Management of liver transplantation perioperative period in acute-on-chronic liver failure / 中华肝脏病杂志

Acute-on-chronic liver failure (ACLF) is a potentially reversible entity that occurs in patients with chronic liver disease accompanied with or without cirrhosis and is characterized by extrahepatic organ failure and high short-term mortality. Currently, the most effective treatment method for patients with ACLF is liver transplantation; therefore, admission timing and contraindications must be emphasized. The function of vital organs such as the heart, brain, lungs, and kidneys should be actively supported and protected during the liver transplantation perioperative period in patients with ACLF. Focusing on the anesthesia management level during anesthesia selection, intraoperative monitoring, three-stage management, prevention and treatment of post-perfusion syndrome, monitoring and management of coagulation function, volume monitoring and management, and body temperature monitoring management for liver transplantation should strengthen anesthesia management. Additionally, standard postoperative intensive care treatment should be recommended, and grafts and other vital organ functions should be monitored throughout the perioperative period to promote early postoperative recovery in patients with ACLF.

Comparison of the performance of SCORTEN and ABCD-10 in evaluating the prognosis of Stevens-Johnson syndrome/toxic epidermal necrolysis / 中华皮肤科杂志

Objective:To compare the performance of the severity-of-illness score for toxic epidermal necrolysis (SCORTEN) and ABCD-10 (age, bicarbonate, cancer, dialysis, 10% body surface area) scoring systems in predicting death in patients with Stevens-Johnson syndrome (SJS) /toxic epidermal necrolysis (TEN) .Methods:Clinical data were collected from 85 patients with SJS/TEN who were hospitalized in Sichuan Provincial People′s Hospital from January 2010 to April 2021, and retrospectively analyzed. The predicted mortality and actual mortality were compared at each score level of SCORTEN and ABCD-10. The receiver operating characteristic (ROC) curve and Hosmer-Lemeshow goodness-of-fit test were used to evaluate the predictive power and calibration of SCORTEN and ABCD-10 on mortality.Results:Among the 85 patients, 37 were males and 48 were females, and their ages were 52.36 ± 19.31 years (range, 14 - 88 years) . There were 61 cases of SJS, 6 of SJS/TEN overlap, and 18 of TEN. Ten patients died in hospital and the fatality rate was 11.76%. Among the SCORTEN and ABCD-10 components, age > 40 years or ≥ 50 years, epidermal exfoliation > 10% body surface area on the 1st day after admission, heart rate > 120 beats per minute, serum urea nitrogen level > 10 mmol/L and serum bicarbonate level < 20 mmol/L were significantly correlated with death ( χ2 = 4.46, 6.18, 25.50, 15.13, 7.59, 8.38, respectively, all P < 0.05) , while malignancies, serum glucose level > 14 mmol/L, and pre-hospital dialysis were not significantly correlated with death ( χ2 = 0.35, 0.10, 1.38, respectively, all P > 0.05) . There were no significant differences between the predicted mortality and actual mortality at every score level of SCORTEN and ABCD-10 (all P > 0.05) . The ROC curve showed that both SCORTEN and ABCD-10 had good predictive power for death (areas under the curve: 0.874 and 0.867, 95% CI: 0.758 - 0.990, 0.773 - 0.962, respectively) , but the model goodness-of-fit of SCORTEN was superior to that of ABCD-10 ( P = 0.944, 0.048, respectively) . Conclusion:Both SCORTEN and ABCD-10 scoring systems could accurately predict mortality of SJS/TEN patients at early stage, but SCORTEN showed more favourable predictive power and calibration.

The predictive value of red blood cell distribution width in predicting the prognosis of patients with Extracorporeal Membrane Oxygenation / 中华急诊医学杂志

