Discovery of proqodine A derivatives with antitumor activity targeting NAD(P)H: quinone oxidoreductase 1 and nicotinamide phosphoribosyltransferase / 中国天然药物

NAD(P)H: quinone oxidoreductase 1 (NQO1) is a flavin protease highly expressed in various cancer cells. NQO1 catalyzes a futile redox cycle in substrates, leading to substantial reactive oxygen species (ROS) production. This ROS generation results in extensive DNA damage and elevated poly (ADP-ribose) polymerase 1 (PARP1)-mediated consumption of nicotinamide adenine dinucleotide (NAD+), ultimately causing cell death. Nicotinamide phosphoribosyltransferase (NAMPT), the rate-limiting enzyme in the NAD+ salvage synthesis pathway, emerges as a critical target in cancer therapy. The concurrent inhibition of NQO1 and NAMPT triggers hyperactivation of PARP1 and intensive NAD+ depletion. In this study, we designed, synthesized, and assessed a novel series of proqodine A derivatives targeting both NQO1 and NAMPT. Among these, compound T8 demonstrated potent antitumor properties. Specifically, T8 selectively inhibited the proliferation of MCF-7 cells and induced apoptosis through mechanisms dependent on both NQO1 and NAMPT. This discovery offers a promising new molecular entity for advancing anticancer research.

Principles of extramural health care for chronic wounds in China / 中华创伤杂志(英文版)

Development of extramural health care for chronic wounds is still in its infancy in China, and thus it is urgent and vital to establish a correct concept and practicable principles. The authors reviewed recent domestic and international literature and summarized the following treatment procedures and principles for extramural health care of chronic wounds. (1) The patient needs to do self-assessment of the wound by using available simple methods; (2) The patient consults with professional physicians or nurses on wound care to define the severity and etiology of the non-healing wound; (3) Professionals evaluate the existing treatment strategies; (4) Etiological treatments are given by professionals; (5) Patients buy needed dressings via the more convenient ways from pharmacies, e-commerce platform or others; (6) Professionals provide a standardized and reasonable therapeutic plan based on the patient's wound conditions; (7) Both professionals and the patient pay attention to complications to prevent adverse outcomes; (8) Professionals strengthen the public education on wound care and integrated rehabilitation. This review expected to provide new perspectives on the therapeutic strategies for chronic wounds in an extramural setting.

High-throughput screening of SARS-CoV-2 main and papain-like protease inhibitors

The global COVID-19 coronavirus pandemic has infected over 109 million people, leading to over 2 million deaths up to date and still lacking of effective drugs for patient treatment. Here, we screened about 1.8 million small molecules against the main protease (Mpro) and papain like protease (PLpro), two major proteases in severe acute respiratory syndrome-coronavirus 2 genome, and identified 1851Mpro inhibitors and 205 PLpro inhibitors with low nmol/l activity of the best hits. Among these inhibitors, eight small molecules showed dual inhibition effects on both Mpro and PLpro, exhibiting potential as better candidates for COVID-19 treatment. The best inhibitors of each protease were tested in antiviral assay, with over 40% of Mpro inhibitors and over 20% of PLpro inhibitors showing high potency in viral inhibition with low cytotoxicity. The X-ray crystal structure of SARS-CoV-2 Mpro in complex with its potent inhibitor 4a was determined at 1.8 Å resolution. Together with docking assays, our results provide a comprehensive resource for future research on anti-SARS-CoV-2 drug development.

nNOS and Neurological, Neuropsychiatric Disorders: A 20-Year Story / 神经科学通报·英文版

In the central nervous system, nitric oxide (NO), a free gas with multitudinous bioactivities, is mainly produced from the oxidation of L-arginine by neuronal nitric oxide synthase (nNOS). In the past 20 years, the studies in our group and other laboratories have suggested a significant involvement of nNOS in a variety of neurological and neuropsychiatric disorders. In particular, the interactions between the PDZ domain of nNOS and its adaptor proteins, including post-synaptic density 95, the carboxy-terminal PDZ ligand of nNOS, and the serotonin transporter, significantly influence the subcellular localization and functions of nNOS in the brain. The nNOS-mediated protein-protein interactions provide new attractive targets and guide the discovery of therapeutic drugs for neurological and neuropsychiatric disorders. Here, we summarize the work on the roles of nNOS and its association with multiple adaptor proteins on neurological and neuropsychiatric disorders.

