Prediction of Vasoactive-Inotropic Score on Prolonged Mechanical Ventilation in Adult Congenital Heart Disease Patients After Surgical Treatment Combined with Coronary Artery Bypass Grafting

ABSTRACT Introduction: This study aimed to investigate the predictive value of the vasoactive-inotropic score (VIS) at different time points for postoperative prolonged mechanical ventilation (PMV) in adult congenital heart disease patients undergoing surgical treatment combined with coronary artery bypass grafting. Methods: Patients were divided into two groups that developed PMV or not. The propensity score matching method was applied to reduce the effects of confounding factors between the two groups. VIS at different time points (VIS at the end of surgery, VIS6h, VIS12h, and VIS12h max) after surgery were recorded and calculated. The value of VIS in predicting PMV was analyzed by the receiver operating characteristic (ROC) curve, and multivariate logistic regression was used to analyze independent risk factors. Results: Among 250 patients, 52 were in the PMV group, and 198 were in the non-PMV group. PMV rate was 20.8%. After propensity score matching, 94 patients were matched in pairs. At each time point, the area under the ROC curve predicted by VIS for PMV was > 0.500, among which VIS at the end of surgery was the largest (0.805). The optimal cutoff point for VIS of 6.5 could predict PMV with 78.7% sensitivity and 72.3% specificity. VIS at the end of surgery was an independent risk factor for PMV (odds ratio=1.301, 95% confidence interval 1.091~1.551, P<0.01). Conclusion: VIS at the end of surgery is an independent predictor for PMV in patients with adult congenital heart disease surgical treatment combined with coronary artery bypass grafting.

Evaluation on quality of internet-based reporting of COVID-19 in Ningxia, 2020-2021 / 中国热带医学

@#Abstract: Objective　To find out the existing problems and provide reference for further improving the quality of report information by analyzing the report cards of COVID-19 and the positive report cards of primary screening reported in Ningxia. Methods　All COVID-19 case cards from 2020 to 2021 and initial screening positive cards were derived from the Chinese Information System for Disease Control and Prevention according to final review date. The timeliness of case reporting, timeliness of case review, completeness and accuracy of the case cards were analyzed. Results　In Ningxia, the first case of COVID-19 was reported on January 20, 2020, and as of December 31, 2021, 122 confirmed cases and 4 symptomatic infected cases were reported. In 2021, the timely reporting rate of COVID-19 was 98.00%, which increased by 8.24% compared with 2020 (90.54%). Compared with 2020, the average time limit for diagnosis to reporting of COVID-19 in 2021 was shortened by 83.12%; in 2021, the timely review rate of COVID-19 was 100.00%, which increased by 13.84% compared with 2020 (87.84%). Compared with 2020, the time from reporting to final review was shortened by 98.91%. In 2021, the timely rate of positive reports in COVID-19 in Ningxia was 90.00%, among which the timely rate of reports by county (district) nucleic acid detection institutions was the highest (92.31%), followed by municipal (91.67%) and autonomous region (81.82%). Conclusions　At the beginning of the epidemic in 2020, the timeliness of COVID-19 in Ningxia was poor, and through the implementation of measures such as technical training, supervision and inspection to continuously optimize the staffing of medical institutions and disease control institutions, the timeliness of reporting COVID-19 in Ningxia in 2021 was substantially improved, but there were still some weak links. In the future work, technical guidance and training should be carried out for weak links, and efforts should be made to improve the quality of reports.

Sunitinib induced resistance of endothelial cells by up-regulating P-glycoprotein and PI3K/Akt pathway

