Efficacy of subcutaneous negative pressure drainage device in the prevention of surgical site infections of superficial incisions in the open surgery of the lower gastrointestinal tract / 国际外科学杂志

Objective:To investigate the role of subcutaneous negative pressure drainage device in the prevention of surgical site infections (SSI) of superficial incisional in lower digestive tract open surgeries.Methods:Clinical data of 104 patients receiving open surgeries on lower digestive tract at Beijing Friendship Hospital, Capital Medical University from October 2018 to June 2020 was analyzed by a propensity score matching (PSM), and the clinical data of 104 patients receiving open surgeries on lower digestive tract at Beijing Friendship Hospital, Capital Medical University from February to December 2021 was analyzed by a randomized controlled trial (RCT). Chi-square tests were conducted to analyze the association of subcutaneous negative pressure drainage device with SSI of superficial incisional. Univariate and multivariate Logistic regression analysis were used to identify the risk factors for SSI in superficial incisions.Results:Patients with subcutaneous negative pressure drainage device encounter significantly less SSI of superficial incisional in both the PSM study ( P=0.007) and the RCT study ( P=0.049). In the PSM study, the independent risk factors for SSI of superficial incisional via univariate and multivariate Logistic regression analysis were absence of subcutaneous drainage ( Puni=0.012, Pmulti=0.009) and postoperative anastomosis leak ( Puni=0.054, Pmulti=0.034). In the RCT study, the independent risk factors for SSI of superficial incisional via univariate and multivariate Logistic regression analysis were absence of subcutaneous drainage ( Puni=0.061, Pmulti=0.017), eldly ( Puni=0.076, Pmulti=0.032), long incision ( Puni=0.078, Pmulti=0.040). Conclusion:Subcutaneous negative pressure drainage device can significantly reduce SSI of superficial incisional in lower digestive tract open surgeries.

Research status and prospects of digestive tract reconstruction after laparoscopic right hemicolectomy of colon cancer / 中华消化外科杂志

Intracorporeal anastomosis in laparoscopic right hemicolectomy of colon cancer is becoming a hot spot in colorectal surgery. A number of retrospective studies have suggested that intracorporeal anastomosis has potential advantages in promoting postoperative recovery and reducing postoperative complications compared with conventional extracorporeal anastomosis. Several randomized controlled trials published recently have also confirmed that intracorporeal anastomosis can promote postoperative gastrointestinal function recovery and reduce postoperative pain, but there is still insufficient evidence to draw a conclusion about the incidence of complications, especially the anastomotic leakage rate. Heterogeneity of surgical techniques and unclear definition of anastomotic leakage are the main difficulties in current studies. Several high-quality prospective randomized controlled trials are currently under way, and high level of evidence is needed to objectively evaluate the laparoscopic right hemicolectomy of colon cancer. The authors review the relevant literatures at home and abroad, systematically elaborate the research status and prospects of digestive tract reconstruction after laparoscopic right hemicolectomy of colon cancer, in order to explore a new direction for the clinical research of colorectal surgery in China.

Application of circulating microRNA in monitoring and predicting the cancer patients' response to chemotherapy / 肿瘤研究与临床

Intra-cellular microRNA (miRNA) has been proved to participate in the occurrence and development of tumors. Whereas extra-cellular miRNA's function as a tumor biomarker has drawn more and more attention recently. Accumulating evidences indicate that the level of certain extra-cellular miRNA is related to patients' response to chemotherapy. This article reviews the recent researches such as generating pathway, detective method and the prediction of patients' response to chemotherapy of tumor-specific extra-cellular miRNA, indicating that the detection of miRNA in the body fluid is considered to be a promising field of biomarker study. However, circulating miRNA mainly comes from blood cells, endothelial cells and other organs with high blood volume, which means that tumor-specific miRNA can easily be submerged. On the other hand, standardized experiment process and enlarged sample size can help to improve the credibility of relevant researches.

Progress of immune check-point inhibitors’ application in advanced gastric cancer / 国际外科学杂志

China is one of the countries with the highest prevalence of gastric cancer, who the majority gastric cancers are advanced stage diseases. Multi-disciplinary treatment including surgery and chemotherapy is not sufficient to effectively improve the prognosis of late-stage gastric cancer. In recent years, immune check-point inhibitor has gained promising results in assorted types of cancers. Therefore, its application in gastric cancer has drew increasing attention. This article will review recent clinical researches and introduced the current clinical application of immune check-point inhibitors in the treatment of gastric cancer. For late-stage gastric cancer patients after failed attempts of treatment by conventional chemotherapy, PD-1 inhibitor is a viable option. Pembrolizumab is currently the only PD-1 inhibitor approved by FDA for application in gastric cancer, whereas CFDA has not approved any immune check-point inhibitors for this purpose. One of the major focus of subsequent basic and clinical researches will be how to further increase the objective response rate of anti-PD-1 treatment.