Analysis of expression of m 6A regulators in colorectal tumor samples based on TCGA and GEO databases / 中国基层医药

Objective:To detect the expression of N6-methyladenosine (m 6A) regulators in colorectal tumor samples and its clinical significance. Methods:From September to December 2021, the data regarding the expression of m 6A regulators in colorectal tumor samples were collected using The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) and the expression of m 6A regulators was compared between different clinical pathological characteristics and between different molecular subtypes. Survival analysis was conducted in patients with colorectal cancer with different m 6A expression levels. Results:In TCGA, insulin-like growth factor 2 mRNA binding protein 1 (IGF2BP1), insulin-like growth factor 2 mRNA binding protein 3 (IGF2BP3), and YTH N6-methyladenosine RNA binding protein 1 (YTHDF1) were higher in colorectal tumor samples than normal tissue samples (TCGA-COAD: IGF2BP3: 12.80 vs. 204.46, logFC = 4.00, P = 0.003; YTHDF1: 2 347.56 vs. 3712.77, logFC = 0.66, P < 0.001; TCGA-READ: IGF2BP1: 6.20 vs. 359.32, logFC = 5.82, P = 0.007; YTHDF1: 2 470.10 vs. 4 369.09, logFC = 0.82, P = 0.020). The intersection of TCGA and GEO databases showed that methyltransferase like 14 (METTL14), YTH domain m 6A RNA binding protein 3 (YTHDF3), and α-ketoglutarate dependent dioxygenase AlkB homolog 5 (ALKBH5) were downregulated in colorectal tumor samples compared with normal tissue samples (TCGA-COAD: METTL14: 1 051.56 vs. 711.40, logFC = -0.56, P < 0.001; YTHDF3:4 613.85 vs. 3 155.05, logFC = -0.55, P < 0.001, ALKBH5: 4 250.10 vs. 2 555.55, logFC = -0.73, P < 0.001; TCGA-READ vs. METTL14: 1 113.3 vs. 674.36, logFC = -0.72, P < 0.001; YTHDF3: 5 034.30 vs. 3 331.95, logFC = -0.60, P = 0.004; ALKBH5: 4 902.20 vs. 2 529.71, logFC = -0.95, P < 0.001; GEO-CRC vs. METTL14: 6.58 vs. 6.33, logFC = -0.06, P < 0.001; YTHDF3: 6.28 vs. 6.20, logFC = -0.02, P = 0.002; ALKBH5: 5.07 vs. 4.98, logFC = -0.02, P < 0.001). In colorectal tumor samples of different molecular subtypes, IGF2BP2, HNRNPC, TP53 and YTHDF2 expression was low in KRAS (IGF2BP2: 48.53 vs. 44.04, t = 2.64, P = 0.008; HNRNPC: 121.30 vs. 112.60, t = 2.32, P = 0.020; TP53: 65.30 vs. 60.26, t = 2.11, P = 0.034; YTHDF2: 54.07 vs. 51.19; t = 1.97, P = 0.048). Different clinical pathological characteristics showed that IGF2BP1 was higher in colorectal cancer with positive lymph nodes (8.97 vs. 6.11, W = 20 008, P = 0.002), distant metastasis (8.94 vs. 6.41, W = 19 104, P = 0.009), or stage Ⅲ-Ⅳ (7.46 vs. 7.13, W = 8 779, P = 0.025) than normal tissue. ALKBH5 overexpression, advanced age, presence of vascular invasion, and late pathological staging were significantly related to a short survival period (high ALKBH5 expression vs. low ALKBH5 expression: 5.85 years vs. not available, HR: 1.63, 95% CI: 1.071-2.491, P = 0.021; > 68 years vs. < 68 years: 6.78 years vs. not available, HR: 1.59, 95% CI: 1.049-2.422, P = 0.047; stage Ⅲ-Ⅳ vs. stage Ⅰ-Ⅱ: 4.55 years vs. 8.33 years, HR: 2.89, 95% CI: 1.895-4.425, P < 0.001; presence of vein invasion vs. absence of vein invasion: 5.48 years vs. not available, HR: 2.82, 95% CI: 1.672-4.783, P < 0.001). Conclusion:Some of the m 6A regulators are associated with the biological characteristics and prognosis of colorectal cancer.

