The application of pelvic unlocking reduction frame for the treatment of old Denis I or II sacral fractures combined with sacral plexus nerve injury / 中华骨科杂志

Objective:To investigate the clinical effect assistant with pelvic unlocking reduction frame for the treatment of old Denis I or II sacral fractures combined with sacral plexus nerve injury.Methods:From January 2013 to October 2020, 37 patients diagnosed with old sacral fractures with sacral plexus nerve injury which Gibbons classification was grade III were divided into the use group and the non-use group according to whether assisted with pelvic unlocking reduction frame. Eighteen patients (11 males, 7 females, mean age 38±6.4, range from 13-56) were selected into the use group and nineteen patients (14 males, 5 females, mean age 42±10.7, range 19-59) were selected into the non-use group. The three-dimensional (3D) pelvic model (1∶1) was printed before operation. The operation time, intraoperative bleeding, Matta score, visual analogue scale (VAS), Majeed score and gibbons sacral nerve injury grade of the two groups were compared. The healing time and complications of each group was recorded.Results:The average operation time of the use group and the non-use group was 121.0±16.2 min and 182.6±16.2 min, respectively, with significant difference ( t=11.54, P<0.001). The mean operative bleeding was 686±382 ml of the use group and 963±348 ml of the non-use group ( t=2.38, P=0.003). The quality of fracture reduction was evaluated according to Matta scoring standard: the excellent and good rate of the use group was 94% (17/18), and that of the non-use group was 68% (13/19) ( P=0.039). The curative effect was evaluated according to the Majeed score: the use group was 88.72±7.03 points, and that of the non-use group was 72.00±9.75 points ( t=5.96, P<0.001) at 1 year post-operative. One year after operation, the VAS scale of the use group was 0.83±0.71 points, and that of the non-use group was 1.00±0.82 points ( t=0.66, P=0.512). According to Gibbons classification, 15 patients were grade I, 1 patient was grade II and 2 patients were grade III in the use group and 11 patients were grade I, 3 patients were grade II and 5 patients were grade III in the non-use group one year after operation ( Z=-1.04, P=0.401). One patient in the use group presented rupture of plate without symptoms. In the non-use group, 1 case with internal iliac vein rupture which treated with gelatin sponge and no obvious bleeding after operation. 4 cases with unequal length of lower limbs, walking claudication. The complication rate of the use group was 6% (1/18), and that of the non-use group was 26% (5/19) ( P=0.042) . Conclusion:The lateral rectus abdominis approach combined with pelvic unlocking reduction frame can reduce the operation time and bleeding, improve the fracture reduction in the treatment of old Denis type I and II sacral fractures with sacral plexus injury.

Synthesis and biological activities of three-molecule conjugates with para-aminosalicylic acid as parent nucleus / 药学学报

Based on the idea of multi-target drug design, taking p-aminosalicylic acid (PAS) as the parent nucleus, the unreported target molecules TM1 and TM2 were designed with PAS, isonicotinic acid and fluoroquinolone as three structural units conjugated by different linkers. Sixteen target molecules were synthesized by multi-step reaction, and their activities against Mycobacterium tuberculosis and human pathogenic bacteria were evaluated. The results showed that the anti-tuberculosis activity of TM2a was stronger than those of the assayed fluoroquinolones, while TM1a was comparable to that of clinafloxacin, the most active compound of the positive control fluoroquinolones; TM1a showed the strongest inhibitory activity to all almost tested strains, TM1b and TM2a showed very strong inhibitory activity to most strains, and TM1h/2h had strong inhibitory activity to some strains; The inhibitory activities of TM1a/1h on Staphylococcus aureus ATCC14125 are much stronger than those of fluoroquinolones, which eminently deserves further study. The hemolysis test results showed that the highly active molecules TM1a and TM2a exhibited relative safety below the concentrations of 8 and 32 μg·mL-1, respectively. In this study, a new hybrid molecule of three molecular pharmacophores with PAS as the parent nucleus was synthesized for the first time, and some of which have highly strong antibacterial activity, which provides a new idea for the research and development of antibiotics.