Objective:To explore the predictive value of Red Blood Cell Distribution Width (RDW) in predicting the prognosis of patients with Extracorporeal Membrane Oxygenation (ECMO).Methods:The clinical data of patients undergoing ECMO admitted to Intensive Care Unit of Sichuan Provincial People’s Hospital from January 2015 to January 2020 were retrospectively analyzed. Patients were divided into the survival group and death group according to the prognosis during ICU hospitalization. The patients' basic data , acute physiology and chronic health score system Ⅱ (APACHE Ⅱ), RDW and activated partial thromboplastin time (APTT) at 72 hours after treatment with ECMO were compared between the two groups. Univariate and Logistic regression multivariate analyses were used to analyze the prognostic factors of patients with ECMO, predictive models and death warning scores were established. The receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic efficacy of RDW and death warning scores for the prognosis of patients with ECMO.Results:A total of 71 patients with ECMO who met the inclusion criteria were included, including 38 patients in the death group and 33 patients in the survival group. The age, APACHE-Ⅱscore, 72 h RDW and 72 h APTT in the death group were higher than those in the survival group. Respectively, the hospitalization time of ICU in the death group was significantly lower than that in the survival group ( P< 0.05). Logistic regression analysis showed that APACHE-Ⅱscore ( OR=1.117, P=0.047)、72 h RDW( OR=1.102, P=0.029) and 72 h APTT ( OR=1.049, P=0.029) were independent risk factors for death in patients with ECMO. ROC curve analysis showed that the area under ROC curve (AUC) of the APACHE-Ⅱ, score 、72 h RDW and 72 h APTT were 0.691, 0.691 and 0.632( P<0.05), Respectively, the combined AUC was 0.764, the sensitivity was 0.526, and the specificity was 0.909. The death warning score of patients with ECMO was established according to the Predictive model , which is less than 2 points with low risk of death and more than 2 points with high risk of death. The area under the ROC curve of death warning score is 0.8, the sensitivity is 0.607 and the specificity is 0.923. Conclusions:The RDW at 72 hours after treatment with ECMO has a good value in predicting the prognosis of patients with ECMO. Besides, a greater predictive value for the prognosis of patients with ECMO by combining 72 hours RDW, 72 hours APTT with APACHE-Ⅱscore than that of any separate indicator.

Effect of hydrogen on activation of A1 astrocytes in hippocampus of mice with sepsis-associated encephalopathy / 中华麻醉学杂志

Objective:To evaluate the effect of hydrogen on activation of A1 astrocytes in the hippocampus of mice with sepsis-associated encephalopathy (SAE).Methods:A total of 164 clean-grade healthy male C57BL/6J mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups ( n=41 each) using a random number table method: sham operation group (group Sham), sham operation plus hydrogen group (group Sham+ H 2), group SAE and SAE plus hydrogen group (group SAE+ H 2). The SAE model was established by cecal ligation and perforation.Group Sham+ H 2 and group SAE+ H 2 inhaled 2% hydrogen starting from 1 and 6 h after operation, respectively.Twenty mice in each group were selected to observe the 7-day survival rate after operation.The remaining mice were sacrificed at 12 h after operation, and brain tissues were removed for examination of the pathological changes in hippocampal CA1 region (with a light microscope) and for determination of the apoptosis in neurons (by TUNEL), co-expression of hippocampal glial fibrillary acidic protein (GFAP) and complement C3 (by immunofluorescence staining), expression of A1 astrocyte marker C3 (by Western blot), and contents of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and high-mobility group box 1 protein (HMGB1) (by enzyme-linked immunosorbent assay). The abnormal cell ratio and apoptosis rate were calculated.Six mice in each group were selected at 7 days after operation to perform Y-Maze paradigm. Results:Compared with group Sham, the 7-day survival rate after operation was significantly decreased, the abnormal cell ratio and apoptosis rate of hippocampal neurons were increased, the contents of TNF-α, IL-6 and HMGB1 were increased, the expression of C3 was up-regulated, the number of cells coexpressing GFAP and C3 was increased, the exploration time spent in the novel arm in Y-Maze paradigm was shortened, and the preference index was decreased in group SAE ( P<0.05). Compared with group SAE, the 7-day survival rate after operation was significantly increased, the abnormal cell ratio and apoptosis rate of hippocampal neurons were decreased, the contents of TNF-α, IL-6 and HMGB1 were decreased, the expression of C3 was down-regulated, the number of cells coexpressing GFAP and C3 was decreased, the exploration time spent in the novel arm in Y-Maze paradigm was prolonged, and the preference index was increased in group SAE+ H 2 ( P<0.05). There was no significant difference in each parameter mentioned above between Sham group and Sham+ H 2 group ( P>0.05). Conclusion:The mechanism by which hydrogen improves SAE may be related to inhibiting activation of A1 type astrocytes in mice.