nNOS and Neurological, Neuropsychiatric Disorders: A 20-Year Story / 神经科学通报·英文版

In the central nervous system, nitric oxide (NO), a free gas with multitudinous bioactivities, is mainly produced from the oxidation of L-arginine by neuronal nitric oxide synthase (nNOS). In the past 20 years, the studies in our group and other laboratories have suggested a significant involvement of nNOS in a variety of neurological and neuropsychiatric disorders. In particular, the interactions between the PDZ domain of nNOS and its adaptor proteins, including post-synaptic density 95, the carboxy-terminal PDZ ligand of nNOS, and the serotonin transporter, significantly influence the subcellular localization and functions of nNOS in the brain. The nNOS-mediated protein-protein interactions provide new attractive targets and guide the discovery of therapeutic drugs for neurological and neuropsychiatric disorders. Here, we summarize the work on the roles of nNOS and its association with multiple adaptor proteins on neurological and neuropsychiatric disorders.

Effects of host proteins interacting with non-structural protein nsp9 of porcine epidemic diarrhea virus on viral replication / 生物工程学报

Porcine epidemic diarrhea virus (PEDV) is a highly pathogenic virus that can cause acute intestinal infectious diseases in both piglets and fattening pigs. The virus encodes at least 16 non-structural proteins, including nsp9, which has been shown to bind to single-stranded RNA. However, its function and mechanism remain unclear. In this study, we aimed to identify potential host proteins that interact with PEDV nsp9 using immunoprecipitation combined with mass spectrometry. The interactions were then confirmed by co-immunoprecipitation (Co-IP) and confocal laser scanning fluorescence techniques. The results showed that nsp9 interacts with HSPA8, Tollip, HSPA9 and TOMM70. Among them, overexpression of HSPA8 resulted in caused first upregulated and then down-regulated expression of nsp9, and promoted the proliferation of PEDV. Overexpression of Tollip significantly upregulated the expression of nsp9 and inhibited the proliferation of PEDV. Overexpression of TOMM70 significantly reduced the expression of nsp9, but did not show significant effect on the proliferation of PEDV. Overexpression of HSPA9 did not show significant effect on the expression of nsp9 and the proliferation of PEDV. These findings may facilitate further investigating the role of nsp9-interacting proteins in PEDV infection.

Advances in N-methyl-D-aspartate Receptor Signaling Pathway and Mechanism of the Pathway-mediated Apoptosis / 中国医学科学院学报

N-methyl-D-aspartate receptor (NMDAR),an important ionic glutamate receptor and a ligand and voltage-gated ion channel characterized by complex composition and functions and wide distribution,plays a key role in the pathological and physiological process of diseases or stress states.NMDAR can mediate apoptosis through different pathways such as mitochondrial and endoplasmic reticulum damage,production of reactive oxygen species and peroxynitrite,and activation of mitogen-activated protein kinase and calpain.This paper reviews the structure,distribution,and biological characteristics of NMDAR and the mechanisms of NMDAR-mediated apoptosis.

