Analysis of Risk Factors for Death in the Coronavirus Disease 2019 (COVID-19) Population: Data Analysis from a Large General Hospital in Anhui, China.

During the coronavirus disease 2019 (COVID-19) pandemic, clinical prevention, early diagnosis, and hematological monitoring were challenging areas. This study aims to compare risk factors and hematological and biochemical data in non-survivor group patients with COVID-19 versus survivor group patients. A total of 204 patients with COVID-19 were selected as research subjects from December 2022 to January 2023. We analyzed the age, sex, time from onset to admission, and laboratory test indicators upon admission. The differences between surviving and deceased patients and mortality-related risk factors were examined. Among the 204 patients, 168 survived, whereas 36 died during hospitalization. Significant differences were observed between the two groups with COVID-19 across various factors, including age (p < 0.0001), WBC count (p < 0.0001), RBC count (p < 0.05), neutrophils (p < 0.0001), lymphocytes (p < 0.05), mean corpuscular hemoglobin concentration (MCHC) (p < 0.0001), RBC distribution width-standard deviation (RDW-SD) (p < 0.0001), RBC distribution width coefficient of variation (RDW-CV) (p < 0.0001), aspartate aminotransferase (AST) (p < 0.05), albumin (ALB) (p < 0.0001), creatinine (CR) (p < 0.0001), uric acid (UA) (p < 0.0001), blood urea nitrogen (BUN) (p < 0.0001), plasma thrombin time (TT) (p < 0.05), prothrombin time (PT) (p < 0.0001), and D-dimer (p < 0.0001). Multivariate logistic analysis revealed that older age, CR, UA, and ALB were independent factors associated with death (p < 0.05). Elderly patients with underlying diseases, abnormal routine blood test indices, and abnormal renal function and coagulation indices are at an increased worse prognosis and should be identified early. Age, UA, CR, and ALB can be used as predictors to assess the worse prognosis in the hospital.

A case report of solitary fibrous tumor of the prostate / 中华泌尿外科杂志

Solitary fibrous tumor (SFT) is a rare tumor originated from mesenchymal spindle cells. It is very rare to occur in the prostate. A 30-year-old male with dysuria was treated by transurethral holmium laser enucleation of the prostate. The postoperative pathological Results showed that solitary fibrous tumor.The urination symptoms of the patients were significantly improved.

Advances of radiotherapy in gallbladder cancer / 国际外科学杂志

Gallbladder cancer is a highly malignant tumor of the digestive tract with a poor prognosis. Currently, only radical surgical resection can achieve good results. As an important part of tumor adjuvant treatment and palliative treatment, radiotherapy has been widely used in the treatment of various malignant tumors and achieved certain effect. This article mainly reviews advances of radiotherapy in gallbladder cancer from four aspects: postoperative radiotherapy, preoperative neoadjuvant radiotherapy, intraoperative radiotherapy and palliative radiotherapy for gallbladder cancer.

Correlation of dyslipidemias and gallbladder polyps-A large retrospective study among Chinese population.

OBJECTIVE: Aim to explore the association of dyslipidemias with GBP prevalence, number and size in a large Chinese population in Beijing. Dyslipidemias include hypercholesterolemia, hypertriglyceridemia, increased low density lipoprotein (LDL) and decreased high density lipoproteins (HDL). METHODS: Prevalence of GBP and its association with dyslipidemias were retrospectively investigated among subjects who underwent check-up at Health Screening Center of Xuanwu Hospital between January 2014 and December 2017. RESULTS: This study enrolled 97117 participants. Prevalence of GBP was 7.3%. There were significant differences in increased LDL (595/7107 vs 6004/90010, P = 0.000) and increased cholesterol (TC) (403/7107 vs 4846/90010,P = 0.000) between GBP group and control group, but not in decreased HDL and increased triglyceride (TG). Logistic regression analysis showed that gender, age, BMI, SBP, DBP and LDL were independently associated with GBP. People with increases LDL had 1.488 times higher risk for GBP formation. Trend of dyslipidemias prevalence change according to age was similar with that of GBP. Increased LDL group had higher GBP prevalence rate (9.0% vs 7.2%, p = 0.000), multiple GBP proportion (2.9% vs 2.2%, p = 0.000) and large polyps with diameter ≥ 5 mm proportion (3.7% vs 2.6%,p = 0.000). Comparing with control group, there was higher proportion of large polyps in Increased TC group (3.2% vs 2.7%, p = 0.019) and decreased HDL group (3.0% vs 2.6%,p = 0.028). Increased TG group had not difference with its control group in GBP prevalence, number or size. CONCLUSION: Dyslipidemias is associated with GBP formation. Dyslipidemias change according to age is consistent with GBP prevalence. Increased LDL was a more related risk factor rather than decreased HDL, increased TC or TG.