Peripartum management of pregnancy with congenital heart disease / 中国实用妇科与产科杂志

The survival rate of adult patients with congenital heart disease(CHD)has increased during the last few decades as a result of significant improvement in diagnosis and treatment.Women with CHD are therefore more likely to live to childbearing age,and to decide to have children.Compared with the general parturients,maternal risk and neonatal complications such as prematurity,intra-uterine fetal growth restriction,fetal demise,or neonatal mortality,are increased in pregnant women with CHD.How can we minimize the maternal mortality and morbidity risk and improve perinatal outcome?We retrospectively reviewed articles and documents about pregnancy with congenital heart disease,and tried to discuss it in this article.

Risk management of postpartum hemorrhage / 中国实用妇科与产科杂志

Postpartum hemorrhage,a frequent emergency in obstetrics,is the first reason for maternal mortality in China and worldwide.The contributors to adverse outcome included delayed treatment because of underestimation of blood loss,lack of blood products,lack of treatment algorithms,lack of knowledge and training,insufficient interdisciplinary communication and inadequate management.Therefore,it is essential to improve the management of medical institutions and set up a protocol for emergency situations.Meanwhile,the key point in rescue postpartum hemorrhage is the teamwork with efficient training and cooperation.This article made a review on the management of postparttum hemorrhage,establishment of emergengy protocol and risk assessment and team cooperation based on guidelines and recommendations published by main authorities and the latest studies.The goal of the article is to provide some ideas to reduce the frequency of severe hemorrhages after delivery and improve maternal outcomes.

Effect of recombinant adiponectin on pregnancy outcome in spontaneous abortion model mice / 上海交通大学学报（医学版）

Objective·To investigate the effect of recombinant adiponectin on the pregnancy outcome and the balance of Th 17/regulatory T cell (Treg) in spontaneous abortion murine model.Methods· CBA/J(♀)×DBA/2(♂) mating was used as a spontaneous abortion model,while CBA/J(♀)×BALB/c(♂) mating as a normal pregnancy model.CBA/J female mice were intraperitoneal injected with 10 μg/(kg·d) recombinant adiponectin for 9 d from day 5 of gestation.The control group received equal volumes of PBS each day.On day 14 of gestation,the mice were killed.The embryo resorption rate was calculated.The levels of serum adiponectin,IL-17 and TGF-β were detected by ELISA.Spleen lymphocytes were isolated.The ratios of Thl 7/Treg were counted by flow cytometry(FCM).Results· Recombinant adiponectin administration had no obvious effect on the embryo resorption rate of the normal pregnancy model,while it significantly reduced the embryo resorption rate from 32.2％ to 13.3％ (P=0.039) of the spontaneous abortion model.ELISA showed that recombinant adiponectin increased the serum adiponectin and TGF-β levels,and reduced the IL-17 level of the spontaneous abortion model (P＜ 0.01).FCM showed that adiponectin administraion could reduce the ratio of Th 17/CD4+ T cells,increase the ratio of Treg/CD4+ T cells and reverse the ratio of Th 17/Treg in abortion mice.Conclusion · Intraperitoneal administration of recombinant adiponectin in early gestation can improve pregnancy outcome in a murine model of abortion maybe through regulating the balance of Th 17/Treg.

Influence of Familiarity on Energy Intake and Plasma Gut Hormone Concentration in Lean and Overweight Young Male Students / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>This study is to examine the influence of familiarity on energy intake, eating behavior, and concentration of the plasma gut hormones in lean and overweight young male subjects.</p><p><b>METHODS</b>Twenty-eight lean and twenty-eight overweight participants were recruited. Their food consumption was documented and analyzed when they had a test meal while they were paired with friends or strangers at the same weight stature. Their eating behavior was recorded with cameras hidden in the carton, and postprandial plasma gut hormone concentration were measured.</p><p><b>RESULTS</b>Compared with overweight strangers (OS), overweight friends (OF) had increased food consumption, prolonged and decreased number of chews per 10 g food. Compared with OS, postprandial plasma concentration of cholecystokinin-8 was significantly lower in OF group at 30, 60, and 90 min, whereas the concentration of glucagon-like peptide 1 was significantly lower at 60 and 90 min. Plasma ghrelin concentration was significantly higher in the OF group than that in the OS group at 90 and 120 min. No significant differences in gut hormone concentration were observed between lean strangers (LS) and lean friends (LF) groups at all time points.</p><p><b>CONCLUSION</b>Familiarity plays an important role in increasing energy intake and in changing of postprandial gut hormone concentration in overweight individuals.</p>