Abstract Drug resistance is a crucial obstacle to achieve satisfactory chemotherapeutic effects. Numerous studies have shown that the PI3K/Akt signaling pathway plays a significant role in various processes of cellular events and tumor progression, while few studies have focused on the PI3K/Akt signaling pathway in drug resistance of endothelial cells. The present study aims to explore the relationship of PI3K/Akt signaling and cellular resistance to anticancer drugs in human microvessel endothelial cells (HMEC-1). We established stable sunitinib-resiatant human microvessel endothelial cells (HMEC-su) after long-term exposure to sunitinib (a small-molecule tyrosine kinase receptor inhibitor) for 12 months. HMEC-su showed significant alternations of cell morphology and exhibited a 2.32-fold higher IC50 of sunitinib than parental HMEC-1 cells. Expression of P-glycoprotein (P-gp) and breast cancer-resistance protein (ABCG2) which mediates drug efflux, increased significantly in HMEC-su lines compared with HMEC-1 cells by western blots assay. Our study further demonstrates that LY294002 (blocking the PI3K/Akt pathway) enhances the sensibility of HMEC-su to suntinib and inhibits the gene transcription and protein expression of P-gp, ABCG2 in HMEC-su cells. In conclusion, these results indicate that LY294002 could reverse P-gp and ABCG2 mediated-drug resistance to sunitinib in HMEC-su cells by inhibiting PI3K/Akt signaling.

Meta analysis of the relationship between the neutrophils/lymphocytes ratio and prognosis in patients with oral squamous cell carcinoma / 口腔疾病防治

Objective@#To clarify the prognostic value of the neutrophil to lymphocyte ratio (NLR) in oral squamous cell carcinoma (OSCC) patients.@*Methods@#literature on the correlation between NLR and the prognosis and clinicopathological features of OSCC was searched in PubMed, Web of Science, Cochrane and Embase. The outcome indicators, including overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), tumor size, cervical lymph node metastasis, tumor stage, extracapsular lymph node invasion and peripheral nerve invasion, were analyzed by RevMan5.3 software@*Results @# In total, 6 180 patients were included in 23 studies. The analysis showed that NLR was significantly negatively correlated with OS [HR=1.62, 95%CI(1.38, 1.91), P < 0.001], DFS [HR=1.48, 95%CI(1.24, 1.77), P < 0.001] and DSS [HR=1.87, 95%CI(1.60, 2.20), P < 0.001]. In addition, higher NLR values were positively correlated with tumor size [OR=2.68, 95%CI (1.84, 3.90), P < 0.001], cervical lymph node metastasis [OR=1.59, 95%CI (1.35, 1.88), P < 0.001], tumor stage [OR=2.85, 95%CI (2.35, 3.47), P < 0.001], extralymphatic invasion [OR=1.72, 95%CI (1.23, 2.40), P=0.001], and peripheral nerve invasion [OR=1.70, 95%CI (1.29, 2.24), P < 0.001]. However, there was no significant correlation with age [OR=0.96, 95%CI (0.71, 1.29), P=0.77], sex [OR=1.08, 95%CI (0.88, 1.33), P=0.55], or degree of differentiation [OR=1.15, 95%CI (0.92, 1.43), P=0.22]@*Conclusion @#Elevated NLR was significantly associated with the prognosis and clinicopathological features of OSCC and might be an independent prognostic factor.

Prognostic Role of Immune-related Genes in Hepatocellular Carcinoma / 肿瘤防治研究

Objective To identify the potential prognostic biomarkers of the immune-related genes signature for patients with hepatocellular carcinoma (HCC). Methods Original HCC data were downloaded from TCGA, and the immune activity of each sample was calculated by ssGSEA. HCC samples were divided into high and low immune cell infiltration groups by "GSVA" package and "hclust" package. The ESTIMATE algorithm scored the tumor microenvironment in each HCC sample. The "limma" package and Venn diagram identified effective immune-related genes. Univariate Cox, Lasso regression and multivariate Cox regression analyses were used to explore key genes. The "rms" package was used to create nomograms and draw calibration curves. Results Compared with the high immune cell infiltration group, the tumor purity of the samples in the low immune cell infiltration group was higher, the immune score, ESTIMATE score and stromal score were lower. In the high immune cell infiltration group, the immune components were more abundant, and the expression levels of TIGIT, PD-L1, PD-1, LAG3, TIM-3, CTLA4 and HLA family were higher. Multivariate Cox regression analysis showed that four immune-related genes (S100A9, HMOX1, IL18RAP and FCER1G) were used to construct the prognosis model. Compared with other clinical features, the risk score of this prognostic model was recognized as an independent prognostic factor. Conclusion This study identified the immune-related core genes which may be used in targeted therapy and immunotherapy of HCC.