Risk factors of gallbladder polyps formation in East Asian population: A meta-analysis and systematic review.

To perform Meta-analysis to identify risk factors associated with gallbladder polyps (GBP) formation in east Asian population. Three English electronic bibliographic databases includes PubMed, Embase and Medline, with reviewed researches from 1986 to 2017. All possible risk factors of GBP formation were recorded. Meta-analyses were performed by Review Manager Software. Pooled odds ratios (OR) or the mean difference (MD) were used to determine risk factors. Sixteen studies and 227021 people were recruited, including 17261 people with GBP and 209760 without GBP. For categorical variables evaluated by OR test., risk factors of GBP formation were male gender (OR, 1.63; 95%CI, 1.42-1.87) and positive HBsAg. GBP formation were not correlated with age <50 years old, hypertension, DM, BMI ≥ 25kg/m2, smoking, drinking, HDL decrease, TC increase, TG increase, fatty liver and GBS. For continuous variables evaluated by MD test, risk factors of GBP formation were DBP (MD, 1.08; 95%CI, 0.15-2.02), mean BMI (MD,0.19; 95%CI,0.02-0.35), waist circumference (MD,1.780; 95%CI, 0.17,3.40), mean LDL (MD,0.89; 95%CI,0.03-1.75), mean HDL (MD,-1.87; 95%CI,-3.21 to -0.52). GBP formation were not correlated with mean age, SBP, mean TC, mean TG, ASL and ALT. In conclusion, risk factors of gallbladder polyp formation included male gender, higher BMI, higher waist circumference, higher DBP, higher LDL, lower HDL and positive HBsAg in east Asian population. GBP formation was not correlated with age, hypertension, DM, smoking, drinking, fatty liver, GBS, TC, TG, SBP, ASL and ALT. The mechanism of Dyslipidemias causing GBP needs deeper study in future.

Follow-up ultrasonographic examinations on gallbladder polyps and to identify their risk factors of formation / 中华肝胆外科杂志

Objective:To study the occurrence and disappearance of gallbladder polyps in patients who underwent multiple ultrasonographic examinations, and to determine the risk factors of formation of gallbladder polyps.Methods:From January 2014 to December 2017, relevant data on patients who underwent follow-up abdominal ultrasound examinations at the Health Screening Center of Xuanwu Hospital was retrospectively analyzed, and the dynamic changes of gallbladder polyps were assessed. A comparative analysis was then conducted between those who had gallbladder polyps (the gallbladder polyps group, n=1 149) and those who had no gallbladder polyps (the control group, n=18 243). The occurrence, changes and disappearance of gallbladder polyps shown on multiple untrasonographic examinations were compared. Results:The patterns of changes of gallbladder polyps showed that the proportions of patients with gallbladder polyps which were stable in size ( n=1 149, 52.1%) were greater than those who had new appearance of gallbladder polyps ( n=797, 36.2%), and these 2 groups of patients were having higher proportions than those who had disappearance of gallbladder polyps ( n=258, 11.7%). The largest proportion of gallbladder polyps were found in middle-aged people, and new polyps were mainly found in the age group of 30.0-59.0 years. The peak of gallbladder polyps incidence was after age 60. There were significant differences in age, male, blood glucose, total cholesterol, low density lipoprotein (LDL), and diastolic blood pressure between the study and the control groups (all P<0.05). Multivariate analysis showed that age ( OR=1.152), male ( OR=1.407) and LDL ( OR=1.656) were independent risk factors of gallbladder polyp formation. Conclusions:The annual incidence of gallbladder polyps was 9.7‰. Gallbladder polyps were more commonly found in middle age, and the incidence of gallbladder polyps was increasing. Gallbladder polyps could disappear. However, with increase in initial diameter of gallbladder polyps, the probability of disappearance decreased. Age, male gender and elevated LDL were independent risk factors of gallbladder polyps formation.