Application of "trinity" co-management mode in prevention of perioperative venous thromboembolism in patients treated with major orthopedic surgery / 中华创伤杂志

Objective:To explore the effect of “trinity”co-management mode in prevention of venous thromboembolism（VTE）during perioperative period in patients undergone major orthopedic surgery.Methods:A retrospective case-control study was conducted to analyze the clinical data of 120 patients undergone major orthopedic surgery in Second Affiliated Hospital of Wenzhou Medical University from January 2019 to August 2019，including 46 males and 74 females at age range of 43-89 years［（63.7 ±11.3）years］. Of all，58 patients were with intertrochanteric fracture，52 with femoral neck fracture and 10 with gonarthrosis. Hip fracture operation was performed in 58 patients，total hip replacement in 37，artificial femoral head replacement in 15 and total knee replacement in 10. A total of 60 patients were treated with traditional care，including traditional prevention of thrombosis，conventional VTE risk assessment，treatment and related health education（traditional care group），and 60 patients a with “trinity” co-management care（co-management care group）on the basis of the traditional care，including the trinity of health education，establishing VTE prevention group and VTE tracking table，strengthening postoperative rehabilitation care and exercise，optimization of medicine，nutrition and pain management. Swelling rate of injured limb，D-dimer level on admission and at postoperative days 3 and 7，incidence of VTE at postoperative day 7，length of hospital stay and patient satisfaction were compared between the two groups.Results:Three days and seven days after operation，swelling rate of the injured limb in co-management care group［13%（8/60），8%（5/60）］was significantly lower than that in traditional care group［42%（25/60），30%（18/60）］（ P < 0.05）. There was no significant difference in level of D-dimer between the two groups on admission（ P > 0.05）. Three days and seven days after operation，level of D-dimer［3.40（2.11，6.10）μg/ml，3.70（2.61，6.82）μg/ml］in co-management care group was significantly lower than that in traditional care group［6.37（3.60，9.81）μg/ml，6.42（3.62，9.83）μg/ml］（ P < 0.01）. Seven days after operation，incidence of VTE in co-management care group［3%（2/60）］was significantly lower than that in traditional care group［13%（8/60）］（ P < 0.05）. Length of hospital stay in co-management care group［（10.1 ± 2.2）days］was shorter than that in traditional care group［（11.4 ± 4.3）days］（ P < 0.05）. Nursing satisfaction was 93%（56/60）in co-management care group，higher than 72%（43/69）in traditional care group（ P < 0.05）. Conclusion:For patients undergone major orthopedic surgery，“trinity” co-management mode is effective to reduce the incidence of postoperative limb swelling，level of D-dimer as well as incidence of VTE，shorten the length of hospital stay and improve patients’ satisfaction during perioperative period.

Projections from Infralimbic Cortex to Paraventricular Thalamus Mediate Fear Extinction Retrieval / 神经科学通报·英文版

The paraventricular nucleus of the thalamus (PVT), which serves as a hub, receives dense projections from the medial prefrontal cortex (mPFC) and projects to the lateral division of central amygdala (CeL). The infralimbic (IL) cortex plays a crucial role in encoding and recalling fear extinction memory. Here, we found that neurons in the PVT and IL were strongly activated during fear extinction retrieval. Silencing PVT neurons inhibited extinction retrieval at recent time point (24 h after extinction), while activating them promoted extinction retrieval at remote time point (7 d after extinction), suggesting a critical role of the PVT in extinction retrieval. In the mPFC-PVT circuit, projections from IL rather than prelimbic cortex to the PVT were dominant, and disrupting the IL-PVT projection suppressed extinction retrieval. Moreover, the axons of PVT neurons preferentially projected to the CeL. Silencing the PVT-CeL circuit also suppressed extinction retrieval. Together, our findings reveal a new neural circuit for fear extinction retrieval outside the classical IL-amygdala circuit.

Influence of fat and muscle on sit-ups in female college students / 解剖学报

Objective To explore the influence of muscle and fat distribution on sit-up ability of female college students. Methods A total of 1560 female students majoring in non-physical education in a Guangxi University were randomly selected. Body composition was measured by the bioresistance antibody component meter. According to the National Physical Health Test Standard, the height, weight and sit-ups of female college students were measured. The students were divided into four groups according to the score of sit-ups:0, P<0.05). Compared with other parameters, the correlation coefficient between trunk muscle mass and sit-ups was the largest. Conclusion The distribution of fat and muscle has different effects on sit-up ability. Female college students' sit-up ability is greatly affected by subcutaneous fat and trunk muscle, and has nothing to do with visceral fat.