Research advances in work-related musculoskeletal disorders among construction workers / 中国职业医学

@#Abstract: - （ ） ， Work related musculoskeletal disorders WMSDs are common occupational diseases in construction workers which have a high prevalence rate and involve a large number of construction workers. WMSDs affect daily work and quality of life of ， patients leading to absenteeism and burden. The main body parts of construction workers suffering from WMSDs are lower back/ ， ， ， ， ， waist neck shoulder knee elbow and hand/wrist and most of the patients are complicated in multiple sites. The prevalence ， of WMSDs varies by site with the lower back/waist being the most common sites. The influencing factors of WMSDs in （ ， ， ， ， ， construction workers mainly include individual factors age years of work gender smoking status sleep habits physical ， ）， （ ， ， ， fitness and physical exercise etc. occupational factors work load job type working posture work organization and ， ） management working environment and social psychological factors. The incidence of WMSDs is the result of multiple factors. ， ， Therefore tertiary prevention is the key to the prevention and control of WMSDs especially the etiological prevention. Chinese ， construction industry is in the period of rapid development and the demand of construction workers is large. It is urgent to carry out epidemiological and intervention studies on WMSDs for construction workers to guide the formulation of relevant guidelines and measures for prevention and control of WMSDs.

Research advances in work-related musculoskeletal disorders among construction workers / 中国职业医学

@#Abstract: - （ ） ， Work related musculoskeletal disorders WMSDs are common occupational diseases in construction workers which have a high prevalence rate and involve a large number of construction workers. WMSDs affect daily work and quality of life of ， patients leading to absenteeism and burden. The main body parts of construction workers suffering from WMSDs are lower back/ ， ， ， ， ， waist neck shoulder knee elbow and hand/wrist and most of the patients are complicated in multiple sites. The prevalence ， of WMSDs varies by site with the lower back/waist being the most common sites. The influencing factors of WMSDs in （ ， ， ， ， ， construction workers mainly include individual factors age years of work gender smoking status sleep habits physical ， ）， （ ， ， ， fitness and physical exercise etc. occupational factors work load job type working posture work organization and ， ） management working environment and social psychological factors. The incidence of WMSDs is the result of multiple factors. ， ， Therefore tertiary prevention is the key to the prevention and control of WMSDs especially the etiological prevention. Chinese ， construction industry is in the period of rapid development and the demand of construction workers is large. It is urgent to carry out epidemiological and intervention studies on WMSDs for construction workers to guide the formulation of relevant guidelines and measures for prevention and control of WMSDs.

Research advances in work-related musculoskeletal disorders among construction workers / 中国职业医学

@#Abstract: - （ ） ， Work related musculoskeletal disorders WMSDs are common occupational diseases in construction workers which have a high prevalence rate and involve a large number of construction workers. WMSDs affect daily work and quality of life of ， patients leading to absenteeism and burden. The main body parts of construction workers suffering from WMSDs are lower back/ ， ， ， ， ， waist neck shoulder knee elbow and hand/wrist and most of the patients are complicated in multiple sites. The prevalence ， of WMSDs varies by site with the lower back/waist being the most common sites. The influencing factors of WMSDs in （ ， ， ， ， ， construction workers mainly include individual factors age years of work gender smoking status sleep habits physical ， ）， （ ， ， ， fitness and physical exercise etc. occupational factors work load job type working posture work organization and ， ） management working environment and social psychological factors. The incidence of WMSDs is the result of multiple factors. ， ， Therefore tertiary prevention is the key to the prevention and control of WMSDs especially the etiological prevention. Chinese ， construction industry is in the period of rapid development and the demand of construction workers is large. It is urgent to carry out epidemiological and intervention studies on WMSDs for construction workers to guide the formulation of relevant guidelines and measures for prevention and control of WMSDs.