Three-dimensional finite element analysis of the cantilever fixed bridge supported by implants with different shapes / 中国组织工程研究

BACKGROUND: The shape of the implant exerts an effect on its biomechanics. At present, the research of implant-supported fixed partial denture with cantilever extension mainly focuses on the same shape, and little is reported on the comparison and analysis of implant-supported fixed partial denture with cantilever extension supported by different shape implants.OBJECTIVE: To compare the biomechanical behaviors of cantilever fixed bridges which were supported by three different implants, including cylindrical implant, tapered implant, expandable implant, in the mandibular posterior region with the help of three-dimensional finite element analysis. METHODS: The three-dimensional finite element models of the cantilever fixed bridges which were supported by cylindrical implant, tapered implant and expandable implant and their surrounding tissue in the mandibular posterior region were established were established. The force of 300 N was applied to the cantilever fixed bridges with axial 90° and buccolingual 45° to evaluate the maximum von Mises stress (Max EQV stress) of cortical bone and cancellous bone and the maximum displacement in implant-abutment complex.RESULTS AND CONCLUSION: Under axial and buccolingual loads, the Max EQV stress in the cortical bone was higher than that in the cancellous bone. The cantilever fixed bridge which was supported by expandable implant had the lowest Max EQV stress in the cortical bone, especially under axial load, and exhibited the highest Max EQV stress in the cancellous bone. The cantilever fixed bridges supported by three different implants showed an increase in the Max EQV stress of the cortical bone and cancellous bone and the maximum displacement in implant-abutment complex under buccolingual load. The cantilever fixed bridge which was supported by expandable implant had the minimum maximum displacement in the buccolingual direction. To conclude, the cantilever fixed bridge which is supported by expandable implant has best stability.

Comparison of incidence rate of anastomotic stricture between conventional anastomosis and double-layers anastomosis after operation of esophageal cancer / 中华老年医学杂志

Objective To explore how to decrease the incidence of anastomotic stricture after the operation of esophageal cancer by improving anastomosis.Methods Clinical data of 374 cases aged ＞ 60 years who had undergone left thoracotomy radical resection of esophagus cancer at our hospital from April 2013 to August 2015 were collected.Patients were divided into double-layers anastomosis group (n=187) and conventional anastomosis group (n=187).During process of stapling anastomosis,double purse string anastomosis on esophagus and gastric wall were performed in doublelayers anastomosis group,with no purse string suture in conventional anastomosis group.Incidence rate of anastomotic stricture was compared between the two groups.Results Conventional anastomosis group versus double-layers anastomosis group showed that a mild anastomotic stricture occurred in 17 cases (9.1 ％) versus 7 cases (3.7 ％) (x2 =4.452,P =0.035),a moderate anastomotic stricture in 12 cases(6.4 ％) vs.4 cases (2.1 ％) (x2 =4.179,P =0.041),a severe anastomotic stricture in 9 cases (4.8％)vs.3 cases(1.6％)(x2 =3.099,P=0.078),total number of anastomotic stricture in 38 cases vs.14 cases (x2 =12.866,P =0.000),showing that double-layers anastomosis was relatively superior to conventional anastomosis.Conclusions Double-layers anastomosis can effectively reduce the incidence of anastomotic stricture after surgery.

Clinical study of valsartan combined with benazepril in the treatment of congestive heart failure / 中国生化药物杂志

Objective To analyze the therapeutic values of valsartan combined with benazepril in the treatment of patients with congestive heart failure.Methods 102 cases of patients with congestive heart failure in Nine 0 Third Hospital were enrolled in the study.They were randomly divided into the control group and the observation group, with 51 cases in each group.Both groups were given cardiac diuretic, anti-infection and other basic treatment and the control group was given benazepril on the basis of basic treatment while the observation group was additionally given valsartan on the basis of treatment in the control group.The curative effects were compared and the changes of cardiac function indexes were detected before and after treatment between the two groups.Results The effective rate of treatment was 80.39% in the control group, which was lower than that in the observation group with 96.08% (P<0.05).After treatment, the observation group LVEF increased significantly, LVESd and LVEDd decreased significantly, and each index was significantly better than that of the control group (P<0.05).Conclusion Valsartan combined with benazepril in the treatment of congestive heart failure can effectively relieve the clinical symptoms and improve the cardiac function, therefore it is worthy of clinical promotion.