TSPAN8 is involved in lipid metabolism in non-alcoholic fatty liver disease in mice / 南方医科大学学报

OBJECTIVE@#To investigate the changes of tetraspanin 8 (TSPAN8) expression levels and its role in lipid metabolism during the development of non-alcoholic fatty liver disease (NAFLD).@*METHODS@#Thirty male C57BL/6J mice were randomly divided into normal diet group and high-fat diet (HFD) group (n=15), and after feeding for 1, 3, and 6 months, the expression levels of TSPAN8 in the liver tissues of the mice were detected with Western blotting. In a HepG2 cell model of NAFLD induced by free fatty acids (FFA), the effect of TSPAN8 overexpression on lipid accumulation was examined using Oil Red O staining and an automated biochemical analyzer, and the mRNA expressions of the key genes involved in lipid metabolism were detected using qRT-PCR.@*RESULTS@#Western blotting showed that compared with that in mice with normal feeding, the expression of TSPAN8 was significantly decreased in the liver tissues of mice with HFD feeding for 3 and 6 months (P < 0.05). In HepG2 cells, treatment with FFA significantly decreased the expression of TSPAN8 at both the mRNA and protein levels (P < 0.01). TSPAN8 overexpression in FFA-treated cells showed significantly lowered intracellular triglyceride levels (P < 0.001) and obviously reduced mRNA expression of fatty acid transport protein 5 (FATP5) (P < 0.01). The expression of FATP5 was significantly increased in FFA-treated cells as compared with the control cells (P < 0.001).@*CONCLUSION@#TSPAN8 is involved in lipid metabolism in NAFLD, and overexpression of TSPAN8 may inhibit cellular lipid deposition by reducing the expression of FATP5.

Emergency psychological intervention of acute ammonia leakage event / 中华劳动卫生职业病杂志

Objective: To analyze the situation of emergency psychological intervention in an acute ammonia leakage event, and to provide reference for emergency response. Methods: In August 2020, the emergency treatment of 65 patients admitted by Zhangqiu District People's Hospital Affiliated to Jining Medical College of Shandong Province in June 2019 in the ammonia tank car leakage incident was analyzed, the psychological intervention in emergency after the incident was collected, the anxiety and depression were evaluated by symptom checklist 90 (SCL-90) , and targeted psychological intervention was implemented according to the psychological evaluation results, And analyze the intervention efficiency. Results: Among the 65 patients, there were 52 cases of ammonia stimulation reaction, 11 cases of mild poisoning and 2 cases of moderate poisoning. There were 60 cases of chest tightness and dyspnea, 11 cases of bloody sputum, 58 cases of sore throat, 43 cases of hoarseness, 28 cases of photophobia and tears, 13 cases of blurred vision, 18 cases of nausea and vomiting, and 2 cases of dry and wet rales in the lungs. The scores of somatization, depression, anxiety, hostility, phobia, paranoia and negative coping in patients with mild and moderate poisoning were higher than those in patients with stimulus response (P<0.05) . The effective rate of intervention was 98.7%. Conclusion: Emergency psychological evaluation and intervention in mass public health events are helpful to the treatment of patients.

Dynamic changes and influencing factors of HIV-1 DNA load in HIV-1 infected individuals under antiretroviral therapy / 中华流行病学杂志

