Application of self fixing mesh with " Y-shaped" placement in laparoscopic transabdominal preperitoneal repair of inguinal hernia of female inguinal hernia / 中国综合临床

Objective:To investigate the effect of self fixing mesh with " Y-shaped" placement in laparoscopic transabdominal preperitoneal repair of female inguinal hernia.Methods:From February 2019 to September 2020, a total of 40 female patients who underwent TAPP (Keyhole method) in Shaanxi Provincial People′s Hospital were researched.Random number table method was used.According to different patch placement methods, the patients were divided into the self fixing mesh with " Y-shaped" placement group (21 cases) and with normal placement group (19 cases). The operative time, placement time, length of stay, Visual Analogue Scale (VAS), postoperative complication were compared between two groups.Results:All 40 patients completed TAPP, and all patients were followed up successfully, with a median follow-up time of 12.5 months.The operation time and patch placement time were (54.9±9.0) min and (10.8±2.5) min in the Y-shaped placement method group and (62.8±11.2) min and (20.3±3.5) min in the conventional placement method group, respectively; the differences between the two groups were statistically significant ( t=2.490, P=0.017; t=.925, P<0.001). There was no statistically significant difference between the two groups in length of stay, VAS score 1 day after surgery and postoperative complications(all P>0.05). Conclusion:In laparoscopic female inguinal hernia repair (keyhole method), the " Y" shape placement method can effectively shorten the time of self fixing patch placement, thus shorten the operation time, and does not increase the risk of complications.

A multicenter retrospective study on surgical indications of gallbladder polyps: a report of 2 272 cases / 中华消化外科杂志

