Safety evaluation of hyperthermic intraperitoneal chemotherapy in patients with local advanced gastric cancer after radical resection for prevention of peritoneal metastasis / 中华胃肠外科杂志

Objective: Patients with advanced gastric cancer have a poor prognosis and a possibility of peritoneal metastasis even if receiving gastrectomy. Hyperthermic intraperitoneal chemotherapy (HIPEC) can effectively kill free cancer cells or small lesions in the abdominal cavity. At present, preventive HIPEC still lacks safety evaluation in patients with locally advanced gastric cancer. This study aims to explore the safety of radical resection combined with HIPEC in patients with locally advanced gastric cancer. Methods: A descriptive case series study was carried out. Clinicopathological data of 130 patients with locally advanced gastric cancer who underwent radical resection + HIPEC at the Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2020 to February 2021 were retrospectively analyzed. Inclusion criteria: (1) locally advanced gastric adenocarcinoma confirmed by postoperative pathology; (2) no distant metastasis was found before surgery; (3) radical resection; (4) at least one HIPEC treatment was performed. Exclusion criteria: (1) incomplete clinicopathological data; (2) tumor metastasis was found during operation; (3) concomitant with other tumors. HIPEC method: all the patients received the first HIPEC immediately after D2 radical resection, and returned to the ward after waking up from anesthesia; the second and the third HIPEC were carried out according to the patient's postoperative recovery and tolerance; interval between two HIPEC treatments was 48 h. Observation indicators: (1) basic information, including gender, age, body mass index, etc.; (2) treatment status; (3) perioperative adverse events: based on the standard of common adverse events published by the US Department of Health and Public Health (CTCAE 5.0), the adverse events of grade 2 and above during the treatment period were recorded, including hypoalbuminemia, bone marrow cell reduction, wound complications, abdominal infection, lung infection, gastroparesis, anemia, postoperative bleeding, anastomotic leakage, intestinal obstruction, pleural effusion, abdominal distension, impaired liver function, and finally a senior professional title chief physician reviewed the above adverse events and made a safety evaluation of the patient; (4) association between times of HIPEC treatment and adverse events in perioperative period; (5) analysis of risk factors for adverse events in perioperative period. Results: Among the 130 patients, 79 were males and 51 were females with a median age of 59 (54, 66) years and an average body mass index of (23.9±7.4) kg/m(2). The tumor size was (5.4±3.0) cm and 100 patients (76.9%) had nerve invasion. All the 130 patients received radical resection + HIPEC and 125 (96.2%) patients underwent laparoscopic surgery. The mean operative time was (345.6±52.3) min and intraoperative blood loss was (82.0±36.5) ml. One HIPEC treatment was performed in 54 patients (41.5%), 2 HIPEC treatments were in 57 (43.8%), and 3 HIPEC treatments were in 19 (14.6%). The average postoperative hospital stay was (13.1±7.5) d. A total of 57 patients (43.8%) had 71 cases of postoperative complications of different degrees. Among them, the incidence of hypoalbuminemia was 22.3% (29/130), and the grade 2 and above anemia was 15.4% (20/130), lung infection was 3.8% (5/130), bone marrow cell suppression was 3.7% (4/130), abdominal cavity infection was 2.3% (3/130), and liver damage was 2.3% (3/130), wound complications was 1.5% (2/130), abdominal distension was 1.5% (2/130), anastomotic leakage was 0.8% (1/130), gastroparesis was 0.8% (1/130) and intestinal obstruction was 0.8% (1/130), etc. These adverse events were all improved by conservative treatments. There were no statistically significant differences in the incidence of adverse events during the perioperative period among patients undergoing 1, 2, and 3 times of HIPEC treatments (all P>0.05). Univariate and multivariate logistic analyses showed that age > 60 years (OR: 2.346, 95%CI: 1.069-5.150, P=0.034) and neurological invasion (OR: 2.992, 95%CI: 1.050-8.523, P=0.040) were independent risk factors for adverse events in locally advanced gastric cancer patients undergoing radical resection+HIPEC (both P<0.05). Conclusions: Radical surgery + HIPEC does not significantly increase the incidence of perioperative complications in patients with advanced gastric cancer. The age >60 years and nerve invasion are independent risk factors for adverse events in these patients.

A study on the integrated application of risk matrix and analytic hierarchy process in risk assessment of vaccination operation / 预防医学

Objective To evaluate the risks of vaccination operation in order to provide scientific basis for policy makings of vaccination operation.Methods The risk matrix and analytic hierarchy process approach were used to evaluate the risks of vaccination operation,including the possibility,severity,risk weight,and risk level.Results Seven items for the first level and thirty one items for the second level vaccination risk factors were determined.In the first level,E level risk (Extremely serious risk ) was vaccination implementation risk,and H level risk (high risk ) was the risks of pre -notification and health education and risks of vaccine and cold chain management.Vaccination implementation risk accounted the largest weight (weight coefficient=38.95%).In second level,E level risk was three inspection and seven verification before vaccination,and H level risk were personnel professional quality,personnel responsibility,pre -inspection,informed before vaccination, vaccination route, site and dose, vaccination operation, post vaccination notification and retention,and three inspection and seven verification before vaccination,accounted the largest weight (weight coefficient=10.14%).The weight of the logical consistency of the test results were satisfactory (consistency ratio<0.1 ).Conclusion The integrated application of risk matrix and analytic hierarchy process in risk assessment of vaccination operation helps to further regulate vaccination services and has application and promotion value.