Objective: To analyze the dynamic changes and influencing factors of HIV-1 DNA load in HIV-1 infected individuals under antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefecture, Yunnan province, and provide information support for the clinical use of HIV-1 DNA quantitative detection. Methods: The HIV infection cases in recent infection cohort from Dehong Center for Disease Control and Prevention during 2009-2018 were selected as study subjects. The dynamic curve of HIV-1 DNA load varrying with time was generated and logistic regression analysis was conducted to identify the risk factors for HIV-1 load in the recent follow up after ART and statistical analysis was performed by using SPSS 17.0. Results: Among the 113 HIV infection cases detected from the recent infection cohort, the recent HIV infection rate were 49.6%(56/113) males, sexual transmission cases and drug injection transmission cases accounted for 53.1% (60/113), 80.5% (91/113) and 19.5% (22/113), respectively. The dynamic changes curve showed that HIV-1 DNA load was relatively high (>800 copies /106 PBMCs) before ART, and droped rapidly (<400 copies /106 PBMCs) after ART for 1 year. However, HIV-1 DNA load decreased insignificantly from the second year of ART, and remained to be 269 copies/106 PBMCs after ART for 6 years. Univariable logistic regression analysis indicated that OR (95%CI) of CD8, CD4/CD8 and HIV-1 DNA load were 1.00 (1.00-1.00), 0.30 (0.09-1.05) and 1.01 (1.00-1.01), respectively. Multivariable logistic regression analysis showed that OR value of HIV-1 DNA load base was 1.00 (1.00-1.01). Conclusions: HIV-1 DNA load decreased significantly in the first year of ART, then remained stable for years. HIV-1 DNA load base was the key factor associated with the decrease of HIV-1 DNA load, the lower the HIV-1 DNA load base, the lower HIV-1 DNA load. Therefore, earlier ART can contribute to the decrease of HIV-1 DNA load.

A new norsesquiterpenoid from Schisandra chinensis / 中国中药杂志

This study investigated the chemical components from the leaves and stems of Schisandra chinensis. Three norsesquiterpenoids were isolated from S. chinensis by various column chromatographies(silica gel, Sephadex LH-20, and MCI), reversed-phase medium-pressure preparative, and semi-preparative high-performance liquid chromatography(HPLC). Their structures were identified based on physicochemical properties, mass spectrometry(MS), nuclear magnetic resonance(NMR), ultraviolet(UV), and electro-nic circular dichroism(ECD) as(3R,4R,5R,6S,7E)-3,4,5,6-tetrahydroxy-7-megastigmen-9-one(1),(3S,5R,6R,7E)-3,5,6-trihydroxy-7-megastigmen-9-one(2), and(3S,4R,9R)-3,4,9-trihydroxymegastigman-5-ene(3). Compound 1 was a new compound, and its absolute configuration was determined by ECD. Compounds 2 and 3 were isolated from the Schisandra plant for the first time.

Protective effects of Moutan Cortex polysaccharides components on renal injury in diabetic nephropathy rats / 中国中药杂志

This study investigated the protective effects of Moutan Cortex polysaccharides components(MCPC) on the renal tissues of diabetic nephropathy(DN) rats and explored their regulation effect on inflammatory response and oxidative stress. The DN rat model was induced by high-glucose and high-fat diet combined with streptozotocin(STZ), and then the rats were randomly divided into control group, model group, positive group and MCPC high(120 mg·kg~(-1)·d~(-1)), low(60 mg·kg~(-1)·d~(-1)) dose groups. After 12 weeks treatment, blood was taken from the orbit of the rats, and then they were sacrificed before the kidney tissues were collected. The serum and tissues were detected for related biochemical indicators and pathological changes of the kidney. Immunohistochemical methods were used to determine the expression of FN and ColⅣ in the kidney tissue of DN rats. Compared with the model group, blood glucose, serum creatinine, blood urea nitrogen and 24 h urine protein in the MCPC high-dose group were significantly reduced(P<0.01). The results of HE, PAS, Masson staining showed that glomerular basement membrane thickening, Bowman's capsule narrowing and inflammatory cell infiltration in DN rats were improved in the MCPC high-dose group; the activity of T-SOD and GSH-Px in serum significantly increased(P<0.001), and the expression level of FN significantly decreased(P<0.001). The high-dose MCPC treatment could effectively inhibit the abnormal expression of Col Ⅳ(P<0.001) and significantly reduce the levels of AGEs and RAGE in serum(P<0.001), the content of VCAM-1 and IL-1β in serum(P<0.001), and the levels of IL-1β mRNA in kidney tissue(P<0.001), but failed to effectively reduce VCAM-1 mRNA levels in kidney tissues. The high-dose MCPC could significantly improve pathological injury of renal tissue and related renal indicators in DN rats, and achieve renal protection in DN rats mainly by regulating oxidative stress and inflammatory factors.