Objective:To investigate the surgical indications of gallbladder polyps.Methods:The retrospective case-control study was conducted. The clinicopathological data of 2 272 patients with gallbladder polyps who underwent cholecystectomy in 11 medical centers from January 2015 to December 2019 were collected, including 585 in the First Affiliated Hospital of Xi′an Jiaotong University, 352 in No. 215 Hospital of Shaanxi Nuclear Industry, 332 in the First People′s Hospital of Xianyang, 233 in Shaanxi Provincial People′s Hospital, 152 in the Second Affiliated Hospital of Xi′an Jiaotong University, 138 in Xianyang Hospital of Yan′an University, 137 in People′s Hospital of Baoji, 125 in Hanzhong Central Hospital, 95 in Baoji Central Hospital, 72 in Ankang Central Hospital, 51 in Yulin No.2 Hospital. There were 887 males and 1 385 females, aged (48±12)years, with a range from 12 to 86 years. Observation indicators: (1) surgical treatment, pathological examination and hospitalization; (2) follow-up and complications; (3) comparison of clinicopathological data between patients with non-neoplastic polyps and neoplastic polyps; (4) comparison of clinicopathological data among patients who had gallbladder polyp diameter of 7 to 9 mm, 10 to 12 mm, or ≥13 mm without cholecystolithiasis; (5) analysis of influence factors for the incidence of neoplastic polyps in patients who had gallbladder polyp diameter of 10 to 12 mm without cholecystolithiasis; (6) construction and evaluation of nomogram prediction model for neoplastic polyps of patients who had gallbladder polyp diameter of 10 to 12 mm without cholecystolithiasis. Follow-up using outpatient examination or telephone interview was conducted to detect complications and survival of patients up to April 2020. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M (range), and comparison between groups was analyzed using the rank-sum test. Ordinal data was analyzed using the rank-sum test of multi-samples. Analysis of influence factors for the incidence of neoplastic polyps was conducted after excluding missing data of CEA and CA19-9. Univariate analysis was conducted using the chi-square test or rank-sum test of multi-samples, and multivariate analysis was conducted using Logistic regression model. Based on Logistic regression model multivariate analysis, the nomogram prediction model was constructed using the R 3.6.0 version software. Results:(1) Surgical treatment, pathological examination and hospitalization: of the 2 272 patients, 2 199 cases underwent laparoscopic cholecystectomy, 43 cases underwent open cholecystectomy, 28 cases underwent radical resection for gallbladder carcinoma, and 2 cases underwent laparoscopic gallbladder preservation and polypectomy. There were 1 050 of the 2 272 patients undergoing intraoperative frozen section examination. Results of pathological examination showed that 1 953 of the 2 272 patients had non-neoplastic polyps including 1 681 cases with cholesterol polyps and 272 cases with inflammatory polyps; 319 cases had neoplastic polyps including 274 with benign polyps (93 cases with adenoma, 66 cases with adenomyoma, 81 cases with adenoma-like hyperplasia, 34 cases with adenoma combined with intraepithelial neoplasia); and 45 cases had malignant polyps including 43 cases with adenocarcinoma, 1 case with adenosquamous carcinoma and 1 case with sarcomatoid carcinoma. The duration of postoperative hospital stay of 2 272 patients was 3 days(range, 1 to 27 days). (2) Follow-up and complications: of the 2 272 patients, 1 932 were followed up for 3.5 to 63.5 months, with a median follow-up time of 31.0 months. During the follow-up, 180 patients had short-term complications and 170 patients had long-term complications. (3) Comparison of clinicopathological data between patients with non-neoplastic polyps and neoplastic polyps: cases with age ≤50 years or >50 years, cases with time from first discovery of polyp to operation <1 year, 1-3 years, >3 years and ≤5 years or >5 years, CEA, CA19-9, CA125, cases with single or multiple polyps in preoperative ultrasonography examination, cases with diameter of polyps in preoperative ultrasonography examination as 1-6 mm, 7-9 mm, 10-12 mm or ≥13 mm, cases with pedicled or broad based polyp wall in preoperative ultrasonography examination, cases with polyp morphology in preoperative ultrasono-graphy examination as nodular, papillary, globular or mulberry-like, cases undergoing or not undergoing intraoperative frozen section examination, cases with diameter of polyps in postoperative pathological examination as 1-6 mm, 7-9 mm, 10-12 mm or ≥13 mm, cases with gallbladder wall thickness in postoperative pathological examination as ≤4 mm or >4 mm of the 1 953 patients with non-neoplastic polyps were 1 118, 835, 1 027, 422, 230, 274, 2.0 mg/L(range, 0.2-8.6 mg/L), 14.5 U/mL(range, 2.6-116.4 U/mL), 10.5 U/mL(range, 1.2-58.7 U/mL), 658, 1 295, 674, 741, 413, 125, 1 389, 564, 407, 1 119, 292, 135, 832, 1 121, 698, 774, 385, 96, 1 719, 234, respectively. The above indicators of the 319 patients with neoplastic polyps were 160, 159, 204, 55, 26, 34, 2.9 mg/L(range, 0.2-28.8 mg/L), 19.7 U/mL(range, 3.5-437.1 U/mL), 15.0 U/mL(range, 1.0-945.0 U/mL), 203, 116, 49, 59, 100, 111, 154, 165, 92, 153, 49, 25, 218, 101, 53, 85, 90, 91, 263, 56, respectively. There were significant differences in the above indicators between the non-neoplastic polyps and neoplastic polyps patients ( χ2=5.599, Z=-3.668, -2.407, -3.023, -3.403, χ2=104.474, Z=-13.367, χ2=65.676, 12.622, 73.075, Z=-11.874, χ2=7.649, P<0.05). (4) Comparison of