Research advances in work-related musculoskeletal disorders among construction workers / 中国职业医学

@#Abstract: - （ ） ， Work related musculoskeletal disorders WMSDs are common occupational diseases in construction workers which have a high prevalence rate and involve a large number of construction workers. WMSDs affect daily work and quality of life of ， patients leading to absenteeism and burden. The main body parts of construction workers suffering from WMSDs are lower back/ ， ， ， ， ， waist neck shoulder knee elbow and hand/wrist and most of the patients are complicated in multiple sites. The prevalence ， of WMSDs varies by site with the lower back/waist being the most common sites. The influencing factors of WMSDs in （ ， ， ， ， ， construction workers mainly include individual factors age years of work gender smoking status sleep habits physical ， ）， （ ， ， ， fitness and physical exercise etc. occupational factors work load job type working posture work organization and ， ） management working environment and social psychological factors. The incidence of WMSDs is the result of multiple factors. ， ， Therefore tertiary prevention is the key to the prevention and control of WMSDs especially the etiological prevention. Chinese ， construction industry is in the period of rapid development and the demand of construction workers is large. It is urgent to carry out epidemiological and intervention studies on WMSDs for construction workers to guide the formulation of relevant guidelines and measures for prevention and control of WMSDs.

Analysis of coping capacity and influencing factors of public health emergencies among college students in Shandong Province / 中国学校卫生

Objective@#To understand the current situation and influencing factors of coping capacity in public health emergencies among college students in Shandong Province, and to provide reference for public health emergencies responses.@*Methods@#Using stratified random sampling method, 7 719 students from 6 colleges and universities in Shandong Province were selected and investigated with self designed questionnaire from April to May 2020. Multiple linear regression was used to analyze the influencing factors of coping capacity in public health emergencies.@*Results@#The overall coping capacity of college students in Shandong Province to public health emergencies scored (46.22±8.47), with dimension from high to low being personal prevention before the event (15.65±2.75), post event cooperation and disposal (15.18±3.08), incident personal precaution (15.01±3.23). Multiple linear regression showed that gender, major, only child, parental education level, knowledge of public health emergencies, emergency drill exercises, and health education for public health emergencies were associated with coping capacity among college students in public health emergencies ( B =-1.53, -1.78, -2.08, 0.60, 0.81, 1.11, 1.38, 0.78, 1.65, 1.86, 9.14, 2.00, 2.62, P <0.05).@*Conclusion@#The overall coping capacity in public health emergencies among college students in Shandong is at a good level, but still needs to be improved through strengthening emergency education and family support.

Evaluation and associated factors of the responses to public health emergencies among college students in Shandong Province / 中国学校卫生

Objective@#To evaluate response to public health emergencies in colleges and universities and associated factors, and to provide references for emergency response mechanisms in colleges.@*Methods@#Using stratified random sampling, recruited 7 719 students in 6 universities in Shandong Province during April May 2020, and analyzed the data with SPSS 25.0 software.@*Results@#About 65.5% of college students reported response to public health emergencies in their college, 67.7% of the students reported that colleges have emergency plans, 53.9% of the students reported that colleges have carried out simulated emergency training, and 64.7% of the students reported that colleges have carried out health education. Evaluation from students for responding to public health emergencies in colleges and universities scored(24.15±4.59), of which measures and policies related to epidemic control were highest(4.05±0.81), while mental health education or counselling services were lowest (3.95±0.85). Gender, grade, major, type of household registration, emergency response measures, emergency response plan, emergency simulation training, health education were associated with the evaluation of the measures by college students(t/F=5.04，43.83，79.92，-3.40，26.86，34.83，29.35，35.01，P<0.01).@*Conclusion@#While recognizing the overall performance on public health responses in universities, college students believe certain limitations still exist; colleges and universities should continuously improve the emergency prevention and control system of public health emergencies in response to the effectiveness and deficiencies in the prevention and control process.

