Trifecta achievement in patients undergoing partial nephrectomy: a systematic review and meta-analysis of predictive factors

ABSTRACT Purpose The predictors of trifecta achievement in partial nephrectomy (PN) were poorly inquired and remained a controversial area of discovery. To evaluate predictive factors of trifecta achievement in patients undergoing PN. Materials and Methods A systematic literature search was performed to identify relevant articles. Only studies focusing on postoperative trifecta achievement and exploring its predictor with multivariable analyses were included. The trifecta achievement was defined as negative surgical margins, warm ischemia time <25 minutes, and no complications. Merged odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the predictive effect. Results Thirteen studies with 7066 patients meeting the inclusion criteria were included. The rate of trifecta achievement ranged from 43.3% to 78.6%. Merged results showed that preoperative eGFR (OR: 1.01, 95% CI: 1.00, 1.02, P=0.02), operative time (OR: 0.99, 95% CI: 0.99, 1.00, P=0.02), estimated blood loss (OR: 1.00, 95% CI: 1.00, 1.00, P <0.001), tumor size (OR: 0.70, 95% CI: 0.58, 0.84, P <0.001), medium (OR: 0.39, 95% CI: 0.18, 0.84, P=0.02) and high PADUA score (OR: 0.23, 95% CI: 0.08, 0.64, P=0.005) were independently associated with trifecta achievement. A publication bias was identified for tumor size. Sensitivity analysis confirmed the stability of result for tumor size. Conclusions Larger tumor size, medium and high PADUA score are associated with decreased probability of trifecta achievement. After verifying by further high-quality studies, these variables can be incorporated into tools to predict probability of trifecta achievement during clinical practice.

Epidemical characteristics of human brucellosis in Inner Mongolia Autonomous Region from 2018 to 2020 / 中华地方病学杂志

Objective:To investigate the epidemic characteristics of human brucellosis in Inner Mongolia Autonomous Region from 2018 to 2020, and provide a reliable scientific basis for formulating brucellosis prevention and control strategies in Inner Mongolia Autonomous Region.Methods:A retrospective study was carried out to collect data of human brucellosis in Inner Mongolia Autonomous Region from 2018 to 2020 from the "China Disease Control and Prevention Information System", and the monitoring data and information of confirmed cases were collected from the annual summary data reported by the leagues (cities) of the Inner Mongolia Autonomous Region. Using descriptive epidemiological methods, the epidemic situation, three distributions (time, region and population distributions) of brucellosis, and the serological and pathogenic test results of active monitoring population were analyzed.Results:From 2018 to 2020, a total of 40 665 cases of brucellosis were reported in Inner Mongolia Autonomous Region, with an annual average incidence rate of 53.47/100 000. The number of annual incidence had increased from 10 111 in 2018 to 16 406 in 2020, and the annual incidence rate had increased from 39.99/100 000 in 2018 to 64.60/100 000 in 2020. The spring and summer was the peak incidence, mainly in March to August, accounting for 64.90% (26 390/40 665) . There were reports of brucellosis cases in 12 leagues (cities) of Inner Mongolia Autonomous Region, and the top 3 regions with the number of reported cases were Tongliao City (9 896 cases), Xing'an League (6 136 cases) and Chifeng City (4 934 cases). The age of onset of brucellosis cases was mainly 30 - < 65 years old(33 539 cases), and the sex ratio between men and women was 2.18 ∶ 1.00 (27 890 ∶ 12 775); the occupational distribution was mainly farmers, accounting for 79.23% (32 221/40 665). From 2018 to 2020, 704 085 people were actively monitored in the region, of which 391 941 were serologically tested, and the infection rate was 4.57% (17 920/391 941); and there were 9 539 new cases in the active monitoring population. In 3 years, 19 strains of Brucella sheep type 3 and 11 strains of Brucella sheep type 1 were isolated. Conclusions:From 2018 to 2020, the incidence rate of brucellosis in Inner Mongolia Autonomous Region is increasing year by year. There are many new cases in the active monitoring population, and more underreporting cases. It is recommended to expand the scope of monitoring, strengthen pathogen monitoring among humans and animals, and joint prevention and control of various departments to improve the self-protection awareness of the masses.