clinicopathological data among patients who had gallbladder polyp diameter of 7 to 9 mm, 10 to 12 mm, or ≥13 mm without cholecystolithiasis: after excluding 311 of the 2 272 patients with cholecystolithiasis, there were 706 cases with gallbladder polyp diameter of 7 to 9 mm, 459 cases with gallbladder polyp diameter of 10 to 12 mm, and 205 cases with gallbladder polyp diameter ≥13 mm, respectively. Cases with time from first discovery of polyp to operation <1 year, 1-3 years, >3 years and ≤5 years or >5 years, CEA, CA19-9, cases with single or multiple polyps in preoperative ultrasonography examination, cases with pedicled or broad based polyp wall in preoperative ultrasonography examination, cases with polyp morphology in preoperative ultrasonography examination as nodular, papillary, globular or mulberry-like, cases with echo intensity of preoperative ultrasonography examination as slightly strong, medium or weak, cases undergoing or not undergoing intraoperative frozen section examination, and cases with pathological types of polyps as non-neoplastic polyps, benign polyps or malignant polyps of the 706 patients with gallbladder polyp diameter of 7 to 9 mm were 291, 170, 107, 138, 2.2 mg/L(range, 0.5-8.6 mg/L), 21.0 U/mL(range, 2.8-116.4 U/mL), 207, 499, 620, 86, 118, 463, 75, 50, 252, 410, 44, 379, 327, 657, 49, 0, respectively. The above indicators of the 459 patients with gallbladder polyp diameter of 10 to 12 mm were 267, 85, 43, 64, 1.6 mg/L(range, 0.4-9.3 mg/L), 10.4 U/mL(range, 3.3-354.0 U/mL), 205, 254, 237, 222, 158, 223, 51, 27, 222, 213, 24, 263, 196, 373, 79, 7, respectively. The above indicators of the 205 patients with gallbladder polyp diameter ≥13 mm were 128, 38, 20, 19, 2.1 mg/L(range, 0.6-28.8 mg/L), 10.2 U/mL(range, 3.6-307.0 U/mL), 120, 85, 75, 130, 68, 97, 22, 18, 98, 95, 12, 148, 57, 113, 71, 21, respectively. There were significant differences in the above indicators among patients who had gallbladder polyp diameter of 7 to 9 mm, 10 to 12 mm, or ≥ 13 mm ( χ2=46.482, 8.093, 39.504, 66.971, 277.043, 60.945, 19.672, 22.340, 197.854, P<0.05). (5) Analysis of influence factors for the incidence of neoplastic polyps in patients who had gallbladder polyp diameter of 10 to 12 mm without cholecystolithiasis: of the 459 patients who had gallbladder polyp diameter of 10 to 12 mm without cholecystolithiasis, there were 373 cases with non-neoplastic polyps, and 86 cases with neoplastic polyps, respectively. Results of univariate analysis showed that CEA, CA19-9, the number of polyps in preoperative ultrasonography examination, diameter of polyps in preoperative ultrasonography examination, polyp wall in preoperative ultrasonography examination were influence factors for the incidence of neoplastic polyps in patients who had gallbladder polyp diameter of 10 to 12 mm without cholecystolithiasis ( χ2=10.342, 5.616, 20.009, Z=-4.352, χ2=6.203, P<0.05). Results of multivariate analysis showed that CEA>5.0 mg/L, CA19-9>39.0 U/mL, single polyp in preoperative ultrasonography examination, polyp diameter of 11 mm in preoperative ultrasonography examination, polyps of broad base in preoperative ultrasonography examination were independent risk factors for the incidence of neoplastic polyps in patients who had gallbladder polyp diameter of 10 to 12 mm without cholecystolithiasis ( odds ratio=8.423, 0.082, 0.337, 3.694, 2.318, 95% confidence interval: 1.547-45.843, 0.015-0.443, 0.198-0.575, 1.987-6.866, 1.372-3.916, P<0.05). (6) Construction and evaluation of nomogram prediction model for neoplastic polyps of patients who had gallbladder polyp diameter of 10 to 12 mm without cholecystolithiasis: CEA, CA19-9, the number of polyps in preoperative ultrasonography examination, diameter of polyps in preoperative ultrasonography examination, polyp wall in preoperative ultrasonography examination were imported into R 3.6.0 version software to establish the nomogram prediction model for neoplastic polyps. The results showed the score for CEA>5.0 mg/L, CA19-9>39.0 U/mL, cases with single polyp in preoperative ultrasonography examination, cases with polyp diameter of 10 mm in preoperative ultrasonography examination, cases with polyp diameter of 11 mm in preoperative ultrasonography examination, cases with polyp diameter of 12 mm in preoperative ultrasonography examination, polyps of broad base in preoperative ultrasonography examination were 25, 27, 100, 0, 26, 72, 98 in the nomogram prediction model, respectively. The C-index of nomogram prediction model was 0.768. Result of nomogram prediction model showed that the incidence of tumor polyps was 0, 6% and 10% in patients with multiple and pedicled gallbladder polyps with diameter of 10, 11, 12 mm and with CEA ≤5.0 mg/L and CA19-9 ≤39.0 U/mL, the incidence of tumor polyps was 43%, 53% and 70% in patients with single and broad base gallbladder polyps with diameter of 10, 11, 12 mm. The calibration curve showed that the probability of the nomogram prediction model predicting neoplastic polyps was nearly consistent with the actual probability. Conclusions:CEA>5.0 mg/L, CA19-9>39.0 U/mL, single polyp in preoperative ultrasonography examination, polyp diameter of 11 mm in preoperative ultrasonography examination, polyps of broad base in preoperative ultrasonography examination are independent risk factors for the incidence of neoplastic polyps in patients who had gallbladder polyp diameter of 10 to 12 mm without cholecystolithiasis. Cholecystectomy should be performed in time for patients with single and broad based gallbladder polyps with diameter of 10, 11, 12 mm.