Parent child communication about sex related topics and associated factors in rural area of Sichuan / 中国学校卫生

Objective@#To understand parent child communication about sex related topics in rural areas of Sichuan Province, and to provide the basis for family sex education.@*Methods@#A multi stage stratified cluster sampling was adopted to select 2 801 parents of children from 53 township kindergartens in Sichuan Province. Questionnaires were conducted to parents about sex education in family by face to face interview or self filling.@*Results@#About 41.63% of parents reported that children had questions about sex, and the rate of proper parent child communication was 57.46%. The results of binary unconditional Logistic regression analysis showed that township residence( OR=1.46, 95%CI =1.12-1.90), high school or higher educational background of mothers( OR= 1.77 , 95%CI =1.38-2.28), non-left-behind children( OR=1.32, 95%CI =1.03-1.69), supportive for parent child communication about sex related topics( OR=1.66, 95%CI =1.05-2.63), sex education at home( OR=1.60, 95%CI =1.25-2.05) were associated with a higher rate of proper parent child communication on sex( P <0.05).@*Conclusion@#In rural areas of Sichuan, proper parent child communication about sex related topics was not common. It is suggested that in rural areas, parents should enhance their awareness of the knowledge and importance of children s sex education, and improve the coping methods of children s sex-related problems so as to promote the healthy growth of children s body and mind.

Cichoric acid from extracted Echinacea purpurea induces the proliferation and apoptosis of peripheral blood mononuclear cells from yaks

BACKGROUND: Cichoric acid (CA) is extracted from Echinacea purpurea. It is well known and widely used for its immunological function. However, the effect of CA on peripheral blood mononuclear cells (PBMCs) from yaks is still unclear. This study investigated the potential influences of CA on the proliferation, cytokine induction, and apoptosis of PBMCs from Datong yak in vivo, and aimed to provide a basis for exploring the pharmacological activities of CA on yaks. RESULTS: In this study, CA promoted PBMCs proliferation by combining concanavalin A (Con A) and exhibited a dose-dependent effect as demonstrated by a Cell Counting Kit-8. The concentration of 60 µg/ml CA was the best and promoted the transformation from the G0/G1 phase to the S and G2/M phases with Con A. Furthermore, 60 µg/ml CA significantly increased IL-2, IL-6, and IFN-γ levels and PCNA, CDK4 and Bcl-2 expression levels, but it significantly inhibited the TP53, Bax, and Caspase-3 expression levels. Transcriptome analysis revealed a total of 6807 differentially expressed genes (DEGs) between the CA treatment and control groups. Of these genes, 3788 were significantly upregulated and 3019 were downregulated. Gene Ontology and pathway analysis revealed that DEGs were enriched in cell proliferation and immune function signaling pathways. The expression level of some transcription factors (BTB, Ras, RRM_1, and zf-C2H2) and genes (CCNF, CCND1, and CDK4) related to PBMCs proliferation in yaks were significantly promoted after CA treatment. By contrast, anti-proliferation-associated genes (TP53 and CDKN1A) were inhibited. CONCLUSIONS: In summary, CA could regulate the immune function of yaks by promoting proliferation and inhibiting inflammation and apoptosis of PBMCs.

Characteristics of 25-hydroxyvitamin D[25(OH)D] level in children with autism spectrum disorder and its correlation with clinical features / 中国学校卫生

Objective@#To investigate the characteristics of 25(OH)D level in children with ASD and its correlation with clinical features.@*Methods@#A total of 196 children with ASD who received outpatient and inpatient rehabilitation training from January 2017 to January 2019 were included in ASD group, and 178 healthy children who visited the hospital during the same period were included in healthy control group. Differences in 25(OH)D levels and general data between study group and healthy control group were compared. In addition, ASD group was divided into 25(OH)D normal group and abnormal group in accordance with 25(OH)D level (≥30 ng/mL). Differences in general data, total score of CARS scale and factor scores were compared between two groups. Finally, the correlation between serum 25(OH)D level and CARS total score and factor scores of children with ASD was evaluated.@*Results@#25(OH)D level in ASD group was significantly lower than that in healthy control group (P<0.01). The incidence of sleep disorder, dietary bias, vomiting, constipation and diarrhea in children with ASD was statistically significant compared with that of healthy children (P<0.01); there were statistically significant differences in breastfeeding, sleep disorder, dietary bias and diarrhea between 25(OH)D normal group and abnormal group (χ2=4.97，8.69,6.67,3.98,P<0.05); there were statistically significant differences in 10 aspects including CARS total score, interpersonal relationship, imitation, emotional response, physical use ability, relationship with inanimate objects, adaptation to environmental changes, visual response, auditory response and general impression (P<0.05); there was a significant negative correlation between serum 25(OH)D level and CARS total score in children with ASD (r=-0.32, P<0.01).@*Conclusion@#Breastfeeding could reduce the risk of 25(OH)D abnormalities in children with ASD. 25(OH)D reduction would cause sleep disorder, dietary bias and gastrointestinal problems, while dietary bias and gastrointestinal problems would affect 25(OH)D uptake and absorption. 25(OH)D might be related to the occurrence of ASD in children. Serum 25(OH)D level could be used as a reference index for the severity of ASD in children.