Retrospective study of the differences of biomarker expression between primary lesions of breast cancer and corresponding lymph node metastases / 国际外科学杂志

Objective To investigate the difference of the expression of estrogen receptor,progesterone receptor,human epidermal growth factor receptor 2 and Ki-67 protein between primary lesions of breast cancer and its synchronous ipsilateral lymph node metastasis,as well as its clinical implications.Methods Retrospectively analyze invasive breast cancer patients treated in Peking University First Hospital from January 2012 to May 2016.The IHC expressions of estrogen receptor,progesterone receptor,human epidermal growth factor receptor 2 and Ki-67 protein in both the primary and lymph node metastatic lesions are compared and analyzed statistically.The count data were represented as n(％),and comparsion between groups were evaluated using the McNemar test.Results One hundred and fifty-six patients were included,of which on 2 cases (1.3％),estrogen receptor status of primary lesions is different from that of lymph node metastases(P =0.500);on 10 cases (6.4％),progesterone receptor status of primary lesions is different from that of lymph node metastases (P =0.344);on 28 cases (18.0％),Ki-67 protein status of primary lesions is different from that of lymph node metastases (P =0.000 18);on 3 cases (1.9％),human epidermal growth factor receptor 2 status of primary lesions is different from that of lymph node metastases (P =1.000).Conclusion There may be difference between primary lesions and lymph node metastases in the expression of estrogen receptor,progesterone receptor,human epidermal growth factor receptor 2 and Ki-67 protein,which can provide a reference for individualized treatment of breast cancer patients.

Effect of mitomycin C in reducing hypertrophic scar in rat traumatic osteomyelitis model / 中华创伤杂志

Objective To investigate the effect and mechanism of mitomycin C in reducing hypertrophic scar in rat traumatic osteomyelitis model.Methods A total of 120 Wistar rats were divided into control group (Group A,n =40),traumatic osteomyelitis group (Group B,n =40),traumatic osteomyelitis treated with Mitomycin C group (Group C,n =40),according to the random number table.The model of traumatic osteomyelitis was produced by Staphylococcus aureus.Muscle tissues around the focus were harvested at 15 d and 30 d postinjury.HE staining was used to observe the changes of muscle tissue structure.Immunohistochemistry was used to detect expression of transforming growth factor (TGF)-β1.Masson staining was used for collagen deposition evaluation.Western blot was used for detection of levels of TGF-β1 and collagen Ⅰ.Results HE staining revealed consistent alignment of fibers within the muscle in Group A.Fibrosis with the muscle was observed in both Group B and C,but the degree of muscle fiber disorder was decreased in Group C compared to Group B.Either 15 d or β0 d after injury,expressions intensity of TGF-β1,collagen fraction volume,and activation levels of TGF-β1 as well as collagen Ⅰ were higher in Group B and C than Group A,and all parameters were decreased in Group C compared to Group B (all P ＜ 0.05).Conclusion Mitomycin C can reduce hypertrophic scar formation in traumatic osteomyelitis model,and the potential mechanism relates to downregulated TGF-β1 and collagen Ⅰ.

Observation of the application of continuous veno-venous hemofiltration in patients with cerebral injury complicated with severe infection / 中国现代医生

Objective To explore the clinical application value of continuous veno-venous hemofiltration (CVVH) in patients with cerebral injury complicated with severe infection. Methods A total of 57 patients with cerebral injury complicated with severe infection who were admitted to our hospital from April 2011 to April 2014 were retrospectively analyzed. They were given CVVH combined with medicinal treatment or pharmacological method respectively. The im-provement of clinical symptoms and prognosis were compared. Each clinical index before and after the treatment (body temperature, mean arterial pressure, white cell count, CRP, PaO2/FiO2, conditions of complications), APACHE II scores and 28-d mortality rate were compared between the two groups. Results Under the conditions that ages, gender, A-PACHEII scores, number of organ failure and the rate of mechanical ventilation were not significantly different, CVVH treatment was applied, and the serum CRP, white cell count, body temperature, and 28 d mortality were significantly different from those in the group who was not given the CVVH treatment. Conclusion CVVH improves the clinical symptoms of patients with cerebral injury complicated with severe infection, and anti-coagulation without heparin does not significantly improve patients' risk of bleeding. The application of CVVH is able to improve the successful rate of rescue for such type of patients.