Immunosenescence and development of influenza vaccines for the elderly / 中华实验和临床病毒学杂志

Immunization with influenza vaccine is an effective prophylactic strategy in preventing seasonal flu. In the elderly, the standard influenza vaccines are not as effective as in non-elderly healthy adults, since the elderly people are particularly susceptible to influenza. With the acceleration of the global aging process, it is necessary to develop novel influenza vaccines which are more effective in the elderly. This review discusses immunosenescence and the substantial progress that has been made in the influenza vaccines for elderly people.

Comparison of uniaxial and polyaxial locking plate fixation for Sanders types Ⅳintra-articular calcaneal fractures / 中国医师进修杂志

Objective To compare the radiographic and clinical outcomes of uniaxial and polyaxial locking plates used in the treatment of Sanders types Ⅳ intra-articular calcaneal fractures. Methods A retrospective comparative study was performed on the 72 patients with Sanders types Ⅳintra-articular calcaneal fractures who had been treated by uniaxial locking plates (A group, 38 cases) or polyaxial locking plates (B group, 34 cases) between January 2012 and December 2016. Operation time, intraoperative bleeding, union time, radiological and functional outcomes and functions by the Maryland foot score were compared between the two groups. Results There were no significant differences between the two groups in operation time, intraoperative bleeding, or union time (P>0.05). The patients in A group were followed up for (23.2 ± 5.4) months, and those in B group were followed up for (22.5 ± 4.9) months. All the patients obtained bony union. B group displayed significantly better Bohler angles [(31.6 ± 4.5)° vs. (27.6 ± 6.1)°, (30.7 ± 4.2)° vs.(27.0 ± 5.4)°] and Gissane angles [(109.2 ± 10.8)° vs. (96.8 ± 9.5)°, (107.3 ± 10.1)° vs. (95.4 ± 10.2)°] at 3 and 12 months after operation , compared with A group (P<0.05). Evaluated by the Maryland foot score, the excellent and good rate for the B group was 91.2％(31/34) , which was insignificantly higher than that for the A group (84.2％, 32/38) (P > 0.05). Conclusions Both uniaxial locking and polyaxial locking plates can lead to satisfactory therapeutic outcomes for Sanders types Ⅳ intra-articular calcaneal fractures, but polyaxial locking plates may be superior in stability and functional recovery.

Correlation analysis between adolescent cognitive ability and health risk behaviors / 中国学校卫生

Objective@#To explore the status of adolescents’ health risk behaviors, relationship between cognitive ability and health risk behaviors, and provide an empirical reference for reducing the occurrence and early prevention of health risk behaviors among adolescents.@*Methods@#Samples were extracted by hierarchical, multi-stage, probability and scale proportional (PPS) methods. There were 112 schools randomly selected from 28 county-level regions(county, district, city), and 19 487 students were investigated by baseline survey, a follow-up study was conducted among 8 636 students during 2014-2015. Descriptive statistical methods of using 2 test and t test, and logistic multivariate regression analysis were used to analyze the relationship between cognitive abilities and healthy risk behaviors.@*Results@#The reported rate of a healthy risk behavior was 20.77%, and the incidence of more than one type of health risk behavior was 16.03%. The student’s cognitive ability standardized score was(0.33±0.82). The average score of cognitive ability of adolescents with healthy risk behavior was 0.14, which was lower than the average score of cognitive ability of adolescents without healthy risk behaviors(0.43). Boys, having rural household registeration, non-residential schools, and parents with low education levels adolescents were more likely to be involved in health behavior risks. There was a significant correlation between adolescent cognitive ability and healthy risk behavior(OR=0.67, P<0.01).@*Conclusion@#The current status of adolescent health risk behaviors is worrying. The cognitive ability has a significant impact on health risk behaviors. It is recommended to use the cognitive ability of adolescents as a starting point to prevent and reduce the occurrence of adolescent health risk behaviors.

Determination of the contents of two types of hemagglutinin B in quadrivalent influenza vaccines (split virion) by single radial immunodiffusion assay / 中华实验和临床病毒学杂志

Objective@#Quadrivalent influenza vaccines contain two lineages of type B virus, this study aimed to assess whether the result of single radial immunodiffusion (SRID) are accurate. The cross-interference of two type B hemagglutinins remains unknown.@*Methods@#We detected the vaccine samples developed by Jiangsu GDK Biological Technology Co., ltd by SRID.@*Results@#There was no significant difference between the HA content of antigen reagent, bulk sample and mixed sample of two B bulk within 10 to 40 μg/ml (P>0.05). Then each hemagglutinin B was diluted respectively by other three HA, 30 μg/ml, the other hemagglutinin B or phosphate buffer solution were measured within 10-160 μg/ml. Within 10-40 μg/ml, the HA content was proportional to the diameters of immunodiffusion (R2=0.998), while within the higher content range, a ternary linear regression equation fitted best (R2=0.999).@*Conclusions@#No cross-interference between B/Brisbane and B/Phuket was found in SRID within both detection ranges.