Clinical progress in diagnosis and treatment of acute appendicitis / 国际外科学杂志

Acute appendicitis is one of the most common acute abdominal diseases in surgery. Due to its urgent onset and rapid progress, timely diagnosis and early treatment are beneficial to the prognosis of patients. The diagnosis of acute appendicitis should be based on the characteristics of different populations, based on clinical symptoms, physical examination, laboratory examination, and imaging methods. Anti-infection treatment should be started as soon as possible in the early stage, and antibiotics should choose effective drug treatment with both anaerobic bacteria and aerobic bacterial infection. Appendectomy is still the most effective treatment for acute appendicitis. In the case of uncomplicated abdominal infection such as simple and non-perforated appendicitis, antibiotic treatment may be chosen, but the development needs to be closely observed. Laparoscopic appendectomy is the first choice, but in pregnancy patients should be cautious. Emergency surgery is required for acute perforated appendicitis and attention should be paid to intraoperative abdominal flushing. Immediate surgical treatment of appendiceal abscess may involve the risk of partial ileectomy. Antibiotic treatment is recommended, with percutaneous abscess puncture and drainage if necessary.

Study on the Protective Effects of Schisandrin A on Hepatic Fibrosis Induced by Carbon Tetrachloride in Mice and Its Mechanism / 中国药房

OBJECTIVE：To study the pr otective effect of schisandrin A （SA）on CCl 4-induced liver fibrosis model mice and its mechanism. METHODS ：Mice were randomly divided into blank control group ，model group ，silymarin group （positive control，100 mg/kg），SA low-dose and high-dose groups （20，40 mg/kg），with 10 mice in each group. Except for blank control group，other groups were given CCl 4 subcutaneously to induce liver fibrosis model. After successful modeling ，administration groups were given relevant medicine intragastrically ，once a day ，for consecutive 6 weeks；blank control group and model group were given constant volume of 0.5％sodium carboxymethyl cellulose solution intragastrically by the same way. HE staining was used to observe the pathological changes of liver tissue in mice. UV spectrophotometry and ELISA assay were adopted to detect the serum levels of liver injury indexes （ALT and AST ）and the contents of inflammatory factors （TNF-α，IL-1β，IL-6）. Western blotting assay was used to detect the expression of NOD like receptor protein 3（NLRP3）/NF-κB and TGF-β/Smad signaling pathway protein. RESULTS ：Compared with blank control group ，obvious pathological changes of liver fibrosis were observed in model group. The serum levels of liver injury indexes and contents of inflammatory factors were significantly increased （P＜0.01）. The expression of NLRP 3，apoptosis associated spot-like protein ，Caspase-1 and IL- 1β，TGF-β1 and ratios ofp-NF-κB p65/NF-κB p65，p-IκBα/IκBα，p-Samd3/Smad3 were increased significantly （P＜0.01）. Compared with model group ，SA could significantly relieve hepatic fibrosis in mice ，reduce serum levels of liver injury indexes and contents of inflammatory factors ，as well as the expression of NLRP 3/NF-κB and TGF-β/Smad signaling pathway protein and phosphorylation level（P＜0.01）. CONCLUSIONS ： SA can effectively relieve liver injury and inflammation of CCl 4-induced hepatic fibrosis model mice ，which may be through the regulation of NLRP 3/NF-κB and TGF-β/Smad3 signaling pathways ，thus inhibiting the process of liver fibrosis.

EASL clinical practice guidelines recommendations for drug-induced liver injury in 2019 / 中华肝脏病杂志

Idiosyncratic (unpredictable) drug-induced liver injury (iDILI) is one of the most challenging liver diseases encountered by hepatologists due to its diverse clinical and pathological manifestations and lack of specific diagnostic markers. An increasing awareness of iDILI diagnosis and carefully excluding liver damage induced by other causes is the key to a proper diagnosis of iDILI. However, delayed diagnosis, inappropriate monitor and care leads to serious clinical consequences, such as acute liver failure or even liver-related death. In addition, there is presently no effective treatment for iDILI. Herein, we presented the main recommendations of the recent EASL published first DILI guidelines into Chinese language to facilitate liver disease authors and health workers to understand the latest research progress of DILI.