Effects of PGC1 / 中南大学学报(医学版)

OBJECTIVES@#Peroxisome proliferator-activated receptor gamma coactivator 1α (PGC1α) controls mitochondrial biogenesis, but its role in cardiovascular diseases is unclear. The purpose of this study is to explore the effect of PGC1α on myocardial ischemia-reperfusion injury and the underlying mechanisms.@*METHODS@#The transverse coronary artery of SD rat was ligated for 30 minutes followed by 2 hours of reperfusion. Triphenyltetrazolium chloride (TTC) staining was performed to measure the area of myocardial infarction. Immunohistochemistry and Western blotting were used to detect the PGC1α expression in myocardium. The rat cardiomyocyte H9C2 was subjected to hypoxia/reoxygenation (H/R) with the knockdown of PGC1α or hypoxia- inducible factor 1α (HIF-1α), or with treatment of metformin. Western blotting was used to detect the expression of PGC1α, HIF-1α, p21, BAX, and caspase-3. CCK-8 was performed to detect cell viability, and flow cytometry was used to detect apoptosis and mitochondrial superoxide (mitoSOX) release. RT-qPCR was used to detect the mRNA expression of PGC1α and HIF-1α. Besides, chromatin immunoprecipitation (ChIP)-qPCR and luciferase reporter gene assay were applied to detect the transcriptional regulation effect of HIF-1α on PGC1α.@*RESULTS@#After I/R, the PGC1α expression was increased in infarcted myocardium. H/R induced H9C2 cell apoptosis (@*CONCLUSIONS@#After I/R, HIF-1α up-regulates the expression of PGC1α, leading to an increase in ROS production and aggravation of injury. Metformin can inhibit the accumulation of HIF-1α during hypoxia and effectively protect myocardium from ischemia/reperfusion injury.

Investigation and analysis of brucellosis infection risk factors in high-incidence areas of Xilinhot Inner Mongolia / 中华地方病学杂志

Objective:To grasp the exposure factors and risk factors of brucellosis in animal products practitioners in Xilinhot, and provide data support for targeted prevention and control of the disease.Methods:In 2018, employees of different types and sizes of cattle and sheep slaughtering and processing related enterprises, as well as individual practitioners engaged in animal product acquisition, trafficking, market transactions, street slaughtering and other activities were selected as the target of the survey in Xilinhot City, Inner Mongolia Animal Products Processing Zone, to conduct a group survey on the selected enterprises, and conduct surveys on individual practitioners by means of searching in the market and recruiting free clinics. The survey was focused on basic conditions, incidence, types of work, and work habits. The sera of the survey subjects were collected for testing. Risk factors were analyzed for the work habits of seropositive cases with brucellosis.Results:A total of 15 cattle and sheep slaughter and processing enterprises were investigated, including 371 workers, of whom 24 were seropositive; 219 individual practitioners were surveyed, 38 of whom were seropositive. Among different types of work, enterprise workers were involved in a total of 10 types of work, of which dead lambs were the most dangerous, with a prevalence of 26.67% (4/15), followed by boning meat, with a prevalence of 14.71% (15/102); 11 individuals were involved in 10 types of work, of which eviscerate meat was the most dangerous, with a prevalence of 50.00% (6/12), followed by treatment of dead lambs, with a prevalence of 33.82% (23/68). As a result of the survey of risk factors, slaughtering and processing enterprises practitioners were surveyed 13 types of work habits, 5 of which were risk factors for brucellosis, including mouth tools, scratching the skin, not wearing a hat, contaminating the whole body, and contaminating the head and face. The individual pratitioners were investigated 12 work habits, 5 of which were risk factors for brucellosis, including not wearing a mask, not taking a bath after work, contaminating the limbs, contaminating the head and face, and not washing hands before meals.Conclusions:Workers engaged in boning meat and dead lamb processing are at higher risk of contracting brucellosis. Individuals and enterprise workers have some work habits, which are risk factors for contracting brucellosis. Publicity and education and behavior intervention measures should be strengthened in the future.