Research and development of high-dose inactivated quadrivalent influenza serial vaccines (split virion) proposed to be used for elderly adults / 中华实验和临床病毒学杂志

Objective@#To evaluate the immunogenicity of high-dose inactivated quadrivalent influenza serial vaccines (split virion) for elderly people.@*Methods@#Immunogenicity assays on mouse as research animal model with inactivated quadrivalent influenza serial vaccines (split virion) were carried out. Then rates of seroconversion and geometric mean hemagglutination inhibition titers (GMTs) at day 21 after the last vaccination among those who received high-dose (HD) A+ B influenza vaccine, were compared with those who received other vaccines by hemagglutination inhibition (HAI) test.@*Results@#The result of HAI test showed in HD serial vaccine groups, GMTs for all kinds of HA in the two HD serial vaccine groups were significantly different from that of the two SD serial vaccine groups, respectively (P<0.0001), but not the titers for A3 in one B dose first group. Further- more, GMTs for strain A in one B dose first groups were significantly higher than that of one B dose first groups in both HD and SD groups, and vice versa in the GMTs for strain B. The result of the assay of the impact of different immunization intervals of HD serial influenza vaccine on immunogenicity indicated that the immunity responses in 7 or 10 d groups were higher than that in 3 d group.@*Conclusions@#It is a new method to prevent the flu for elderly by HD A+ B serial influenza vaccine, whose HA dose per immunization was reduced into two injections, worked best when the immunization interval was 7-10 d. The protective immunity can be improved by selecting immune procedure of the serial vaccine according to the epidemic type surveillance of influenza virus A and B strains.

Effects of small RNA interference targeting mammalian target of rapamycin on paraquat-induced pulmonary fibrosis in rats / 中华危重病急救医学

Objective To investigate the effects of small RNA interference targeting mammalian target of rapamycin (mTOR) expression on paraquat-induced pulmonary fibrosis in rats.Methods Human embryonic kidney cells HEK-293 were culturedin vitro. The mTOR small interfering RNA (mTOR-siRNA) expression plasmid transfection lentivirus was constructed, and non-specific sequence plasmid with no homology to mTOR gene was set as the control. Seventy-two healthy male Sprague-Dawley (SD) rats were randomly divided into normal saline (NS) control group, paraquatmodel group, mTOR unrelated sequence group, and mTOR-siRNA group, with 18 rats in each group. Paraquat poisoning animal model was reproduced by intraperitoneally injecting 20% paraquat solution 15 mg/kg, while the NS control group was intraperitoneally injected the same volumes of NS. Rats in the mTOR unrelated sequence group and mTOR-siRNA group were injected 1×109 TU/mL lentivirus solution 50μL into the airway, respectively, while in the NS control group and paraquat model group were injected the same volumes of NS. At 7, 14 and 28 days after treatment, 6 rats in each group were sacrificed respectively for lung tissue, the pathological changes and fibrosis of lung tissues were observed under light microscope. The levels of hydroxyproline (HYP) in lung tissues were determined by alkaline hydrolysis. The mRNA and protein expressions of mTOR in lung tissues were determined by reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot.Results Under light microscope, there was no obvious pathological changes in the lung tissues in the NS control group, while in the paraquat model group and mTOR unrelated sequence group, lung tissue in rats were damaged, there were a lot of inflammatory cell infiltration, a large number of matrix collagen and fibrous tissues hyperplasia, and gradually increased with time, and it was consistent with paraquat-induced lung tissue fibrosis process. The pathological and fibrotic changes in lung tissue of mTOR-siRNA group were obviously reduced after silencing mTOR gene. The levels of HYP and the expression levels of mTOR mRNA and mTOR protein of lung tissues in the paraquat model group and mTOR unrelated sequence group were continuously increased in time-dependent manner, and they were significantly higher than those in the NS control group at all of the time points, but no significant difference was found between mTOR unrelated sequence group and paraquat model group. In mTOR-siRNA group, silencing mTOR gene could inhibit paraquat poisoning induced HYP increase in lung tissue, and the expressions increase in mTOR mRNAand mTOR protein, the values were close to the levels of NS control group, and the significant difference was found as compared with paraquat model group at 7 days or 14 days, and the change was maintained to 28 days [7 days: HYP (μg/mg) was 1.13±0.06 vs. 1.25±0.07; 14 days: HYP (μg/mg) was 1.19±0.09 vs. 1.29±0.12, mTOR mRNA (2-ΔΔCt) was 0.99±0.11 vs. 1.94±0.12, mTOR protein (gray value) was 0.39±0.08 vs. 0.75±0.09; 28 days: HYP (μg/mg) was 1.28±0.06 vs. 1.40±0.05, mTOR mRNA (2-ΔΔCt) was 1.15±0.13 vs. 2.85±0.15, mTOR protein (gray value) was 0.45±0.10 vs. 0.86±0.12, allP < 0.05].Conclusion Lentivirus-mediated mTOR-siRNA could effectively inhibit the expressions of mTOR in lung tissues of paraquat-poisoned rats, and reduce the damage and fibrosis of lung tissues caused by paraquat.