Early childhood sexuality education among parents of 3-6 years old left behind children in rural areas and associated factors / 中国学校卫生

Objective@#To understand the current situation of early childhood sexuality education among parents of leftbehind children in rural areas and associated factors, to provide the evidence to launch the sexuality education for left behind children in rural areas in the future.@*Methods@#An anonymous questionnaire survey was conducted among 1 348 parents of left behind children in rural areas who were selected by multistage stratified sampling during Mar. to May. 2018.@*Results@#The rate of early childhood sexuality education of rural areas in Sichuan was 48.4%(652). Multivariate analysis showed that parents whose child was in higher grade ( OR=1.32, 95% CI =1.12-1.55); total annual income <10 000 yuan( OR=1.48, 95%CI =1.02-2.14), children had asked sexrelated questions ( OR=1.44, 95%CI =1.11-1.87), reckoning it necessary( OR=3.78, 95%CI =2.57-5.58), considering children’s sexuality education should be held by parents ( OR=2.69, 95%CI =1.78-4.07), other family members had launched the early childhood sexuality education( OR=7.86, 95%CI =5.16-11.95), school had launched it ( OR=3.13, 95%CI =2.25-4.34) had a highter rate of early childhood sexuality education.@*Conclusion@#Early childhood sexuality education of parents of left behind children of rural areas in Sichuan is in low level. Sexual health education should be based in school, together with parental training towards positive attitude and increases in early childhood sexuality education.

Clinical characteristics and epidemiological analysis of pathogenic bacteria of severe abdominal infection in surgical intensive care unit / 中华危重病急救医学

Objective:To study the clinical characteristics of patients with severe abdominal infection and the epidemiological characteristics of pathogenic bacteria in a hospital, to provide a basis for rational use of antibiotics and reduce the drug resistance rate of pathogens.Methods:A retrospective analysis was performed on 237 patients with abdominal disease as the primary disease admitted to the surgical intensive care unit (ICU) of the First Affiliated Hospital of Guangxi Medical University from January 1st, 2017 to December 31st, 2019. They were divided into two groups according to whether abdominal infection occurred or not. The clinical features of patients in both groups were analyzed, including gender, age, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, chronic underlying diseases, primary abdominal site, abdominal trauma or bleeding, multiple organ dysfunction syndrome (MODS) involving organs and surgical treatment. At the same time, the bacterial origin, bacterial distribution and antibiotics sensitivity test results of patients with abdominal infection were recorded.Results:Abdominal infection occurred in 141 of the 237 patients and did not occur in the remaining 96 patients. There were no statistically significant differences between the abdominal infection group and the non-abdominal infection group in terms of gender, age, chronic underlying diseases, etiology and trauma. The APACHE Ⅱ score in the abdominal infection group was obviously higher than that of the non-abdominal infection group (24.0±8.1 vs. 17.1±5.8, P < 0.01). Incidences of abdominal bleeding, MODS involving four or more organs, surgery and the times of surgery ≥ 3 in the abdominal infection group were significantly higher than those in the non-abdominal infection group (36.2% vs. 17.7%, 20.6% vs. 1.0%, 84.4% vs. 21.9%, 9.3% vs. 0%, all P < 0.05). Among the 141 patients with abdominal infection, 107 obtained positive microbial culture results, and a total of 133 pathogenic strains were detected, including 115 strains of bacteria (86.5%) and 18 strains of fungi (13.5%). The main source of bacteria was abdominal drainage (46.1% of non-bloody specimens and 13.9% of bloody specimens). Among the 115 bacteria, Gram-negative (G -) bacteria were the most common (72.2%) and Gram-positive (G +) bacteria accounted for 27.8%. Escherichia coli and Acinetobacter baumannii were the top two G - bacteria (40.9% and 13.9%, respectively), and enterococcus faecalis accounted for the largest proportion of G + bacteria (7.8%). The pathogenic bacteria of abdominal infection were sensitive to tigacycline. Conclusions:The patients with abdominal infection in our hospital had high APACHE Ⅱ score, more organs failure and were easily complicated with intraperitoneal hemorrhage and required surgical intervention and even repeated surgery. The pathogenic bacteria in patients with abdominal infection in ICU were mainly G - bacteria, and the rate of multi-drug resistance of Acinetobacter baumannii was high. Empirical anti-infective treatment should be started as soon as possible according to the microbial spectrum of the region until the pathogenic bacteria results are obtained. Broad-spectrum antimicrobial therapy and combined antimicrobial therapy are recommended for the healthcare acquired abdominal infection in hospital.