Role of penehyclidine in acute organophosphorus pesticide poisoning / 世界急诊医学杂志（英文）

BACKGROUND@#Penehyclidine is a newly developed anticholinergic agent. We aimed to investigate the role of penehyclidine in acute organophosphorus pesticide poisoning (OP) patients.@*METHODS@#We searched the Pubmed, Cochrane library, EMBASE, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical literature (CBM) and Wanfang databases. Randomized controlled trials (RCTs) recruiting acute OP patients were identified for meta-analysis. Main outcomesincluded cure rate, mortality rate, time to atropinization, time to 60% normal acetylcholinesterase (AchE) level, rate of intermediate syndrome (IMS) and rate of adverse drug reactions (ADR).@*RESULTS@#Sixteen RCTs involving 1,334 patients were identified. Compared with the atropine-or penehyclidine-alone groups, atropine combined with penehyclidine significantly increased the cure rate (penehyclidine+atropine vs. atropine, 0.97 vs. 0.86, RR 1.13, 95% CI [1.07–1.19]; penehyclidine+atropine vs. penehyclidine, 0.93 vs. 0.80, RR 1.08, 95% CI [1.01–1.15]) and reduced the mortality rate (penehyclidine+atropine vs. atropine, 0.015 vs. 0.11, RR 0.17, 95% CI [0.06–0.49]; penehyclidine+atropine vs. penehyclidine, 0.13 vs. 0.08, RR 0.23, 95% CI [0.04–1.28]). Atropine combined with penehyclidine in OP patients also helped reduce the time to atropinization and AchE recovery, the rate of IMS and the rate of ADR. Compared with a single dose of atropine, a single dose of penehyclidine also significantly elevated the cure rate, reduced times to atropinization, AchE recovery, and rate of IMS.@*CONCLUSION@#Atropine combined with penehyclidine benefits OP patients by enhancing the cure rate, mortality rate, time to atropinization, AchE recovery, IMS rate, total ADR and duration of hospitalization. Penehyclidine combined with atropine is likely a better initial therapy for OP patients than atropine alone.

Analysis and Some Thoughts on Safety Evaluation of Hearing Aids / 中国医疗器械杂志

Based on analysis of the domestic and foreign laws and regulations for hearing aids,some suggestions of safety evaluation about standards,premarket technical review and regulation are presented in this article.It is hoped to be helpful for registration and regulation of hearing aids.

Epidemiological analysis of 1 940 cases of brucellosis in Hohhot / 中华地方病学杂志

Objective To understand the epidemiological characteristics of recent brucellosis in Hohhot.Methods Clinical data of patients with brucellosis in Hohhot City were retrospectively analyzed,and the patients were diagnosed in the outpatient clinic of Comprehensive Center for Disease Prevention and Control of Inner Mongolia Autonomous Region from 2014 to 2017.To analyze the patient's area,age,gender,occupation and time distribution of the disease.Results A total of 1 940 patients with brucellosis were diagnosed in Hohhot from 2014 to 2017,with an average age of 50.8 years old.There were 1 464 males with an average age of 50.4 years old and 476 females with an average age of 51.9 years old;the male-female ratio was 3:1.The number of cases of brucellosis in 2014-2017 was 612,649,402,and 277,respectively.Brucellosis was mainly distributed in three districts including Horinger County (937 cases),Tumd Left Banner (236 cases) and Tuoketuo County (191 cases),accounting for 70.31％ (1 364/1 940) of the total number of cases in the city.The age of onset was at least 1 year old,the oldest age was 86 years old,and most cases were in the 45-＜ 65 age group,the total number of cases was 1 046,accounting for 53.92％ (1 046/1 940) of the total number of cases in the city;the occupational distribution was mainly farmers (1 795 cases),herders (13 cases) and veterinarians (17 cases),with a total of 1 825 cases,accounting for 94.07％ (1 825/1 940).The time distribution was mainly concentrated in March-July,and the number of cases was 1 157 cases.Conclusions The number of brucellosis cases in Hohhot area of Inner Mongolia is mainly from Horinger County,Tumd Left Banner and Tuoketuo County;the cases occur frequently in Spring and Summer;the age of onset is mainly between 45-＜ 65 years old,they are mainly male farmers.

Relationship between Wound Age and the Expression of Fzd2 in Rats Skeletal Muscle after Contusion / 法医学杂志

Objective To investigate the relationship between wound age and the expressions of frizzled-2 (Fzd2) mRNA and its protein in rats skeletal muscle after contusion,and to explore its possibility of being an index for wound age estimation.Methods The mRNA and protein expressions of Fzd2 in rats skeletal muscle of the control group and the experimental group within 4-48 h after contusion were detected per 4 h by RT-qPCR and Western blotting.Results The relative expression of Fzd2 mRNA increased at 24h,36h and 40h after contusion,and the expression at 24h was twice as the control group (P＜0.05).The relative expression of Fzd2 protein changed inconspicuously after contusion (P＞0.05).Conclusion The changes of Fzd2 mRNA expression after contusion in a certain time can be a basis to estimate wound age by combined multi-indicators.