Effects of the combination therapy of the West and Taditional Chineses Medicine for 59 acute appendicitis patients with postoperative diarrhea / 中国基层医药

Objective To find out the efficacy of the combination therapy of the West and Taditional Chineses Medicine for acute appendicitis patients with postoperative diarrhea.Methods According to the digital table,109 acute appendicitis patients with postoperative diarrhea were randomly divided into 59 cases of the treatment group and 50 cases of the control group.The control group were given with the conventional therapy and Western medicine therapy,and the treatment group were given with the Traditional Chinese Medicine based on the control group.Test results of stool specimens pathogen,the efficacy and the occurrence of adverse drug reactions were observed.Results 96 pathogens were detected in stool specimens of the two groups of patients,the four pathogens with thelargest constituent ratios were Vibrio,Shigella,Aeromonas and Proteus,and the constituent ratio were respectively 36.5 ％,22.9％,18.8％ and 11.5％.The remarkable effective rate and total efficiency of the treatment group was 83.1％,96.6％,respectively,which were significantly higher than 58.0％,84.0％ of the control group(x2 =8.426,4.598,all P ＜ 0.05).The incidence of adverse drug reactions of treatment group and the control group were 5.1％,6.0％,respectively,there was no significant difference between the two groups (x2 =1.028,P ＞ 0.05).Conclusion The efficacy of the combination therapy of the West and Waditional Chineses Medicine for acute appendicitis patients with postoperative diarrhea was significant effect,and the incidence of adverse drug reactions was less.

Biosynthesis of Tautomycin and Its Inhibition Region of Protein Phosphatase / 微生物学通报

Tautomycin is one of well-known specific protein phosphatase inhibitors and exhibiting potent antifungal ability, especially to Sclerotinia sclerotiolum. This article reviews the recent research progress of tautomycin, focusing on its inhibition region and biosynthesis.

Amine-lyases and Their Applications in Preparation of Pharmaceutical Intermediates / 微生物学通报

Carbon-nitrogen lyases (E.C.4.3) are a group of enzymes that release ammonia, amidine or amino group etc, and also show ability to form double bond or ring structure. Specifically, enzymes forming amino group are called amine-lyases (E.C.4.3.3), which are critical in the industrial production of many medicine intermediates. In this review is a summary of four major amine-lyases in terms of their source, enzymatic characteristics and their applications in preparation of pharmaceutical intermediates.

Optimization of atrioventricular delay by surface electrocardiography during dual chamber pacing / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Nominal atrioventricular (AV) interval in dual chamber pacemaker (DDD) is not the best AV delay in the majority of patients with atrioventricular block. To find a simple method for optimizing AV delay adjustment, we assessed surface electrocardiography (ECG) for optimizing AV delay during dual chamber pacing.</p><p><b>METHODS</b>DDD pacemakers were implanted in 46 patients with complete, or almost complete, AV block. Optimal AV delay was achieved by programming an additional delay of 100 ms, to the width of intrinsic P wave or to the interval between pacing spike to the end of P wave on surface ECG. Left ventricular (LV) end diastolic and end systolic volumes, ejection fraction and diastolic parameters were measured by Doppler echocardiography during both nominal and optimal AV delay pacing.</p><p><b>RESULTS</b>Compared to nominal AV delay setting, LV end diastolic volume increased [to (53.2 +/- 11.3) ml from (50.2 +/- 10.2) ml, P < 0.05], end systolic volume decreased [to (26.1 +/- 9.0) ml from (27.9 +/- 8.2) ml, P < 0.05] during adjusted AV delay pacing, resulting in an increase in LV ejection fraction [to (68.2 +/- 5.3)% from (64.5 +/- 4.3)%, P < 0.05]. LV diastolic filling and isovolumic relaxation time were not significantly changed.</p><p><b>CONCLUSION</b>Optimization of AV delay by surface ECG is a simple method to improve LV systolic function during dual chamber pacing.</p>

BREEDING OF PHAFFL4 RHODOZYMA FOR ASTAXANTHIN OVER-PRODUCTION / 微生物学通报

Phaffia rhodozyma is a good strain for astaxanthin production. An over-producing mutant YB-20-29 was obtained by means of Cs137-?ray and N-methy1-N'-nitro-N-nitrosoguanidin (NTG) treatment. The biomass for this strain by shake culture was 36.32 g/L, the pigment content was 1216.0 ?g/g, an increase of 308% compare to o-riginal strain. The astaxanthin content in broth was 30.9?g /mL. It was a potential strain for astaxanthin over-production.