The investigation of laparoscopic teaching in animal operation teaching / 中华医学教育探索杂志

Animal operation training is an important course that medical students need to study before they get into their clinical practice.Because there is no cavity mirror operation training standard and teaching experience for interns,we have put forward and conducted the animal laparoscopic teaching applications in surgery teaching,and evaluated the teaching effect.Through training,the clinical medical students have personally experienced and learnt basic operation skills of laparoscopic surgery,which is an organic link from textbooks to clinical practice,and at the same time they have improved the ability of clinical practice,cultivate and strengthen their interest in laparoscopic surgical skills training and operation,which help them lay a good foundation for clinical practice.

Advances in tubeless percutaneous neprolithotomy / 中国综合临床

Percutaneous neprolithotomy (PCNL) is the preferred method for the treatment of the majority of urinary calculi, especially for the calculi lies in the renal and upper ureteral.Recently, a number of trials were applied into TPCNL, such as, decrease the nephrostomy and indwelling externally grooved ureteral stent, internal ureteral catheter and not aiming replace the preventive use of renal tube.TCNL has its advantages in postoperative pain, hospitalization time and postoperative recovery than standard percutaneous neprolithotomy.

CORRELATIONS BETWEEN SERUM 25 (OH) D LEVELS AND SUBCORTICAL ARTERIO-SCLEROTIC ENCEPHALOPATHY / 现代医院

Objective To explore the correlations between the levels of serum 25 ( OH) D and age, blood sugar, blood lipid, blood pressure and insulin levels in patients with subcortical arteriosclerotic encephalopathy . Methods A total of 100 patientswith subcortical arteriosclerotic encephalopathy ( SAE) and 50 healthy persons were enrolled in the study.ELISA was adopted to determine serum 25(OH)D levels in two groups.Meantime, fasting glu-cose, blood lipid, blood pressure and insulin levels were measured and compared between two groups .Results The systolic blood pressure , diastolic blood pressure , fasting glucose , total cholesterol and insulin levels in SAE patients were significantly higher than those in the healthy control (p0.05).The serum 25(OH)D levelswere negatively related with age, SBP, DBP and fasting glucose(p<0.05,p<0.01) but not correlative with TC, TG, LDL, HDL, and insulin levels in SAE patients.Conclusion The serum 25(OH)D levels in SAE patients are reducedby playing a regulative role in the occurrence and development of SAE throughaffectingthe energy metabolism .

Comparation of efficacy between percutaneous decortication and ureteroscopic decompression in treating simple renal cyst / 国际外科学杂志

Objective To compare the efficacy and complications of percutaneous nephroscope decortication of cystic renal disease with transureteroscopic decompression of cystic renal disease.Methods Retrospectively analyze the clinical data of 42 simple renal cyst cases,who under treatment of surgical in Zhongnan Hospital of Wuhan University from Sep.2010 to Sep.2014 via percutaneous nephrolithotomy as well as ureteroscope.There were 21 patients in each group.Comparisons were made between the two groups on operation time,peripheral tissue injury,blood loss,postoperative infection,hospitalzation time.Postoperative recurrence were followed up.Results For the percutaneous nephroscope decortication of cystic renal disease group and transureteroscopic decompression of cystic renal disease group,the operation time were (38.43 ± 9.76) minutes,(28.95 ± 8.67) minutes,the number of tissue injury were 8,6;the blood loss were (28.62 ± 9.82) mL,(23.48 ± 7.65) mL;the number of postoperative infection was 4,10;the postoperative recurrence were 2,5;the hospitalzation time were 2 days and 8 days.Compared with the transureteroscopic decompression group,the percutaneous nephroscope decortication group had a less postoperative infection and fewer postoperative recurrence (P ＜ 0.05).But the operation time was longer in the percutaneous nephroscope decortication group (P ＜ 0.05).Conclusions The therapeutic effect of percutaneous nephroscope decortication is much better than that of transureteroscopic decompression,but also has a little disadvantage.

Contrast-enhanced CT for the diagnosis of mandibular invasion caused by oral cancers: a systematic review / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To assess the diagnostic efficacy of contrast-enhanced CT in diagnosing mandibular invasion of oral cancers.</p><p><b>METHODS</b>PubMed, Excerpta Medica Database (EMBASE), the European Grey Literature Database, Chinese Biomedical Literature Database (CBM), and CQVIP were searched electronically on January 03, 2014. Hand-searching was also performed on 19 relevant Chinese journals. The methodological quality assessment, as suggested in Cochrane Handbook, and the data extraction of the studies included were performed by two reviewers in duplicate. Meta-analysis was conducted using the Meta Disc 1.4 software.</p><p><b>RESULTS</b>Fourteen studies that involved 642 participants were included. Among the seven prospective studies, one had a low bias risk and the rest had unclear bias risks. When mandibular invasion was diagnosed the Meta-analysis results showed that the pooled sensitivity (SEN) was 0.718 [95% confidence interval (CI), 0.665-0.767], the pooled specificity (SPE) was 0.909 (95% CI, 0.872-0.938), the area under curve (AUC) was 0.906 1, and the Q* was 0.837 8. When mandibular medullary invasion was diagnosed, the SEN was 0.787 (0.643-0.893), the SPE was 0.904 (0.790-0.968), the AUC was 0.949 6, and the Q* was 0.890 0. The Meta-regression results showed that the smaller slide thickness had a higher diagnosis efficacy.</p><p><b>CONCLUSION</b>CT showed a high efficacy in diagnosing mandibular or medullary invasion caused by oral cancers. With a high SPE, contrast-enhanced CT can confirm the clinical diagnosis of bone invasion effectively. In addition, selecting a smaller slide thickness CT can increase diagnosis efficacy.</p>

