorded to evaluate clinical efficacy.@*RESULTS@#In Key-hole group and Zero-P group, the surgical incision length, intraoperative blood loss, operation time, final follow-up Cobb angle and immediate postoperative VAS score respectively were (1.2±0.2) cm, (5.3±0.3) cm;(35.3±9.7) ml, (120.2±13.5) ml;(56.4±11.3) min, (90.6±12.6) min;(3.2±3.9)°, (7.3±3.8)°;(2.8±1.2)points, (3.8±1.1) points;the Zero-P group was larger than the Key hole group, with statistical significance(@*CONCLUSION@#The cervical spine Key-hole technology is similar to the anterior cervical Zero-P system in the treatment of CSR. The Key-hole technique has certain advantages in incision length, intraoperative blood loss, and operation time. It is a safe, effective and can be widely used cervical spine surgery method.

Effect of a double-buffered diagnosis and treatment model for emergency orthopedic trauma patients during pandemic of corona virus disease 2019 / 中华创伤杂志

During pandemic of corona virus disease 2019 (COVID-19), emergency orthopedic trauma is commonly seen. It is particularly important to ensure the emergency treatment quality of orthopedic trauma but avoid cross-infection between doctors and patients. The double-buffered diagnosis and treatment mode refers to the model of patients first undergoing medical observation in the comprehensive buffer ward and the inpatient buffer rooms of various disciplines after admission to confirm the exclusion of COVID-19 and then receiving specialist diagnosis and treatment. The authors summarize the experiences of using the double-buffered diagnosis and treatment model in the Department of Orthopedics, Renmin Hospital of Wuhan University during the prevention and control of COVID-19 pandemic so as to provide a reference for treatment of orthopedic patients.

Relationship of lower limb force line and the progression of lateral compartment arthritis after unicompartmental knee arthroplasty with mobile bearing / 中国组织工程研究

BACKGROUND: The long-term follow-up report shows that the progress of lateral compartment osteoarthritis is an important reason for the revision of unicompartmental knee arthroplasty, and the force line of lower limbs is considered to be an important factor leading to the progress of lateral compartment osteoarthritis after unicompartmental knee arthroplasty. OBJECTIVE: To explore the influence of lower limb force line on the progression of lateral compartment arthritis in unicompartmental knee arthroplasty with mobile bearing. METHODS: From March 2014 to March 2017, a retrospective analysis was conducted in 84 patients who underwent unicompartmental knee arthroplasty in the Department of Arthrology, Foshan Hospital of Traditional Chinese Medicine. Kellgren-Lawrence X-ray grading was used to evaluate the osteoarthritis of the lateral compartment during the follow-up. According to whether osteoarthritis of the lateral compartment was more advanced than that of the operation during the last follow-up, it was divided into the advanced group and the non-advanced group. The force lines of the lower limbs, such as hip-knee-ankle angle and Kennedy area distribution of the mechanical axis of the lower limbs, were compared between the two groups. Simultaneously, the knee joint function of the two groups was compared by the Hospital for Special Surgery knee score, visual analogue scale score of the knee joint, and motion range of the knee. The relationship between the changes of lower extremity force lines and the progress of lateral compartment arthritis was analyzed. RESULTS AND CONCLUSION: (1) All patients were followed up for 36-72 months, and no complications such as infection, poor wound healing, periprosthetic fracture, polyethylene gasket dislocation occurred. (2) Among the 84 patients, 27 cases were in the advanced group and 57 cases were in the non-advanced group. Significant differences in Hospital for Special Surgery knee score and visual analogue scale score were detected at the last follow-up between the advanced group and the non-advanced group (P 0.05). (3) At the last follow-up, the average hip-knee-ankle angle in the advanced group was (-1.02±3.13)°, while that in the non-advanced group was (3.94±1.56)°. The difference between the two groups was statistically significant (P < 0.05). Meanwhile, there was a significant difference in hip-knee-ankle angle between the last follow-up and the preoperation between the two groups (P < 0.05). (4) The regional distribution of lower limb mechanical axis Kennedy was compared between the two groups at the last follow-up, and the difference was statistically significant (P < 0.05). The postoperative lower limb force lines were mostly located in zone 3 and C in the advanced group, and mostly located in zone 2 in the non-advanced group. (5) Good lower limb alignment is the key factor affecting the clinical efficacy after unicompartmental knee arthroplasty with mobile bearing. Average varus angle of mechanical axis was approximately 3.94° in patients with well-functioning unicompartmental knee arthroplasty at follow-up, whereas patients for progression of osteoarthritis were in more valgus (mean 1.02° of valgus).