Preparation Technology of Zucapsaicin Cream / 医药导报

Objective To select the optimal preparation technology of zucapsaicin cream and compare it with zuacta cream.Methods Cold stability,thermal stability,centrifugal stability,and appearance were used as indicators to select the ratio of prescription.In this study preparation technology was optimize by using orthogonal experiment method,and transdermal absorption of the homemade zucapsaicin cream and zucata cream were investigated by employing modified Franz diffusion pool.Results The optimized preparation technology was as follows,emulsifying temperature was maintained at 70 ℃,the stirring speed was set at 2 000 r·min-1,the main medicine was added into the oil phase,emulsifying time was 30 min.The results showed that there was no significant difference between the homemade zucapsaicin cream and the reference Zuacta cream.Conclusion The homemade zucapsaicin were tested to have reasonable ratio of prescription,stability,and definite transdermal effect,which was basically in accordance with zuacta cream.

Effect of Curcumin on Expression of Hepatocyte Nuclear Transcription Factor in Liver Cancer Cell Hepg-2 Induced by TNF-α / 中国中医药信息杂志

Objective To investigate the effect of curcumin on the expression of nuclear transcription factor (NF-kappa B) and its inhibitory protein (Iκ-Bα) in liver cancer cells (Hepg-2) induced by TNF-α, and explore its effect on non-alcoholic steatohepatitis. Methods The cells were divided into normal group, TNF-alpha group, and different concentrations of curcumin treatment group. MTT and Western blotting were used to assay curcumin’s effect on Hepg-2 proliferation activity and changes of NF-κB and Iκ-Bα’s in Hepg-2. Results Compared with the normal group, TNF-αgroup enhanced NF-κB and Iκ-Bαexpression, but the increase of Iκ-Bα had no statistical significance (P>0.05). Curcumin treatment group’s NF-κB expression was significantly weakened than TNF-α group, while Iκ-Bα was significantly enhanced than that of TNF-α group. Conclusion Curcumin can antagonize NF-κB inflammatory signaling pathway activation induced by TNF-α, thus reduce the inflammatory injury of the liver cells.

Expression of MCP-1 in the pancreas of piglet with chronic obstructive pancreatitis and its significance / 中华胰腺病杂志

Objective To determine the serum concentration of MCP-1 and the expression of MCP-1 protein in the pancreas in the piglet with chronic obstructive pancreatitis and to explore the role of MCP-1 protein in pancreatic fibrosisits.Methods The piglet model of chronic obstructive pancreatitis was established by incomplete ligation of the pancreatic duct.The piglets were sacrificed at 4, 6, 8 weeks after induction.Pathological changes of pancreas were examined.Pancreatic fibrosis was assessed by VG staining.Serum MCP-1 concentrations were detected by ELISA method.MCP-1 and α-SMA, PDGF, TGF-β1 and NF-κB protein expression were detected by immunohistochemistry.Results The induction was successful in 14 piglets ( 58.3% ).Mild atrophic changes, interstitial fibrosis, chronic inflammatory cell infiltration could be observed in the body and tail of pancreas from the 4th week in the experimental group.The most obvious changes occurred in the 8th week.Stage Ⅰ pancreatic fibrosis occurred in 5 piglets (35.7%), stage Ⅱ in 4 piglets (28.6%), stage Ⅲ in 5 rats ( 35.7% ).Seurm MCP-1 at 4, 6, 8 weeks was ( 102.44 ± 36.25 ) pg/ml,(97.84 ± 28.67) pg/ml, ( 94.32 ± 28.42 ) pg/ml, respectively, and was significantly higher than that in control group [ ( 10.42 ±5.86) pg/ml, (8.58 ±4.86) pg/ml, (8.22 ±4.58) pg/ml, P ＜0.01 ].There was no MCP-1 protein expression in the control group;MCP-1 protein was detected in the successful induction group, and MCP-1 expression was positively correlated with expressions of the PDGF, TGF-β1, α-SMA and NF-κB.Conclusions MCP-1 may play an important role in the course of pancreatic fibrosis in chronic obstructive pancreatitis.