Clinical analysis of proton pump inhibitor combined with Clostridium butyricum live bacteria tablets on treatment with HP type peptic ulcer patients / 中国生化药物杂志

Objective To investigate the Helicobacter pylori (HP) infection in the clinical curative effect of peptic ulcer patients using proton pump inhibitor combined with Clostridium butyricum live bacteria treatment. Methods 112 cases of peptic ulcer patients with Helicobacter pylori infection were randomly divided into two groups, the study group used proton pump inhibitor combined with Clostridium butyricum lactobacillus tablets treatment, the control group only used proton pump inhibitor treatment, the clinical efifcacy of the two groups were compared. Results 1 months after treatment, symptom relief rate in study group was 98.21%, higher than 87.50%in control group, (χ2=4.846, P=0.028);ulcer healing rate in study group was 94.64%, superior than 75%in control group (χ2=8.391, P=0.004);HP eradication rate in study group was 89.29%, higher than 73.21%,in control group (χ2=4.747, P=0.029);adverse medication in the process were nausea, vomiting, loss of appetite, anorexia, dizziness, weakness, abdominal pain and distension, there were no signiifcant differences between two groups. Conclusion Proton pump inhibitor combined with Clostridium butyricum lactobacillus tablets has good curative effect and highly HP eradication rate on treatment with HP type peptic ulcer patients.

Effect of livin gene suppression by genistein on apoptosis, cell cycle and proliferation of malignant melanoma LiBr cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effect of livin gene suppression by genistein on apoptosis, cell cycle and proliferation of malignant melanoma LiBr cells.</p><p><b>METHODS</b>RT-PCR was used to detect the expression of livin mRNA in LiBr cells 48 h after treatment with 40 µmol/L genistein. Flow cytometry with annexin V-FITC/PI double staining was employed to detect cell apoptosis, and the caspase-3 protein expression in the cells following genistein treatment was assayed using Western blotting. The changes in the cell cycle and proliferation of the cells after genistein treatment were examined with flow cytometry with PI staining and MTT colorimetric assay, respectively.</p><p><b>RESULTS</b>Genistein can suppress the expression of Livin Gene (87.94% with 40 µmol/L genistein) and induce the apoptosis of LiBr effectively, both in the early and late phases (27.87∓5.38% and 11.87∓3.86% respectively). LiBr cells in phase G(0)/G(1) increases notably(G(0)/G(1)=72.11∓5.89%,S=14.53∓3.47%,G(2)/M=12.36∓2.64%). Genistein significantly reduced caspase-3 protein expression and inhibit cell proliferation.</p><p><b>CONCLUSION</b>Genistein can suppress Livin Gene expression, induce LiBr cell apoptosis, hinder cell generation cycle, restrain cell proliferation.</p>

Bloom's syndrome in two brothers / 中华皮肤科杂志

The patient 1 was a 9-year-old boy of Hui nationality who presented with recurrent erythema over the face and auricles for 8 years.Telangiectasis and erythema developed on both cheeks 7 months after birth,which gradually spread to the auricles,forearms and both legs with a mild ichthyosiform appearance.At 5 years of age blisters and erosions appeared on the lips,which occurred and were aggravated after exposure to strong sunlight during summer and spontaneously subsided or disappeared in winter.The patient 2,a 3-year-old boy who was the younger brother of the patient 1,presented with recurrent erythema for 2 years.At 1 year of age,erythema began to appear on both cheeks and gradually spread to the buccal region,with mild pruritus and scaling.Meanwhile,the skin of both legs was dry and scaling and gave an ichthyosifonn appearance.The lesions usually appeared in early summer and gradually subsided in winter.No abnormality was found by systemic,laboratory,pathological or other auxiliary examination.Chromosomal abnormality was undetected.Body height was normal.The parents of the two siblings were first cousins.Both children were diagnosed with Bloom's syndrome.