Observation on the role of miR-16-5p in the replication of Zika virus / 中国输血杂志

【Objective】 To investigate the role of non-coding microRNA miR-16-5p in ZIKV replication and the underlying mechanism. 【Methods】 1×105/mL HeLa cells were seeded in 24-well plate and infected with ZIKV(MOI=5). RNAs were harvested, and miR-16-5p expression levels were measured by qRT-PCR at 24, 48 and 72 hour post infection, respectively. HeLa cells were transfected with 20nM miR-16-5p mimic and infected with ZIKV(MOI=5) at 24h post transfection. RNAs were extracted and ZIKV RNA and several inflammation factors expression were tested using qRT-PCR at 48h post infection. HeLa cells were co-transfected with 1μg NFκB-luc and 10ng pRL-TK with 20nM miR-16-5p mimic, and then infected with ZIKV(MOI=5) for 24h before the luciferase expression was tested at 48h post infection. HeLa cells were transfected with 20nM miR-16-5p mimic and infected with ZIKV(MOI=5) at 24h post transfection, and cell apoptosis was assayed through flow cytometry. 【Results】 Compared with uninfected control, miR-16-5p expression was significantly decreased at 24h, 48h and 72h following ZIKV infection. MiR-16-5p over-expression inhibited ZIKV replication, while upregulated NFκB activity and inflammation factors expression compared with the negative mimic-transfected cells. MiR-16-5p overexpression also promoted HeLa cell apoptosis. 【Conclusion】 ZIKV infection downregulated intracellular miR-16-5p expression. Overexpression of miR-16-5p suppressed ZIKV infection. MiR-16-5p inhibited ZIKV replication and promoted cell apoptosis probably by activating NFκB pathway and stimulating inflammation factors expression.

Effect of hsa_circ_0001613 on Zika virus replication: Preliminary study / 中国输血杂志

【Objective】 To investigate the effect of transfusion-transmitted Zika virus (ZIKV) on the expression of non-coding circular RNA (hsa_circ_0001613) and the role of hsa_circ_0001613 in Zika virus replication. 【Methods】 Human adenocarcinomic alveolar basal epithelial cells (A549) were seeded on a 12-well plate at 1.8×105/ well and infected with ZIKV at 0.05 MOI. The Total RNAs were isolated every day for 5 days after infection, and the relative expression level of hsa_circ_0001613 was detected by qRT-PCR. In addition, 10nM siRNA-hsa_circ_0001613 was transfected into 2×105/ well A549 cells to specifically knock down the expression level of hsa_circ_0001613. 24h later, the cells were infected with ZIKV (MOI=0.05). Total RNAs were isolated at day 1-5 post-infection, proteins were extracted 96h post-infection. ZIKV replication, relative host antiviral gene expression, and interferon stimulated response element (ISRE) activity were tested using qRT-PCR, western blot and dual luciferase assay, respectively. 【Results】 The relative expression of hsa_circ_0001613 decreased significantly after 1-5 days of ZIKV infection. Knockdown of hsa_circ_0001613 inhibited ZIKV replication. Meanwhile, hsa_circ_0001613 knockdown significantly upregulated IFN-α/β and its downstream interferon-stimulated genes (ISGs) expression, also increased ISRE activity. 【Conclusion】 ZIKV infection significantly suppressed hsa_circ_0001613 expression in A4549 cells. Preliminary study indicated that hsa_circ_0001613 knockdown inhibited ZIKV replication possibly through activating type-Ⅰ IFN signaling pathway as showed by increased ISGs expression and ISRE activity.