Three-dimensional finite element analysis of the cantilever fixed bridge supported by implants with different shapes / 中国组织工程研究

BACKGROUND: The shape of the implant exerts an effect on its biomechanics. At present, the research of implant-supported fixed partial denture with cantilever extension mainly focuses on the same shape, and little is reported on the comparison and analysis of implant-supported fixed partial denture with cantilever extension supported by different shape implants.OBJECTIVE: To compare the biomechanical behaviors of cantilever fixed bridges which were supported by three different implants, including cylindrical implant, tapered implant, expandable implant, in the mandibular posterior region with the help of three-dimensional finite element analysis. METHODS: The three-dimensional finite element models of the cantilever fixed bridges which were supported by cylindrical implant, tapered implant and expandable implant and their surrounding tissue in the mandibular posterior region were established were established. The force of 300 N was applied to the cantilever fixed bridges with axial 90° and buccolingual 45° to evaluate the maximum von Mises stress (Max EQV stress) of cortical bone and cancellous bone and the maximum displacement in implant-abutment complex.RESULTS AND CONCLUSION: Under axial and buccolingual loads, the Max EQV stress in the cortical bone was higher than that in the cancellous bone. The cantilever fixed bridge which was supported by expandable implant had the lowest Max EQV stress in the cortical bone, especially under axial load, and exhibited the highest Max EQV stress in the cancellous bone. The cantilever fixed bridges supported by three different implants showed an increase in the Max EQV stress of the cortical bone and cancellous bone and the maximum displacement in implant-abutment complex under buccolingual load. The cantilever fixed bridge which was supported by expandable implant had the minimum maximum displacement in the buccolingual direction. To conclude, the cantilever fixed bridge which is supported by expandable implant has best stability.

A comparative study between laparoscopic versus open choledocholithotomy / Мэс засал

Introduction: Choledocholithiasis is present in approximately 15-20% of patients with gallstone and laparoscopic common bile duct exploration has been effectively employed many cases currently. National Center for Health Development, Mongolian Ministry of Health, registered 23180 cases of bile duct diseases which were 3.4% of total diseases, 2.5% of total surgery, 12.2% of total gastrointestinal disease, 46.9% of total liver and biliary tract diseases between 2000 and 2006. Biliary tract diseases increased 2.4 times and bile duct surgery increased 5.2 times than 15 years ago in Mongolia. To compare open choledocholithotomy and laparoscopic choledocholithotomy for common bile duct stones. Materials and Methods: This study was carried out in Mongolian national second central hospital and Inner Mongolian first medical university hospital. The clinical data of the106 patients with common bile duct stones were analyzed between Арril 2015 and Арril 2016. Duration of operation, blood loss, postoperative complication, period of hospital stay and expenditure of treatment were compared in open choledocholithotomy and laparoscopic choledocholithotomy. All patients were placed on a “T” tube drainage. Results: In results of the duration of operation (p=0.001), blood loss (p=0.001) and period of hospital (p=0.01) were significantly lower in laparoscopic choledocholithotomy group Postoperative complications and gastrointestinal function recovery time were lower in laparoscopic group whereas expenditure of treatment were lower in open choledocholithotomy. Conclusion: In conclusion main advantages of laparoscopic choledocholithotomy were reduced duration of operation, blood loss, period of hospital stay and lower postoperative complications however costly.