Cardiovascular and Cerebrovascular Diseases Induced by Air Pollution / 中国医学科学院学报

Air pollution has severe detrimental effects on public health.A substantial number of studies have demonstrated that air pollution exposure is a risk factor for the occurrence of cardiovascular and cerebrovascular diseases and a cause of non-communicable diseases.Both long-term and short-term exposure to air pollution are associated with respiratory diseases,stroke,coronary artery disease,and diabetes.Aiming to better understand the association,we reviewed the latest studies about the association of air pollution with cardiovascular and cerebrovascular diseases,especially stroke,coronary heart disease,arrhythmia,hypertension,and heart failure,and summarized the underlying mechanisms of the health damage caused by long-term and short-term exposure to air pollution.

Cardiac Protection Mechanism and Clinical Application of Dexmedetomidine / 中国医学科学院学报

Dexmedetomidine is an α2 adrenoceptor agonist and has cardioprotective effect,the mechanism of which is being studied.Increasing studies have proved the clinical value of dexmedetomidine in reducing postoperative complications and improving the prognosis of patients.Therefore,this review summarizes the cardiac protection mechanism of dexmedetomidine based on the existing studies and expounds the application of dexmedetomidine in the perioperative period of cardiovascular surgery.

Progress in circular RNAs of plants / 生物工程学报

With the development of high-throughput sequencing technology, circular RNAs (circRNAs) have gradually become a hotspot in the research on non-coding RNA. CircRNAs are produced by the covalent circularization of a downstream 3' splice donor and an upstream 5' splice acceptor through backsplicing, and they are pervasive in eukaryotic cells. CircRNAs used to be considered byproducts of false splicing, whereas an explosion of related studies in recent years has disproved this misconception. Compared with the rich studies of circRNAs in animals, the study of circRNAs in plants is still in its infancy. In this review, we introduced the discovery of plant circRNAs, the discovery of plant circRNAs, the circularization feature, expression specificity, conservation, and stability of plant circRNAs and expounded the identification tools, main types, and biogenesis mechanisms of circRNAs. Furthermore, we summarized the potential roles of plant circRNAs as microRNA (miRNA) sponges and translation templates and in response to biotic/abiotic stress, and briefed the degradation and localization of plant circRNAs. Finally, we discussed the challenges and proposed the future directions in the research on plant circRNAs.

Synthesis and antibacterial activity of synephrine sulfonamide derivatives containing tetrazole and sulfuryl groups / 药学学报

Synephrine is a natural small-molecule alkaloid found in Aurantii fructus immaturus with versatile biological activities, but its derivatives have been rarely studied so far. Based on the multi-target drug design strategy, the phenolic hydroxyl and secondary amino group of synephrine were modified structurally by the molecular splicing method in this study and thus five intermediates and fifteen target molecules were designed and synthesized. These compounds were evaluated with certain human pathogenic bacteria and fungi, and found that the inhibitory activities of IM4 and IM5 against E.coli are comparable to those of eight fluoroquinolones; TM1n showed stronger inhibitory activity against drug-resistant C. trobicans and drug-resistant C. albicans than the positive control drug fluconazole. TM1d and TM1f against C. albicans ATCC90023, TM1o and TM1f against drug-resistant C. albicans, and TM1f against C. parapsilosis ATCC22019 are all comparable to fluconazole, all of which have the potential for in-depth research. In this study, synephrine derivatives with strong inhibitory activities against human pathogenic fungi were discovered for the first time, which provided a new idea for the further study of synephrine.

Molecular cloning and characterization of three phenylalanine ammonia-lyase genes from Schisandra chinensis / 中国天然药物