Taxonomic classification and detection of potential pathogens in healthy voluntary blood donors: Based on metagenomics analysis / 中国输血杂志

【Objective】 To map a comprehensive description of microbiome presented in healthy blood donations in Liangshan Yi Autonomous Prefecture, and detect the potential pathogens and its prevalence. 【Methods】 A total of 1 299 blood samples were randomly selected from healthy blood donors in Liangshan Prefecture. Total nucleic acids were extracted and sequenced by high-throughput sequencing, and the microbiome was determined by metagenomics analysis. Quantitative real-time PCR (qPCR) and ELISA assays were used to detect antibodies against HSV DNA and HSA in each sample. The prevalence of HSV in healthy blood donors was compared in terms of gender, age, occupation, education level, and frequency of donation. 【Results】 3.49GB data were obtained from DNA pool through high-throughput sequencing. After filtering the data of human genome, the DNA sequences annotated as bacteria, parasites / fungi and viruses were 213 057, 10 623 and 15 reads, respectively. A total of 2.79GB data were obtained from cDNA pool, after filtering the data of human genome, the fragments annotated as bacteria, parasites / fungi and viruses were 4 105 600, 18 446 and 0 reads, respectively. The prevalence of IgG and / or IgM antibodies against herpes simplex virus type 1 and 2 were 8.62% (112 / 1 299) and 18.32% (238/1 299), and that of nucleic acid was 0.77 ‰ (1/1 299). 【Conclusion】 The microbiome of healthy blood donors in Liangshan Prefecture and the potential pathogens were identified in this study. Regional specificity of HSV infections emerged in Liangshan Prefecture. Considering the collaboration between HSV-2 and HIV infection, epidemiological investigation of HSV-2 infection should be conducted preferentially among different populations in Liangshan Prefecture and other HIV high prevalence areas in order to benefit the prevention and control of HIV.

Anxiolytic Effect of Increased NREM Sleep after Acute Social Defeat Stress in Mice / 神经科学通报·英文版

Social defeat stress (SDS) plays a major role in the pathogenesis of psychiatric disorders like anxiety and depression. Sleep is generally considered to involve recovery of the brain from prior experience during wakefulness and is altered after acute SDS. However, the effect of acute SDS on sleep/wake behavior in mice varies between studies. In addition, whether sleep changes in response to stress contribute to anxiety is not well established. Here, we first investigated the effects of acute SDS on sleep/wake states in the active period in mice. Our results showed that total sleep time (time in rapid eye-movement [REM] and non-REM [NREM] sleep) increased in the active period after acute SDS. NREM sleep increased mainly during the first 3 h after SDS, while REM sleep increased at a later time. Then, we demonstrated that the increased NREM sleep had an anxiolytic benefit in acute SDS. Mice deprived of sleep for 1 h or 3 h after acute SDS remained in a highly anxious state, while in mice with ad libitum sleep the anxiety rapidly faded away. Altogether, our findings suggest an anxiolytic effect of NREM sleep, and indicate a potential therapeutic strategy for anxiety.

Progress of the mechanism research of acupuncture in treatment of diet-induced obesity / 针刺研究

The literature of experimental research on diet-induced obesity treated with acupuncture was retrieved. The aspects of epigenetics, neuroendocrine system, intestinal flora, inflammatory response, oxidative stress and substance metabolism of the mechanism of acupuncture in the treatment of diet-induced obesity were summarized. It is suggested that the potential mechanism of acupuncture in the treatment of diet-induced obesity should be discussed in the aspects of the interaction of Toll-like receptors on obesity-intestinal flora-immune function, the improvement of insulin resistance, epigenetics and antioxidant stress.