Effect of body mass index on the early-term hip functional recovery after total hip arthroplasty by three-dimensional gait analysis / 中国组织工程研究

BACKGROUND: The impact of obesity on total hip arthroplasty has been discussed. However, there is a lack of follow-up study on the patients with different body mass indexes using three-dimensional gait analysis. OBJECTIVE: To investigate the effect of body mass index on the early-term functional recovery after total hip arthroplasty by three-dimensional gait analysis. METHODS: Sixty patients who underwent total hip arthroplasty at Department of Joint Surgery of Affiliated Zhongshan Hospital of Dalian University from January 2017 to June 2018 were enrolled. According to the body mass index at admission, they were divided into overweight group (body mass index ≥ 25 kg/m2) and normal group (body mass index 0.05). The operation time in the overweight group was significantly longer than that in the normal group (P=0.000). (2) In terms of time-distance parameters, there was no significant difference in the stride length, stride frequency and mean velocity between two groups. The stride length in the overweight group was smaller than that in the normal group (1.08±0.18 vs. 1.35±1.45 m). (3) The range of motion of each planes of hip joint in the overweight group was significantly less than that in the normal group (P < 0.05). (4) In terms of kinetic parameters, the peak torque of hip flexion in the overweight group was significantly less than in the normal group (P=0.011). There was no significant difference in the peak torque of hip extension between two groups (P=1.000). (5) To conclude, obesity has certain effect on the early functional recovery after total hip arthroplasty.

Epidemic trend of corona virus disease 2019 (COVID-19) in mainland China / 中华预防医学杂志

Objective@#In order to master the epidemic trend of corona virus disease 2019 (COVID-19) and evaluate the effect of prevention and control, we evaluate the epidemic dynamics of COVID-19 in mainland China, Hubei province, Wuhan city and other provinces outside Hubei from January 16 to February 14, 2020.@*Methods@#We collected the daily number of new confirmed COVID-19 cases by nucleic acid detection reported by the National Health Commission from January 16, 2020 to February 14, 2020. The analysis includes the epidemic curve of the new confirmed cases, multiple of the new confirmed cases for period-over-period, multiple of the new confirmed cases for fixed-base, and the period-over-period growth rate of the new confirmed cases.@*Results@#From January 16 to February 14, 2020, the cumulative number of new confirmed cases of COVID-19 in mainland China was 50 031, including 37 930 in Hubei province, 22 883 in Wuhan city and 12 101 in other provinces outside Hubei. The peak of the number of new confirmed cases in other provinces outside Hubei was from January 31 to February 4, 2020, and the peak of new confirmed cases in Wuhan city and Hubei province was from February 5 to February 9, 2020. The number of new confirmed cases in other provinces outside Hubei showed a significant decline (23% compared with the peak) from February 5 to February 9, 2020, while the number of new confirmed cases in Wuhan city (30% compared with the peak) and Hubei Province (37% compared with the peak) decreased significantly from February 10 to February 14, 2020.@*Conclusion@#The epidemic prevention and control measures taken by the state and governments at all levels have shown very significant effects, effectively curbing the spread of the COVID-19 epidemic in China.

Light therapy: a new option for neurodegenerative diseases / 中华医学杂志(英文版)

Given the increasing incidence of neurodegenerative disease (ND), recent research efforts have intensified the search for curative treatments. Despite significant research, however, existing therapeutic options for ND can only slow down the progression of the disease, but not provide a cure. Light therapy (LT) has been used to treat some mental and sleep disorders. This review illustrates recent studies of the use of LT in patients with ND and highlights its potential for clinical applications. The literature was collected from PubMed through June 2020. Selected studies were primarily English articles or articles that could be obtained with English abstracts and Chinese main text. Articles were not limited by type. Additional potential publications were also identified from the bibliographies of identified articles and the authors' reference libraries. The identified literature suggests that LT is a safe and convenient physical method of treatment. It may alleviate sleep disorders, depression, cognitive function, and other clinical symptoms. However, some studies have reported limited or no effects. Therefore, LT represents an attractive therapeutic approach for further investigation in ND. LT is an effective physical form of therapy and a new direction for research into treatments for ND. However, it requires further animal experiments to elucidate mechanisms of action and large, double-blind, randomized, and controlled trials to explore true efficacy in patients with ND.

