Meta-analysis of clinical efficacy and safety of transanal endoscopic microsurgery and endoscopic submucosal dissection in the treatment of rectal tumors.

Aim: The aim of the article was to systematically evaluate the clinical efficacy and safety of transanal endoscopic microsurgery (TEM) and endoscopic submucosal dissection (ESD) in the treatment of rectal tumors. Material and methods: Control studies were conducted on cases included in the electronic databases Medline, Embase, Cochrane Library, and CNKI. Patients with colorectal tumors were included in the TEM and ESD groups for treatment, with the main indicators being R0 resection rate, postoperative perforation and bleeding incidence, and tumor recurrence rate. The meta-analysis was carried out using RevMan 5.3 software. Results: A total of 10 studies were included, with 736 patients. The analysis showed that for the recurrence rate in the TEM group compared to ESD, OR = 1.23, 95% CI = 0.56-2.72, p = 0.60; for the R0 resection rate between the TEM group and ESD group, OR = 1.35, 95% CI = 0.82-2.22, p = 0.24; for the incidence of perforation in the TEM and ESD groups, OR = 0.59, 95% CI = 0.25-1.40, p = 0.23. The inter-group comparison of these three items was statistically significant. Compared with the ESD group, the hospitalization time and the incidence of bleeding of the TEM group were both lower, with SD = 0.48, 95% CI = 0.26-0.69, p < 0.001 and OR = 0.35, 95% CI = 0.13-0.92, p = 0.03. The differences were statistically significant. Conclusions: Both TEM and ESD endoscopic treatment techniques can achieve a higher R0 resection rate and lower risk of tumor recurrence in the treatment of colorectal tumors. However, TEM may have higher surgical safety than ESD technology, and can shorten postoperative hospitalization time and lower postoperative bleeding rate.

Effects of center pivot sprinkler fertigation on the yield of continuously cropped soybean.

Continuous cropping is a common agricultural practice in Northeast China. Focusing on soybeans cropped continuously for two consecutive years, this article fully explores the effects of the amount of water, fertilizing rate, and fertilizing method on the growth and yield of soybean. Specifically, an orthogonal experimental plan was designed involving these three factors. Each factor was divided into three levels: the amount of water was set as 52.62 mm (W1), 73.41 mm (W2), and 138.6 mm (W3); the fertilizing rate was set as 6.75 kg/hm2 (N1), 9.75 kg/hm2 (N2), and 13.5 kg/hm2 (N3); and the fertilizing method was set as center pivot sprinkler (CPS) fertigation (F1), microspray (MS) fertigation (F2), and MS fertilizing + CPS spraying and leaching (F3). During the experiments, the growth traits at each growth stage were monitored, and the soybean yield was measured. The following results were obtained through the analysis of the experimental data: the amount of water significantly affects the growth traits of soybean in the early stage of growth; the fertilizing rate greatly affects the stem diameter; and the fertilizing method is a major influencer of soybean yield. The highest yield (2811.88 kg/hm2) was observed in zone 4 (W2N1F2). This means irrigation and fertilization are very important to the normal growth of continuously cropped soybean; the yield loss induced by continuous cropping can be mitigated effectively through timely and adequate irrigation and topdressing, plus fertilization by the suitable method. To prevent yield loss, farmers in Northeast China are suggested to replace continuous cropping with crop rotation. If continuous cropping is unavoidable, foliage fertilizer should be sprayed timely for topdressing at the flowering and seed-filling stages.

Hypouricemic and arthritis relapse-reducing effects of compound tufuling oral-liquid in intercritical and chronic gout: A double-blind, placebo-controlled, multicenter randomized trial.

TRIAL DESIGN: In the double-blind, randomized, controlled trial, we aimed to evaluate the effects of compound tufuling oral liquid (CoTOL) on serum uric acid (sUA) levels and recurrence of acute gouty arthritis in intercritical and chronic gout treatment. METHODS: A total of 210 patients with gout were screened from 8 hospitals to observe the sUA and acute gouty arthritis recurrence rate-reducing effects of CoTOL in intercritical and chronic gout during a 12-week treatment. We treated 139 and 71 patients with CoTOL and the placebo, respectively, and evaluated their sUA levels, acute gouty arthritis recurrence rate, and adverse events at week 0, 6, and 12. RESULTS: Twenty-five and 12 patients in the treatment and control groups, respectively, had interrupted treatments, whereas 114 and 59 cases, respectively, completed their treatments. At the end of the 12-week treatment, the average decrease in sUA was 74.26 (95% confidence interval [CI]: 56.74-91.77 µmol/L) and 28.81 µmol/L (95% CI: 4.91-52.71 µmol/L) in the treatment and control groups, respectively (P = 0.004). The average decrease rate of sUA was 12.76% (95% CI: 9.82%-15.70%) and 4.57% (95% CI: 0.42%-8.71%) in the treatment and control groups, respectively (P = 0.004), and the gouty arthritis recurrence rate of the treatment group was lower than that of the control group (from week 6 to 12, 21.93% and 50.88% in the treatment and control group, respectively, P < 0.001; from baseline to week 12, 38.5% and 63.16%, respectively, P = 0.003). Severe adverse events were not observed in either groups, and fewer leucopenia incidences were observed in the treatment group than those in the control group (3/139 vs. 7/71, respectively, P = 0.033). CONCLUSION: CoTOL reduced sUA levels and effectively prevented acute arthritis recurrence in intercritical and chronic gout without serious adverse events.

Progress in study on synergism and detoxification of Chinese medicine for glucocorticoid.

Glucocorticoid (GC) plays an important role in anti-inflammatory, anti-allergic effects and immunosuppression, and has become a widely used drug in clinical departments. However, GC also produces a number of serious side effects at the same time. After GC acting on human body, the syndrome change has some regular pattern and it can be treated on the basis of syndrome differentiation and stage to aim at further improving therapeutic efficacy. The Chinese medicine can reduce the side effects of GC when treating the primary disease, thus plays a role in Synergism and Detoxification.