Comparison of corneal curvature measured by Pentacam, IOL Master and corneal topography in adolescents with low and moderate myopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare differences and consistency of corneal curvatures in adolescent patients with low and moderate myopia measured by Pentacam, IOL Master and corneal topographic.<p>METHODS: A prospective clinical study. 291 adolescent patients(291 eyes)with low and moderate myopia who underwent orthokeratology in the Affiliated Eye Hospital of Nanjing Medical University from January 2019 to September 2019 were selected. Among them, 141 cases(141 eyes)were low myopia and 150 cases(150 eyes)were moderate myopia. Corneal curvature(K1, k2, Km)and corneal Astigmatism(J0, J45)were examined by Pentacam, IOL Master, and corneal topography. And then the difference, correlation and consistency of the measurement results of three instruments were analyzed.<p>RESULTS: Differences analysis showed that in the measurement of J45, there was no difference between Pentacam and corneal topography(<i>P</i>>0.05)in patients with low and moderate myopia; in the measurement of J0,there was no difference between Pentacam and IOL Master(<i>P</i>>0.05)in patients with low myopia; in the measurement of K2,there was no difference between Pentacam and corneal topography(<i>P</i>>0.05)in patients with low myopia; in the measurement of J0,there was no difference between Pentacam and corneal topography(<i>P</i>>0.05)in patients with moderate myopia. But there were significant differences in other measurements among three instruments(<i>P</i><0.05). Pearson correlation analysis showed that K1, K2, Km, J0, and J45 were highly correlated among three instruments(<i>r</i>=0.545-0.997, all <i>P</i><0.001). Bland-Altman consistency analysis showed that three instruments had good consistency.<p>CONCLUSION: Pentacam, IOL Master and corneal topographic have good consistency and can be used as a mutual reference before orthodontic fitting of low and moderate myopia patients. The measurement difference between Pentacam and corneal topography is the smallest among three instruments, but whether three instruments can be replaced by each other needs to be considered in combination in clinical application.

Prevention value of four treatments of pancreatic stump for pancreatic fistula after distal pancreatectomy: a Meta-analysis / 中华消化外科杂志

Objective To systematically evaluate the clinical effects of four treatments of pancreatic stump including stapler closure,hand-sutured closure,stapler with hand-sutured closure,and manual anastomosis on the prevention of postoperative pancreatic fistula after distal pancreatectomy.Methods Databases including PubMed,Embase,the Cochrane Library,CBM,CNKI,and VANFUN were searched for from January 1979 to January 2019 with the key words including "distal pancreatectomy,left pancreatectomy,distal pancreatic resection,left pancreatic resection,pancreatic fistula,fistula,leak,stapler,suture,anastomosis,胰腺远端切除 术,胰体尾切除术,闭合器,手工缝合,吻合,胰瘘”.Patients undergoing dissection of distal pancreas with Endo-GIA stapler were allocated into stapler group,patients undergoing hand-sutured closure of pancreatic stump after dissection of distal prancreas with electrotome or ultrasonic scalpel were allocated into hand-sutured closure group,patients undergoing dissection of distal pancreas with Endo-GIA stapler and hand-sutured closure of pancreatic stump were allocated into stapler with hand-sutured closure group,patients undergoing pancreaticojejunostomy or pancreatogastrostomy after dissection of distal pancreas were allocated into manual anastomosis group,respectively.Two reviewers independently screened literatures,extracted data and assessed the risk of bias.Count data were described as odds ratio (OR) and 95％ confidence interval (95％ CI).The heterogeneity of the studies included was analyzed using the I2 test.Funnel plot was used to test potential publication bias if the studies included ≥ 5,and no test was needed if the studies included ＜5.Results (1) Document retrieval:a total of 10 available prospective studies were included.There were 1 363 patients,including 565 in the stapler group,484 in the hand-sutured closure group,182 in the stapler with hand-sutured closure group,and 132 in the manual anastomosis group.(2) Results of Meta-analysis.① There was no statistically significant difference in postoperative fistula after distal pancreatectomy between the stapler group and the handsutured closure group (OR =0.75,95％CI:0.45-1.25,P＞0.05).Further study showed that there was no statistically significant difference in the incidence of grade B and C postoperative fistula between the two groups (OR=0.45,95％CI:0.14-1.52,P＞0.05).The left-right asymmetry was presented in the funnel plot based on the 8 studies,suggesting that publication bias may exsited.② There was no statistically significant difference in postoperative fistula after distal pancreatectomy between the stapler group and the stapler with hand-sutured closure group (OR =0.96,95％ CI:0.48-1.91,P ＞ 0.05).③ There was no statistically significant difference in postoperative fistula after distal pancreatectomy between the stapler with hand-sutured closure group and manual anastomosis group (OR =0.80,95％ CI:0.49-1.32,P＞ 0.05).④ There was no statistically significant difference in postoperative fistula after distal pancreatectomy between the manual anastomosis group and the stapler group (OR=0.73,95％CI:0.39-1.34,P＞0.05).Further study showed that there was no statistically significant difference in the incidence of grade B and C postoperative fistula between the two groups (OR =0.60,95％CI:0.21-1.68,P＞0.05).The bilateral symmetry was presented in the funnel plot based on the 5 studies,suggesting that publication bias had little influence on results of Meta-analysis.⑤ There was no statistically significant difference in postoperative fistula after distal pancreatectomy between the manual anastomosis group and the handsutured closure group (OR=0.24,95％CI:0.08-0.74,P＜0.05).The bilateral symmetry was presented in the funnel plot,suggesting that publication bias had little influence on results of Meta-analysis.Conclusions Compared with hand-sutured closure,pancreaticojejunostomy or pancreatogastrostomy after distal pancreatectomy can help to reduce the incidence of postoperative pancreatic fistula.However,there was equivalent prevention value of stapler,hand-sutured closure,and stapler with hand-sutured closure for postoperative fistula after distal pancreatectomy.The manual anastomosis group has equivalent prevention value with stapler group.