The expression and clinical significance of hsa-miR-144 in esophageal squamous cell carcinoma / 天津医药

Objective To investigate the expression of hsa-miR-144 in esophageal squamous cell carcinoma, and its relationship with clinicopathological features and prognosis. Methods Reverse transcriptase polymerase chain reaction (RT-PCR) method was used to detect the hsa-miR-144 in 46 cases of esophageal squamous cell carcinoma and adjacent normal tissue. The expression of hsa-miR-144 in esophageal squamous cell carcinoma and its difference in the clinicopatho?logical characteristics including gender, age, and tumor size were investigated. The relationship between the expression of hsa-miR-144 and prognosis of patients with esophageal squamous cell carcinoma was analyzed. Kaplan-Meier method and Log-rank test were used to analyse the differences in survival rates in different pathological characteristics. Results The ex?pression level of hsa-miR-144 was lower in esophageal squamous cell carcinoma 0.97(0.22-24.48)×10-6 than that of adjacent normal tissue 8.60(0.09-258.20)×10-6, the difference was statistically significant (Z=2.221, P0.05). There was no correlation between the expression of hsa-miR-144 and prognosis in patients with esophageal squamous cell carcino?ma (rs=0.031, P=0.839). In the survival rate, there was no statistic significance between high expressive of hsa-miR-144 group and low expressive group (P=0.828). The survival rate was lower in patients with lymph node metastasis than that of pa?tients without lymph node metastasis. The survival rates were lower in patients with relatively deep invasion and higher patho?logic stage (P<0.05). Conclusion The expression of hsa-miR-144 is down regulated in esophageal squamous cell carcino?ma, and which is associated with lymph node metastasis and pathological staging of esophageal carcinoma. It shows that hsa-miR-144 may serve as an anti-oncogene in the occurrence and development of esophageal squamous cell carcinoma.

Cataract-causing mutation S228P promotes βB1-crystallin aggregation and degradation by separating two interacting loops in C-terminal domain

β/γ-Crystallins are predominant structural proteins in the cytoplasm of lens fiber cells and share a similar fold composing of four Greek-key motifs divided into two domains. Numerous cataract-causing mutations have been identified in various β/γ-crystallins, but the mechanisms underlying cataract caused by most mutations remains uncharacterized. The S228P mutation in βB1-crystallin has been linked to autosomal dominant congenital nuclear cataract. Here we found that the S228P mutant was prone to aggregate and degrade in both of the human and E. coli cells. The intracellular S228P aggregates could be redissolved by lanosterol. The S228P mutation modified the refolding pathway of βB1-crystallin by affecting the formation of the dimeric intermediate but not the monomeric intermediate. Compared with native βB1-crystallin, the refolded S228P protein had less packed structures, unquenched Trp fluorophores and increased hydrophobic exposure. The refolded S228P protein was prone to aggregate at the physiological temperature and decreased the protective effect of βB1-crystallin on βA3-crystallin. Molecular dynamic simulation studies indicated that the mutation decreased the subunit binding energy and modified the distribution of surface electrostatic potentials. More importantly, the mutation separated two interacting loops in the C-terminal domain, which shielded the hydrophobic core from solvent in native βB1-crystallin. These two interacting loops are highly conserved in both of the N- and C-terminal domains of all β/γ-crystallins. We propose that these two interacting loops play an important role in the folding and structural stability of β/γ-crystallin domains by protecting the hydrophobic core from solvent access.

Analysis of prognostic factors in patients with recurrent and metastatic esophageal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The aim of this study was to explore the influencing factors of prognosis for recurrent and metastatic esophageal carcinoma, and to provide reference for clinical treatment for these patients.</p><p><b>METHODS</b>The clinicopathological and follow-up data of 247 patients with recurrent and metastatic esophageal squamous cell carcinoma after radical resection were retrospectively reviewed, combined with analysis of prognostic factors in these patients. Kaplan-Meier method was used to analyze the survival, difference between groups was compared by Log rank test, and Cox model was used for multivariate analysis.</p><p><b>RESULTS</b>Among the 247 recurrent and metastatic patients, locoregional recurrence was in 139 patients (56.3%), distant metastasis in 60 patients (24.3%), and combined recurrence in 48 patients (19.4%). The survival time was 1 to 42 months in the 247 patients, and the median survival time was 10 months. The 1-, 3- and 5-year survival rate after recurrence and metastasis was 26.4%, 6.3% and 2.4%, respectively. Univariate analysis indicated that regional lymph node metastasis of the primary tumor, distant lymph node metastasis, clinical staging, interval between operation and recurrence, recurrent and metastatic patterns, and treatment methods after recurrence and metastasis were influencing factors of prognosis (all P<0.05). Cox multivariate analysis indicated that clinical staging of the primary tumor, interval between operation and recurrence, recurrent and metastatic patterns, and treatment methods after recurrence and metastasis were independent factors influencing prognosis (all P<0.05).</p><p><b>CONCLUSIONS</b>The prognosis of patients with recurrent and metastatic esophageal carcinoma is poor, and it is affected by many factors. Comprehensive treatment is effective in prolonging the survival time of the patients.</p>