Phenylalanine ammonia-lyase (PAL), which catalyzes the conversion from L-phenylalanine to trans-cinnamic acid, is a well-known key enzyme and a connecting step between primary and secondary metabolisms in the phenylpropanoid biosynthetic pathway of plants and microbes. Schisandra chinensis, a woody vine plant belonging to the family of Magnoliaceae, is a rich source of dibenzocyclooctadiene lignans exhibiting potent activity. However, the functional role of PAL in the biosynthesis of lignan is relatively limited, compared with those in lignin and flavonoids biosynthesis. Therefore, it is essential to clone and characterize the PAL genes from this valuable medicinal plant. In this study, molecular cloning and characterization of three PAL genes (ScPAL1-3) from S. chinensis was carried out. ScPALs were cloned using RACE PCR. The sequence analysis of the three ScPALs was carried out to give basic characteristics followed by docking analysis. In order to determine their catalytic activity, recombinant protein was obtained by heterologous expression in pCold-TF vector in Escherichia coli (BL21-DE3), followed by Ni-affinity purification. The catalytic product of the purified recombinant proteins was verified using RP-HPLC through comparing with standard compounds. The optimal temperature, pH value and effects of different metal ions were determined. Vmax, Kcat and Km values were determined under the optimal conditions. The expression of three ScPALs in different tissues was also determined. Our work provided essential information for the function of ScPALs.

The association between body mass index and varicocele: A meta-analysis

ABSTRACT Objective: Recently, several studies have found that obesity had a protective effect against varicocele, but no meta-analysis has confirmed this finding. Therefore, we conducted this meta-analysis to investigate the association between body mass index (BMI) and varicocele. Material and Methods: We searched for studies in PubMed, Science Direct and the Cochrane Library from inception until February 2018. The association between BMI and varicocele was assessed by pooling the odds ratios (ORs). Results: Eleven eligible studies with a total study population of 1.376.658 participants were included in our analysis. According to BMI, the subjects were defined as belonging to the obese, overweight and underweight groups. Our results showed that the obese group had a lower risk of varicocele when compared with the normal weight group (odds ratio [OR] 0.46, 95% confidence intervals [CIs] 0.37-0.58). Additionally, an overweight BMI had a protective effect against varicocele (OR 0.70, 95% CIs, 0.56-0.86). However, underweight patients had a more than 30% higher risk of varicocele (OR 1.31, 95% CI, 1.04-1.64). Furthermore, there was no publication bias in any of the analyses. Conclusions: Our study demonstrates that BMI is negatively associated with the presence of varicocele.

Protective effect of bone marrow mesenchymal stem cell-derived exosomes against the reproductive toxicity of cyclophosphamide is associated with the p38MAPK/ERK and AKT signaling pathways / 亚洲男科学杂志(英文版)

Spermatogenic dysfunction caused by cyclophosphamide (CP) chemotherapy has seriously influenced the life quality of patients. Unfortunately, treatments for CP-induced testicular spermatogenic dysfunction are limited, and the molecular mechanisms are not fully understood. For the first time, here, we explored the effects of bone marrow mesenchymal stem cell-derived exosomes (BMSC-exos) on CP-induced testicular spermatogenic dysfunction in vitro and in vivo. BMSC-exos could be taken up by spermatogonia (GC1-spg cells). CP-injured GC1-spg cells and BMSC-exos were cocultured at various doses, and then, cell proliferation was measured using 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay. In addition, photophosphorylation of extracellular-regulated kinase (ERK), p38 mitogen-activated protein kinase (p38MAPK), and protein kinase B (AKT) proteins was evaluated by western blotting as well as apoptosis in GC1-spg cells measured using flow cytometry. Treatment with BMSC-exos enhanced cell proliferation and reduced apoptosis of CP-injured GCI-spg cells. Phosphorylated levels of ERK, AKT, and p38MAPK proteins were reduced in CP-injured spermatogonia when co-treated with BMSC-exos, indicating that BMSC-exos acted against the reproductive toxicity of CP via the p38MAPK/ERK and AKT signaling pathways. In experiments in vivo, CP-treated rats received BMSC-exos by injection into the tail vein, and testis morphology was compared between treated and control groups. Histology showed that transfusion of BMSC-exos inhibited the pathological changes in CP-injured testes. Thus, BMSC-exos could counteract the reproductive toxicity of CP via the p38MAPK/ERK and AKT signaling pathways. The findings provide a potential treatment for CP-induced male spermatogenic dysfunction using BMSC-exos.