Histopathological diagnosis and follow-up analysis of gastric mucosal biopsy / 临床与实验病理学杂志

Purpose To investigate the histopathological diagnosis and follow-up of gastric mucosal biopsy. Methods A detailed histopathological observation was performed on 5 748 gastroscopic biopsies and 3 288 patients were followed up. Results In 5 748 cases of endoscopy biopsy specimens, acute gastritis was rechecked in 125 cases, of which 112 cases were cured or improved (89.6％ ), 10 cases (8.0％ ) had little change, and 3 cases (2.4％) were aggravated. There were 2430 cases of chronic atrophic gastritis, in which 1521 cases were cured/improvement (62.6％ ), 737 cases (30.3％ ) had little change, and 172 cases (7.1％ ) were aggravated. In the 71 cases of special type of gastritis, 23 cases were cured or improved, accounting for 32.3％.42 cases were not changed much, accounting for 59.2％, and 6 cases were aggravated (8.5％ ). About druginduced gastritis/stomach reexamination in 94 cases, 57 cases were cured/improved, accounting for 60.6％, 34(36.3％ ) cases did not change, and 2 cases were aggravated(3.2％ ).183 cases of gastric polyp were reviewed, 165 cases(90.2％ ) were cured / improved, 13 cases (7.1％ ) were not changed and 5 cases (2.7％ ) were aggravated. No neoplasia/ nondysplasia was found in 205 cases, 196(95.6％ ) cases was cured / improved, no change was seen in 6 cases (2.9％ ) and aggravation was seen in 3 cases(1.5％). Indefinite neoplasia/ dysplasia was reexamined in 24 cases, 2 cases (8.3％) were cured/improved, no change was seen in 13 cases (54.2％ ), and aggravation was seen in 9 cases(37.5％).156 cases of intraepithelial neoplasia were retrospectively reviewed, in which138 (88.5％ ) cases were cured or improved, 4(2.6％ ) cases showed no change, and 13(8.3％) cases were aggravated. Conclusion It is of great significance to improve the early diagnosis rate, reduce missed diagnosis rate and misdiagnosis rate of gastric cancer by establishing 11 pathological changes and accompanying lesions.

Development of a hospital performance scale based on patient experience / 中华医院管理杂志

The paper described the development stages of a hospital performance evaluation scale based on patient experience.An empirical application on 7 856 patients of 26 hospitals in four provinces in the country identified the challenges encountered in the course of its application.These include limits of patients experience,variations on the experience reports incurred by different services experienced by patients,and setting of the patient-inpatient ratio among others.Solutions proposed based on these studies aim at creating a patient experience scale tailored to Chinese patients.