Clinical cliaracteristics and treatment strategy of paroxysmal sympatlietic hyperactivity / 第二军医大学学报

Objective To study the clinical characteristics , treatment methods and prognosis of the paroxysmal sympathetic hyperactivity (PSH). Methods We comprehensively analyzed 48 patients diagnosed with PSH from the neurosurgery department of Changzheng Hospital in Shanghai using a prospective study design. The patients were divided into two groups according the treatments they received. In addition to general treatment and hyperbaric oxygen treatment , patients in group A were mainly given propranolol , gabapentin , and benzodiazepines combined therapy , and those in group B received hibernation therapy as controls. The clinical characters , case characteristic , and treatment effect after two weeks of treatment were recorded and compared. Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) scores were used to evaluate the prognoses of patients after 12 months. Results The average age of the PSH patients was (27. 48+9. 62) years old , with the GCS score ' 8 at admission. The treatment group (group A) had a shorter hospitalization time ([206. 08 + 28. 57] d vs [223. 75 + 27. 74] d , P<0. 05) and a shorter episode time after two weeks7 treatment ([170. 08 + 79. 39] min vs [225. 63 + 105. 70] min , P< 0. 05) compared with the control group. Two patients in group A were lost in the 12 months follow-up. The GOS score of group A was significantly better than that of the control group (P<0. 05). The GCS scores were not significantly different between the 40 survived patients in the two groups (20 in each group). Conclusion PSH is commonly seen in young people suffering severe traumatic brain injury , who require early drug treatment. Propranolol combined with gabapentin treatment can improve the prognosis of patients , and t is superior to artificill hibernation by shortening hospitalization time and improving patient survival.

Meta-analysis of Tanreqing Injection Treatment of Viral Pneumonia / 浙江中医药大学学报

[Objective]To evaluate the efficacy and safety of Tanreqing injection in the treatment of viral pneumonia.[Methods]CNKI database, VIP database and CBM database were searched by keywords, and the obtained references were screened for clinical trials on the introduction of Tanreqing in therapy of viral pneumonia. The clinical trial results of efficacy were meta-analyzed. [Results]7 clinical trials were included, involving 604 patients, the result of Chi-Square testing was 2.21(P=0.09, I2=0%), so a fixed effect model was chosen and the results showed that Tanreqing injection showed a better clinical thera-py than control group[odd ratio (OR):5.45, 95% confidence interval (CI): (2.89, 10.27), Z=5.25, P<0.00001]. No serious adverse effects were reported. [Conclusion]Tanreqing was more effective and safer in the treatment of viral pneumonia according to our results. However, higher quality clinical studies are needed as most trials included in this review are of lower quality.

Management of Fournier's gangrene: a report of 23 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the clinical characteristics and treatment of Fournier's gangrene.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 23 cases of Fournier's gangrene, all with flare and pains in the scrotum and penis and different degrees of involvement of the scrotum, penis, perianal area, perineum, inguinal and lower extremities. The patients were treated by early debridement, incision-drainage, anti-infection and hyperbaric oxygen therapy, respectively. Scrotoplasty was performed for 11 of the cases, penile and scrotal dermatoplasty for 7, and penile amputation and urethral fistulation for 2 with penile necrosis. One of the cases underwent suprapubic cystostomy, and another 1 received colostomy.</p><p><b>RESULTS</b>Twenty of the patients were recovered and 3 (1 with diabetes and 1 with AIDS) died after surgery.</p><p><b>CONCLUSION</b>Fournier's gangrene is a fatal disease. Early diagnosis and timely surgical intervention are essential for the management of the disease.</p>

Study on the relations between smoking and the risk of age-specific lung cancer deaths in urban and rural areas of China / 中华流行病学杂志

y increased. Control of smoking prevalence should play a vital role in the prevention of the lung cancer death risks in China.