Periacetabular osteotomy through the lateral-rectus approach for obsolete acetabular fractures / 中华创伤骨科杂志

Objective:To investigate the surgical techniques and clinical efficacy of periacetabular osteotomy through the lateral-rectus approach (LRA) for obsolete acetabular fractures.Methods:The 22 patients with old acetabular fracture were retrospectively analyzed who had been admitted to Department of Traumatic Surgery, The Third Affiliated Hospital to Southern Medical University from June 2012 to June 2019. They were 16 males and 6 females, aged from 22 to 61 years (average, 45.0 years). By the Judet-letournel classification, there were 4 anterior + posterior hemitransverse fractures, 2 T-shaped fractures and 16 both column fractures. The time from injury to surgery was 3 to 12 weeks in 15 cases, 3 to 6 months in 5 cases, 9 months in one case, and 3 years in one case. After the whole acetabulum was exposed outside the peritoneum through LRA in all patients, periacetabular osteotomy was conducted under direct vision, followed by fixation with multiple reconstruction plates or integrated acetabular airfoil anatomical plates after reduction. Recorded were the operation time, intraoperative blood loss, fracture reduction quality, affected hip function and complications in the patients.Results:In this cohort the operation time ranged from 110 to 205 min, averaging 140.5 min; intraoperative blood loss ranged from 500 to 2,100 mL, averaging 1,250.4 mL. According to the Matta X-ray criteria, the postoperative reduction was assessed as excellent in 7 cases, as good in 11 and as poor in 4, yielding an excellent and good rate of 81.8% (18/22). All the 22 patients were followed up for 12 to 36 months (mean, 22.1 months) and achieved fracture union. The one-year follow-up showed that their modified Merle d'Aubigné & Postel scores ranged from 6 to 18 points, averaging 14.6 points and giving 6 excellent, 10 good, 3 fair and 2 poor cases [an excellent and good rate of 72.7% (16/22)]. Osteonecrosis of the femoral head developed in 2 patients one of whom underwent total hip replacement.Conclusions:As LRA can expose the entire hemipelic ring from the medial side of the pelvis, the periacetabular osteotomy can be performed and the fractures of anterior or posterior column and the quadrilateral area can be reduced under direct vision through the medial side of the acetabulum. Moreover, ideal results can be achieved with the use of multiple reconstruction plates or integrated acetabular airfoil anatomical plates.

Screening and analysis of gastric cancer in large-scale natural population in Wuxi / 中华消化内镜杂志

Objective:To explore the screening scheme of gastric cancer in large-scale natural population in Wuxi.Methods:From December 2016 to December 2019, 105 865 residents of 19 communities (villages) in six streets of Xinwu District, Wuxi were randomly enrolled in this study by random number table. A household epidemiological questionnaire survey was conducted among 50 063 target population subjects (aged 40-69), and then, respondents were divided into four categories, category Ⅰ: HP (-), PG (-); category Ⅱ: HP (+ ), PG (-); category Ⅲ: HP (+ ), PG (+ ); category Ⅳ: HP (-), PG (+ )according to the serological Helicobacter pylori ( HP) antibodies and pepsinogen (PG) test results. People in category Ⅲ and Ⅳ were all selected into group C and group D respectively, then individuals 3 times of group D were randomly selected from category Ⅰ to assign to group A, and individuals 3 times of group C from category Ⅱwere assigned to group B in the same way. Remaining individuals in category Ⅰ and Ⅱ who had first-degree family history of gastric cancer were also included in group A and group B, respectively. Endoscopic and pathological examination were performed on the above enrolled subjects for high grade intraepithelialneoplasia (HGIN), early gastric cancer and gastric cancer. Results:Of the 50 063 target subjects, 31 508 questionnaires were finally collected, with a participation rate of 62.9%. A total of 19 745 people were tested for serology, and the participation rate was 39.4% (19 745/50 063). Serological results showed that there were 11 152 people (56.48%) in category Ⅰ, 8 170 (41.38%) in category Ⅱ, 124 (0.63%) in category Ⅲ, and 299 (1.51%) in category Ⅳ. According to the exclusion criteria and principle of voluntariness, 3 400 individuals were candidates to undergo gastroscopy. Finally, a total of 2 389 people came to the hospital for gastroscopy, 1 263 in group A, 814 in group B, 86 in group C and 226 in group D, with an overall response rate of 70.3% (2 389/3 400), target population participation rate of 4.8% (389/50 063), and the overall population participation rate of 2.3% (2 389/105 865). In the 2 389 cases, there were 32 cases (1.34%) of HGIN and gastric cancer by gastroscopy and biopsy pathology, among which 1 case (3.125%) aged 40-49, 9 (28.125%) aged 50-59, and 22 (68.750%) aged 60-69. Among the 32 cases, 25 cases (78.13%)were pathologically confirmed as having HGIN or early gastric cancer by endoscopic submucosal dissection or surgical operation. By eliminating 810 people (including 3 gastric cancer) without first-degree family history with gastric cancer in group Ⅰ and Ⅱ, and increasing the gastroscopy screening age to 50 years (exluding 214 people aged 40-49, including 1 gastric cancer), the number of people who should undergo gastroscopy could be reduced from 2 389 to 1 365, and 28 cases of HGIN or gastric cancer were still detected, including 22 HGIN or early gastric cancer.Conclusion:Gastroscopy after the screening with epidemiological, serological tests, age and first-degree relative with gastric cancer family history is suitable for gastric cancer screening in Wuxi. Based on Chinese national conditions, a new community gastric cancer screening program is recommended in Wuxi considering cost-effectiveness, which includes those over 50 years old, serological PG (+ ) and first-degree relatives with family history of gastric cancer.