Risk factors for cardiovascular disease and their clustering among middle aged and old people in Jilin province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the risk factors for cardiovascular disease (CVD) and their clustering among middle aged and old people in Jilin province and provide evidence for the development of effective intervention measures.</p><p><b>METHODS</b>A total of 13 914 people aged 35-79 years were selected from 32 counties (district) in 9 prefectures (municipality) of Jilin province through multi-stage stratified cluster sampling to conduct a face to face questionnaire survey and health examination. Complex weighted computation was conducted to analyze the survey results.</p><p><b>RESULTS</b>The prevalence of hypertension, diabetes, dyslipidemia, smoking and overweight were 41.3%, 11.5%, 42.8%, 31.5% and 53.5%, respectively. Only 16.2% of the subjects surveyed were free of the 5 risk factors. ≥ 1 risk factor and ≥ 3 risk factors were found to clustering in 83.8% and 29.9% of the middle aged and old people. Compared with females, the odds ratios of ≥ 1, ≥ 2 and ≥ 3 risk factors clustering in males were 3.18, 4.28 and 5.58 times higher, respectively. Compared with urban residents, the odds ratios of ≥ 1, ≥ 2 risk factors clustering in rural residents were 1.22 and 1.20 times higher. In addition, the odds ratios of ≥ 1, ≥ 2 and ≥ 3 risk factors clustering increased with age (all P < 0.001).</p><p><b>CONCLUSION</b>High prevalence of major cardiovascular disease risk factors and their clustering were found in middle aged and old people in Jilin province. More attention and intervention should be given to the old males in rural areas.</p>

Risk factors for cardiovascular disease and their clustering among middle aged and old people ;in Jilin province / 中华流行病学杂志

Objective To understand the risk factors for cardiovascular disease(CVD)and their clustering among middle aged and old people in Jilin province and provide evidence for the development of effective intervention measures. Methods A total of 13 914 people aged 35-79 years were selected from 32 counties (district) in 9 prefectures (municipality) of Jilin province through multi-stage stratified cluster sampling to conduct a face to face questionnaire survey and health examination. Complex weighted computation was conducted to analyze the survey results. Results The prevalence of hypertension,diabetes,dyslipidemia,smoking and overweight were 41.3%,11.5%, 42.8%,31.5%and 53.5%,respectively. Only 16.2%of the subjects surveyed were free of the 5 risk factors.≥1 risk factor and≥3 risk factors were found to clustering in 83.8%and 29.9%of the middle aged and old people. Compared with females,the odds ratios of ≥1,≥2 and ≥3 risk factors clustering in males were 3.18,4.28 and 5.58 times higher,respectively. Compared with urban residents,the odds ratios of≥1,≥2 risk factors clustering in rural residents were 1.22 and 1.20 times higher. In addition,the odds ratios of≥1,≥2 and≥3 risk factors clustering increased with age(all P<0.001). Conclusion High prevalence of major cardiovascular disease risk factors and their clustering were found in middle aged and old people in Jilin province. More attention and intervention should be given to the old males in rural areas.

Risk factors for cardiovascular disease and their clustering among middle aged and old people ;in Jilin province / 中华流行病学杂志

Objective To understand the risk factors for cardiovascular disease(CVD)and their clustering among middle aged and old people in Jilin province and provide evidence for the development of effective intervention measures. Methods A total of 13 914 people aged 35-79 years were selected from 32 counties (district) in 9 prefectures (municipality) of Jilin province through multi-stage stratified cluster sampling to conduct a face to face questionnaire survey and health examination. Complex weighted computation was conducted to analyze the survey results. Results The prevalence of hypertension,diabetes,dyslipidemia,smoking and overweight were 41.3%,11.5%, 42.8%,31.5%and 53.5%,respectively. Only 16.2%of the subjects surveyed were free of the 5 risk factors.≥1 risk factor and≥3 risk factors were found to clustering in 83.8%and 29.9%of the middle aged and old people. Compared with females,the odds ratios of ≥1,≥2 and ≥3 risk factors clustering in males were 3.18,4.28 and 5.58 times higher,respectively. Compared with urban residents,the odds ratios of≥1,≥2 risk factors clustering in rural residents were 1.22 and 1.20 times higher. In addition,the odds ratios of≥1,≥2 and≥3 risk factors clustering increased with age(all P<0.001). Conclusion High prevalence of major cardiovascular disease risk factors and their clustering were found in middle aged and old people in Jilin province. More attention and intervention should be given to the old males in rural areas.