Effect of Helicobacter pylori on Cell Gap Junction Ultrastructure of Gastric Epithelial Cells / 生物化学与生物物理进展

To observe the effect of Helicobacter pylori(H.priori) on cell gap junction ultrastructure of gastric epithelial cells,and to explore carcinogenic mechanism of H.priori from the changes of cell gap junction,BGC-823 cells were co-cultured with different H.prlori strains for 24 h and 48 h.The cell gap junction ultrastructure was observed under transmission electron microscope with sample preparation of fixation and embedding in situ.In 70 patients with gastric eancer(GC),H.priori was detected by rapid urease test,basic fuchsin stain and 14C-urea breath test.The CagA gene of H.prlori was determined by PCR and the cell gap junction ultrastructure was observed under transmission electron microscope.More cell gap junctions and junction complexes of BGC-823 cells were found in control group without H.priori.Groups with H.priori had less number of cell gap junctions,less number of junctions/unit perimeter,shorter length of junctions/unit perimeter,and bigger width of the intercellular space,comparing to control groups without H.priori(P＜ 0.001 or P＜ 0.005).The number of cell junctions and the number of junctions/unit perimeter in the groups co-cultured with NCTC J99,GC 01 and NCTC 11639(CagA+) were less than that in the groups co-cultured with NCTC 12908(CagA-)(P ＜0.001 or P＜0.05),and the length of junctions/unit perimeter in the groups co-cultured with NCTC J99 and GC 01 was shorter than that in the groups co-cultured with NCTC 12908 (P＜ 0.001).In patients with GC,the number of cell junctions,the number of junctions/unit perimeter and the length of junctions/unit perimeter in group H.priori infection were all less than those in group without H.prior/infection(P ＜0.001),and that in CagA+ H.prlori group were less than that in CagA- H.prlori group,but its smallest width of the intercellular space was longer than that in CagA- H.prlori group.The above results showed that the changes of cell gap junction of gastric epithelial cells were associated with H.prlori infection especially CagA+ H.prlori infection.

Preliminary Prooerties of Meridian System as a Complex Network / 针灸推拿医学（英文版）

The system of meridians and acupoints in the traditional Chinese medication (TCM) builds up a complex network. We analyze the features and properties of the system of meridians and acupoints as a complex network based on knowledge of TCM and mathematics. The system shows some important features of complex networks such as the small-world effect and the scale-free property. A preliminary discussion on the robustness of the meridian system as a complex network, and the biomedical functions of such robustness is also given.

Effects of recipe for invigorating kidney on expression of estrogen receptors in ovariectomized rats / 中西医结合学报

OBJECTIVE: To observe the effects of recipe for invigorating kidney on expression of estrogen receptors in ovariectomized rats. METHODS: The rats, which were given high-cholesterol diet after ovariectomy, were chosen as experimental subjects. After fed kidney-invigorating recipe for 16 weeks, the rats were killed and the levels of serum lipid and estradiol of these rats were examined. The expressions of estrogen receptor alpha and beta mRNAs in aorta, pituitary gland and hypothalamus, and the affinity of estrogen receptor-ligand were also detected. RESULTS: The kidney-invigorating recipe could increase the expression levels of estrogen receptor alpha and beta mRNAs in different parts such as aorta, pituitary gland and hypothalamus, and enhance the affinity of estrogen receptor-ligands. CONCLUSION: The recipe for invigorating kidney may meliorate atherosclerosis in ovariectomized rats by regulating the estrogen receptors.

Arthroscopic Reconstruction of Anterior Cruciate Ligament with Hamstring Tendons and Button-Suture Plate / 中国微创外科杂志

Objective To study the efficacy of arthroscopic reconstruction of anterior cruciate ligament(ACL)with hamstring tendons and button-suture plate.Methods Thirty-two cases of ACL rupture received arthroscopic reconstruction with hamstring tendons and button-suture plate.The Lachman test and Pivot shift test were performed before and after operation to assess the stability of the knee joint.The knee function was evaluated according to Lysholm rating scale.Regular MRI,anterioposterior and lateral films of knee joint,patella axial radiography were conducted before the operation,to exclude the possibility of osteal avulsion at both ends of ACL.Results The 32 cases were followed for 3.5-29 months,in which 25 cases were more than 12 months.The knee stabilities of all cases recovered.The preoperative Lachman test results were positive in 32 cases,and the Pivot shift test results were positive in 28 cases.Lysholm rating score was 51.8?5.6.The postoperative Lachman tests result were negative in 30 cases,and weakly positive in 2 cases.The Pivot test showed negative results in all the cases.The Lysholm rating score was increased to 90.7?2.5 after the operation.Three cases experienced joint effusion and were treated with puncture aspiration.Conclusions The short-term clinical effect of arthroscopic reconstruction of ACL with hamstring tendons and suture plate is favorable.