The application of gait analysis in the identification, differential diagnosis and assessment of Parkinson's disease / 中华神经科杂志

Parkinson′s disease is a neurodegenerative disease with characteristic motor symptoms. Due to its increasing disease burden, it has been received widespread attention worldwide. At present, its diagnosis, differential diagnosis, assessment of symptoms and therapeutic effect mostly rely on the clinical experience of medical staff and the subjective feelings of patients, while lack objective and quantitative evaluation criteria. Gait analysis can quantify gait abnormalities by collecting spatiotemporal parameters in the walking cycle, providing new ideas for early identification, accurate discovery of disease progression, and reasonable selection of therapies of Parkinson′s disease. In the future, with the further improvement and maturity of gait analysis technology, it may become an indispensable and important method in the diagnosis and treatment of Parkinson′s disease.

Advances in robot-assisted laparoscopic nephroureterectomy / 中华泌尿外科杂志

Nephroureterectomy is the golden standard for surgical treatment of upper urinary tract urothelial carcinoma. With the development of surgical robotics, the number of robot-assisted laparoscopic nephroureterectomy has increased rapidly worldwide. With the advantages of 3D imaging, high-definition camera and flexible joints, this procedure reduces the complexity of approaches in nephroureterectomy such as dissection of distal and intramural ureter as well as suture of the bladder wound, with comparable oncological outcome to open surgery. The present article reviewed the research progress in preoperative preparation, intraoperative technique, perioperative parameters and prognosis of robot-assisted laparoscopic nephroureterectomy.

Treatment of pelvic fragility factures in the elderly patients via lateral-rectus approach / 中华骨科杂志