Application value of three-dimensional visualization technology in management of middle hepatic vein processing in associating liver partition and portal vein ligation for staged hepatectomy / 中华消化外科杂志

Objective:To investigate the application value of three-dimensional visualization technology in management of middle hepatic vein (MHV) processing in associating liver partition and portal vein ligation for staged hepatectomy(ALPPS).Methods:The retrospective and descriptive study was conducted. The clinical data of 40 patients with right massive liver cancer or multiple right liver lesions who underwent ALPPS in the First Affiliated Hospital of Guangxi Medical University from November 2017 to August 2019 were collected. There were 34 males and 6 females, aged (44±9)years, with a range from 26 to 64 years. All patients underwent multi-slice computed tomography (CT) plain and enhanced scan of superior abdominal region before operation, and the data were transmitted to the liver visualization analysis software IQQA system with 1.5 mm thin-layer images to complete the three-dimensional reconstruction of the liver and its blood vessels. Patients were performed ALPPS based on results of three-dimensional reconstruction and intraoperative findings. Observation indicators: (1) results of preoperative three-dimensional reconstruction; (2) surgical situations; (3) follow-up. Follow-up was conducted using outpatient examinations and telephone interview to detect postopeartive survival of patients up to March 2020. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were described as M (range). Count data were represented as absolute numbers. Results:(1) Results of preoperative three-dimensional reconstruction: 40 patients underwent three-dimensional reconstruction successfully, of which 37 clearly showed MHV, tumor location and relationship between them, 3 patients showed unclearly MHV and were classified based on two-dimensional images. Of the 40 patients, 12 had MHV classified as type A, 13 as type B, 9 as type C, and 6 as type D. Three-dimensional reconstruction of vessels showed 22 with umbilical veins and 9 with anterior veins. Of the 40 patients, 35 were predicted to preserve MHV, and 5 were predicted to resect MHV. Total estimated liver volume, tumor volume, and reserved liver volume were (1 012±119)cm 3, 600 cm 3(8-2 055 cm 3), (346±80)cm 3. The ratio of future liver remnant to standard liver volume was 34%±8%. (2) Surgical situations : 40 patients underwent the first-stage ALPPS, including 35 with preservation of MHV and 5 with resection of MHV, which was accorded with preoperative prediction. Thirty-four patients underwent the second-stage ALPPS, and 6 patients had failure to receive the second-stage ALPPS due to undificiency future liver remnant. The operation time and volume of intraoperative blood loss for 40 patients undergoing first-stage ALPPS were (350±79)minutes and 300 mL(range, 100-2 600 mL). Three patients received blood transfusion and no perioperative death occurred. There were 24 patients with grade A heptic insufficiency according to criteria of International StudyGroup of Liver Surgery (ISGLS) and 16 patients with grade B heptic insufficiency after the first-stage ALPPS. Twenty-eight patients had grade Ⅰ complications of Clavien-Dindo classification, including 17 with a small pleural effusion, 10 with a small pleural and abdominal effusion, 1 with hypoproteinemia; 8 patients had grade Ⅱ complications of Clavien-Dindo classification, including 5 with pneumonia, 1 with pneumonia combined with pleural and abdominal effusion, 1 with coagulation disorders, 1 with biliary fistula; 3 patients had grade Ⅲ complications of Clavien-Dindo classification, including 2 with pneumothorax and pneumonia, 1 with pneumothorax, pneumonia and coagulation disorders; 1 patient had grade Ⅳ complications of Clavien-Dindo classification as systemic inflammatory response syndrome. All patients with complications were improved after symptomatic treatment, anti infection, transfusion of fresh frozen plasma or drainage. For the 34 patients undergoing the second-stage ALPPS, the operation time and volume of intraoperative blood loss were (320±83)minutes and 500 mL(range, 200-6 000 mL). Twelve patients received blood transfusion. There were 12 patients with grade A heptic insufficiency according to criteria of ISGLS and 22 with grade B heptic insufficiency after the second-stage ALPPS. Eighteen patients had grade Ⅰ complications of Clavien-Dindo classification, including 11 with a small pleural effusion, 7 with a small pleural and abdominal effusion; 12 patients had grade Ⅱ complications of Clavien-Dindo classification, including 4 with pneumonia, 4 with coagulation disorders, 3 with massive abdominal effusion, 1 with biliary fistula; 3 patients had grade Ⅲ complications of Clavien-Dindo classification, including 1 with pneumothorax and pneumonia, 1 with massive pleural effusion, 1 with obstructive jaundice; 1 patient had grade Ⅳ complications of Clavien-Dindo classification as pneumonia and anemia. All patients with complications were improved after symptomatic treatment, anti infection, transfusion of fresh frozen plasma or drainage. (3) Follow-up: 40 patients were followed up for 2-35 months, with a median follow-up time of 17 months. The 6-month, 1-, and 2-year survival cases were 35, 26, 21 cases. Conclusion:Three-dimensional visualization technology can clearly show the MHV classification and its relationship with tumor location, which has an important guiding significance in the decision-making of MHV management in ALPPS.