Operative method choice and strategy of laparoscopic surgery therapy for gallbladder stones and common bile duct stones / 中华外科杂志

Objective@#To explore the selection method and technology of laparoscopic surgery for gallbladder stones and common bile duct stones(GCBDS).@*Methods@#Data was collected from 318 in-patients of GCBDS at Department of General Surgery,Xuanwu Hospital of Capital Medical University from January 2013 to December 2017, and 298 in-patients acceptedlaparoscopic cholecystectomy(LC) and choledocholithotomy were recruited into final analysis.There were 138 males and 160 females,aged (60.4±18.6)years (range:25-89 years).Retrospective analysis was done on method distribution,effect and safety of laproscopic surgery.Comparisons of basic characters and therapeutic effects were performed betweenlaparoscopic common bile duct exploration (LCBDE) combined with primary closure and T tube drainage(TTD).@*Results@#Among therecruited in-patients,LC combined with common bile duct exploration was performed in 7 cases(2.3%, 7/298), LC combined with LCBDE was performed in 291 cases(97.7%,291/298).There were 133 cases (45.7%,133/291) who treated by LCBDE combined with TTD and 158 cases(54.3%,158/291) who treated by LCBDE combined with primary closure.In LCBDE combined with primary closure group,18 cases (11.4%,18/158)had intraoperative biliary manometry.All patients were followed up for 6 months at least and there no death.Postoperative complications rate was 10.0% (29/291).There were no significant differences in sex ratio,age,American Society of Anesthesiologists score,concomitant diseases and previous abdominal surgery history between LCBDE combined with primary closure and LCBDE combined with TTD group.Patients in LCBDE combined with primary closure group were accompanied with less acute cholangitis than TTD group (43.3% vs.76.7%; χ2=9.061, P=0.002).There were no significant differences in the diameter of common bile duct, the number of stones, hospitalization expenses and the incidence of complications between the two groups(all P>0.05).LCBDE combined with primary closure had shorter operation time ((134.2±28.3)minutes vs.(148.3±19.6)minutes; t=-1.830, P=0.011)and post-operative hospitalization time ((5.6±2.6)days vs. (7.2±2.4)days; t=-1.847,P=0.014).Bile duct leakage rate was higher in primary closure group(6.3% vs.0.8%, χ2=3.934, P=0.047) and TTD group had higher residual stones rate(6.8% vs.1.3%; χ2=6.008, P=0.014).@*Conclusion@#Strategy for treating GCBDS by laparoscopic surgery should be considered preoperative evaluation and intraoperative exploration to select appropriate minimally invasive surgical methods and techniques.

Clinical study of Xiaoyaosan and Shengmaiyin combined with conventional western medicine in the treatment of xerophthalmia / 国际中医中药杂志

Objective To evaluate the effect of Xiaoyaosan and Shengmaiyin combined with conventional western medicine for xerophthalmia.Methods A total of 76 xerophthalmia patients who met the criteria were divided into two groups according to random number table,with 38 cases in each group.The control group was treated with routine western medicine,while the observation group was treated with Xiaoyaosan combined with Shengmaiyin on the basis of the control group.Both groups were treated for 4 weeks.Before and after treatment,the symptoms were scored,and the tear film stability was evaluated according to the results of fluorescent test (FL),breakup time of tear film (BUT) and schirmer Ⅰ test (SIT).The contents of IL-1β,IL-6 and TNF-α in tear were detected by ELISA,and the clinical efficacy was evaluated.Results The total effective rate was 92.9％ (65/70) in the observation group and 76.4％ (55/72) in the control group,and there was significant difference between the two groups (Z=-2.991,P=0.002).After treatment,the SIT (6.9 ± 0.8 mm vs.4.3 ± 0.5 mm,t=3.751),BUT (10.5 ± 1.6 s vs.6.4 ± 0.8 s,t=4.228) in the observation group were significantly higher than those in the control group (P＜0.05).The FL score (0.9 ± 0.1 vs.1.4 ± 0.2,t=3.208) in the observation group was significantly lower than that of the control group (P＜0.05).The scores of aningeresting,foreign body sensation,visual fatigue,photophobia and visual blur in the observation group were significantly lower than those in the control group (t were 3.559,4.015,4.119,3.983,4.120,all Ps＜0.05).The levels of IL-1β,IL-6 and TNF-α in tear were significantly lower than those in control group (t were 11.887,8.028,8.112,all Ps＜0.001).Conclusions The Xiaoyaosan combined with Shengmaiyin can improve tear film stability,relieve local ocular surface inflammation and improve clinical symptoms in patients with xerophthalmia.