Objective:To explore the surgical method and clinical efficacy of lateral-rectus approach (LRA) in the treatment of fragility fractures of the pelvis (FFP) in the elderly.Methods:A retrospective study was conducted for elderly FFP patients from January 2011 to December 2019. All the pelvic fractures should be exposed and reduced through LRA and fixed with pelvic reconstruction plates and channel screws. Then, a total of 30 elderly patients were included in the study, including 9 males and 21 females, with an average age of 72.5 years (range, 60-87 years). Fractures were caused by car accident in 5 cases, by falling from high places in 8 cases and by tumbling in 17 cases. According to the FFP classification, there were 6 cases of type IIc (6/30, 20%), 22 cases of type III (22/30, 73.33%, of which 13 cases were type IIIa, 7 cases were type IIIb, and 2 cases were type IIIc), 2 cases of type IVa (2/30, 6.67%). Among that, 2 cases suffered ipsilateral acetabular fractures, 17 suffered medical diseases such as hypertension, coronary heart disease, diabetes, etc., and none suffered extremities fractures or other types of injuries. Surgical field was exposed retroperitoneally through LRA, combined with lower limb traction to reduce the anterior and posterior pelvis ring fractures. Then, the reductions were done in direct visions and verified through X-ray fluoroscopy. After that, the posterior ring was fixed with reconstruction plate and/or sacroiliac screws, and the anterior ring was fixed with reconstruction plate or INFIX. The quality of fracture reduction was evaluated by Matta score and the postoperative function was evaluated by Majeed score.Results:All the 30 patients were surgical treated through LRA. The time from injury to operation was 5 to 20 days, with an average of 9.9 days. The operating time ranged from 35 to 150 min (mean, 73.5 min) and the intraoperative bleeding ranged from 220 to 2 400 ml (mean, 586.7 ml). Fractures were successfully reduced under direct vision and the positions of the plates and screws were monitored through X-ray fluoroscopy during the operation. Postoperative X-rays and CT scans showed satisfactory reduction of the pelvic ring. According to Matta criteria, the quality of fracture reduction was evaluated as excellent in 18 cases, good in 6 cases, fair in 4 cases and poor in 2 cases. The overall excellent and good rate was 80% (24/30). All patients were followed up for 6-24 months, the fractures were all healed, and all fractures healed for 2-5 months, with an average of 3.5 months. At the last follow-up, Majeed scores were 86.1±6.11 (range, 66-92), including 21 excellent cases, 7 good cases and 2 fair cases, with an excellent and good rate of 93.3% (28/30). As for complications, 1 patient developed deep venous thrombosis of the affected lower limb, and the thrombosis disappeared after thrombolytic therapy. One patient had fat liquefaction in the incision, and the wound healed after intensive dressing change. After INFIX fixation, 2 patients showed numbness on the lateral thigh of the affected side, and the symptoms were relieved after symptomatic treatment. Four patients were found to have internal fixation screws loosening during follow-up, but still achieved good fracture healing.Conclusion:The entire hemipelvic ring could be exposed through LRA without cutting the peritoneum, so that the sacroiliac joint, ilium wing and anterior ring fractures could be reduced under direct version. In the treatment of pelvis fragility fractures of the elderly, effective reduction and fixation could be achieved using reconstruction plates or channel screws through LRA.

Three-dimensional CT reconstruction combined with three-dimensional color printing compared with conventional imaging technology in treatment of complex hepatolithiasis using laparoscopy and choledochoscopy / 中华肝胆外科杂志

Objective:To study the efficacy of three-dimensional (3D) CT reconstruction combined with 3D color printing compared with traditional imaging technology in treatment of complex hepatobiliary calculi treated with laparoscopy and choledochoscopy.Methods:A retrospective study was conducted on 128 patients with complex hepatobiliary calculi who underwent hepatobiliary surgery at the Qingdao Chengyang People’s Hospital, Qingdao Municipal Hospital Affiliated to Qingdao University and Qingdao University Affiliated Hospital from January 2019 to December 2019. A comparison was made between patients who underwent three-dimensional CT reconstruction combined with 3D color printing (the study group, n=62) and the traditional imaging technology group (the control group, n=66) on operation time, intraoperative blood loss, liver blood flow occlusion time, stone clearance rate, postoperative complication rate, and recurrence of calculi after operation. Results:The study group was significantly better than the control group in operation time, intraoperative blood loss, porta hepatis occlusion time, hospital stay and treatment cost (all P<0.05). The stone clearance rate of the study group was 96.8% (60/62), which was significantly higher than that of the control group (86.4%, 57/66) ( P<0.05). The incidence of postoperative complications in the study group was 3.2% (2/62), which was significantly lower than that in the control group (18.2%, 12/66) ( P<0.05). There was no significant difference in the stone recurrence rate between the two groups (all P>0.05). Conclusion:Three-dimensional CT reconstruction combined with 3D color printing contributed significantly to the surgical treatment of complex intrahepatic bile duct stones as these imaging technologies significantly improved surgical accuracy, improved stone clearance and reduced postoperative complication rates, and reduced surgical treatment costs.