Expression and Significance of Foxa2 in Colorectal Polyps and Colorectal Cancer / 胃肠病学

Background: Forkhead box A2 (Foxa2) plays an important role in the proliferation and distant metastasis of colorectal cancer, but the expression of Foxa2 in colorectal polyps has not been reported yet. Aims: To investigate the expression and significance of Foxa2 in colorectal polyps and colorectal cancer. Methods: A total of 45 patients with hyperplastic polyps, 135 patients with adenomatous polyps and 45 patients with colorectal cancer and corresponding adjacent tissue from January 2018 to May 2019 at Renmin Hospital of Wuhan University were collected. Immunohistochemical SP staining was used to detect the expression of Foxa2. Expressions of Foxa2 mRNA and protein were determined by real-time fluorescence quantitative PCR and Western blotting, respectively. The relationships between the expression of Foxa2 and colorectal polyps, colorectal cancer were analyzed. Results: The positive expression rate of Foxa2 in normal colorectal mucosal tissue, hyperplastic polyps, adenomatous polyps and colorectal cancer was gradually increased (13.3%, 31.1%, 62.2%, 86.7%, respectively), and the difference was statistically significant (P<0.05). The expressions of Foxa2 mRNA and protein were also increased, and the differences were statistically significant (P<0.05). The expression of Foxa2 in adenomatous polyps was related to size of polyps and presence of pedicle (P<0.05); the expression of Foxa2 in colorectal cancer was related to differentiation, lymph node metastasis and TNM staging (P<0.05). Conclusions: The expression of Foxa2 is high in adenomatous polyps and colorectal cancer, and increases with the increase of risk of canceration. Therefore, detecting the expression of Foxa2 in colorectal polyps is helpful for the early detection of colorectal cancer.

Challenges and solution to health technology assessment of rare diseases / 国际药学研究杂志

Rare diseases are diseases with a low incidence and prevalence. In 2018, China published its first list of 121 rare diseases, which set up the foundation for future rare diseases policy formulation. Health technology assess-ment(HTA)is a policy analysis to evaluate the cost-effectiveness, patient reported outcomes, and societal benefits of in-novative technology from multiple dimensions. Due to the nature of rare diseases, there are a number of challenges to ap-ply HTA in rare disease area, including the very low disease prevalence, high heterogenicity of the diseases and a rela-tively higher cost of innovative interventions. Hence, many of the developed countries are applying special methods and procedures for rare diseases HTA, such as the acceptance of lower-level evidence, a higher threshold of cost-effective-ness ratio, and complete exemption of HTA for orphan drugs. In China, the HTA system has not been formally estab-lished yet. Rare disease-related HTA is facing even more challenges. However, the publication of the first list of rare dis-eases is an important milestone to facilitate the establishment of an HTA process of rare disease interventions in China.

Minimally invasive application of alveolar surfactant in neonatal respiratory distress syndrome / 中华实用儿科临床杂志

Pulmonary surfactant (PS) replacement therapy has been widely used in the treatment of neonatal respiratory distress syndrome (NRDS). At present, PS is widely applied with intubation-surfactant-extubation (INSURE). As an invasive operation, INSURE can lead to airway injury and tracheal intubation related complications.Therefore, attention has been paid to minimally invasive surfactant therapy(MIST), including administration of exogenous surfactant by intrapharyngel instillation, nebulization, a laryngeal mask and a thin catheter [less invasive surfactant administration(LISA)]. LISA can reduce the airway injure caused by INSURE administration of exogenous surfactant and decrease the risk of mechanical ventilation and bronchopulmonary dysplasia, so LISA has a good prospect in clinical application.In order to make better and more reasonable use of MIST, this paper describes the current situation and curative effect of MIST on NRDS.