Clinical application of laser selective melting titanium alloy for removable partial denture frameworks / 口腔疾病防治

Objective@#To investigate the effect of denture stomatitis of selective laser melting (SLM) titanium alloy for removable partial denture frameworks.@*Methods @#Twenty patients with dentition defects in our hospital were divided into two groups according to the different methods of creating a removable partial denture framework: the SLM group and casting group. The success rate, placement rate, masticatory efficiency and incidence of denture stomatitis were compared. Experimental data were analyzed with SPSS20.0.@*Results @# The success rate of the SLM framework group was 100.00%, which was higher than that of the casting group (90.00%) (P ＜ 0.01). The rate of framework placement in the SLM group was slightly lower than that in the casting group (P ＜ 0.05). The masticatory efficiency of the SLM group was higher than that of the casting group (0.783 ± 0.030 vs. 0.699 ± 0.037, P ＜ 0.001). The incidence of denture stomatitis (10.00%) in the SLM group was significantly lower than that in the casting group (30.00%) (P ＜ 0.001). @*Conclusion @#SLM is superior to the traditional casting method in mastication efficiency and reducing the incidence of denture stomatitis. This method can meet the clinical requirements, but the accuracy of the long-term stent needs to be improved.

Intestinal absorption of phenolic acids in Rhus chinensis extracts by in situ single-pass perfusion model in rats / 中国中药杂志

The intestinal absorption properties of four main effective components(gallic acid, ocinolglucoside, ethyl gallate and penta-O-galloyl-β-D-glucose) in Rhus chinensis extracts were investigated by in situ single-pass intestinal perfusion model in rats. The liquid accumulation of perfusion was corrected by gravimetry. The HPLC method was established to determine the concentration of the four effective components in the intestinal perfusion. It showed significant differences(Pethyl gallate>gallic acid>ocinolglucoside, with significant differences between them(P<0.05). In conclusion, gallic acid, orpheolglucoside, ethyl gallate and pentacyl-glucose could be absorbed in the whole intestine. Their absorption rate and permeation ability were related to the intestinal section and the perfusate concentration. These results indicated potential active transport or facilitated diffusion in the intestinal transport process of the four effective components.