Effect of Buyang-Huanwu decoction on incidence of macular edema, visual acuity and serum VEGF, IL-6 levels after operation in diabetic cataract patients / 国际中医中药杂志

Objective To study the effect of Buyang-Huanwu decoction on incidence of macular edema, visual acuity and serum VEGF, IL-6 levels after operation in diabetic cataract patients. Methods A total of 46 post-operative patients with diabetic cataract were randomly divided into two groups. The control group was treated with pranoprofen eye drops combined with tobramycin dexamethasone eye drops, and the study group was treated with Buyang-Huanwu decoction combined with Salviae Miltiorrhizae and Ligustrazine Hydrochloride injection based on the control group. The central subfield mean thickness (CSMT) at baseline before operation and 1d, 1w, 4w, 8w, 12w after operation, corrected vision at 0w, 1w, 6w, 12w, serum levels of vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) before and after treatment of two groups were observed, and the incidence of macular edema was analysed. Results The CSMT of study group at 8 w (226.35 ± 9.88 μm vs. 214.74 ± 9.27 μm, t=2.118) and 12 w (233.57 ± 11.25 μm vs. 213.62 ± 10.13 μm, t=2.258) after operation were significantly lower than those of control group (P＜0.05). The best corrected visual acuity of study group at 6 w (4.61 ± 0.32 vs. 4.82 ± 0.25, t=2.0460 and 12 w (4.57 ± 0.29 vs. 4.79 ± 0.24, t=2.180) after operation were significantly higher than those of control group (P＜0.05). The levels of VEGF (174.31 ± 45.63 pg/ml vs. 83.65 ± 24.47 pg/ml, t=4.145) and IL-6 (27.25 ± 9.21 pg/ml vs. 15.24 ± 3.14 pg/ml, t=3.829) of study group were significantly lower than those of control group (P＜0.05). The incidence of macular edema at 8 w and 12 w after operation in study group were respectively 0.0% and 2.9% (1/35), and the control group were 16.2% (6/37) and 21.6% (8/37). The difference was statistically significant (P＜0.05). Conclusions The Buyang-Huanwu decoction in treatement of post-operation patients with diabetic cataract could reduce the incidence of macular edema and improve the visual acuity.

Secondary metabolites from Streptococcus mutans and their ecological roles in dental biofilm / 生物工程学报

Dental biofilms are composed of hundreds of bacterial species, among which Streptococcus mutans is widely recognized as the major pathogen of dental caries. The cariogenic potential of S. mutans is related to its ability to form a robust biofilm on the tooth surface and its acidogenic and acid-tolerant properties. Co-evolution of S. mutans with the host has resulted in the diversity of secondary metabolism of S. mutans in strain level. A variety of secondary metabolites, including 10 bacteriocins (mutacins) and one hybrid Polyketide/Non-Ribosomal Peptide type compound, have been characterized. Studies on these secondary metabolites indicate that they play a significant role either in interspecies or in inter-kingdom interactions in the dental biofilm. As more S. mutans strains are isolated and sequenced, additional secondary metabolites with novel functions will be discovered. The study of secondary metabolites in S. mutans is anticipated to be helpful for oral disease treatment and prevention by providing new strategies.

Early intervention of life-threatening cardiac malformations in the newborn / 中国小儿急救医学

Objective To investigate the methods of early identification and early intervention for newborn with life-threatening congenital heart disease.Methods Between January 2010 and December 2010,223 neonates with serious congenital cardiac malformations were hospitalized in PICU of Fuwai Hospi-tal.Results The most type of cardiac lesions was complete transposition of the great arteries,accounting for 59%(131 cases),and the second was total anomalous pulmonary venous connection,17%(39 cases).For the primary clinical symptoms,the most common were any cyanosis,dyspnea and cardiac murmur,accounting for 91 %(204 cases),56%(125 cases)and 53%(1 18 cases),respectively.Fifty-nine cases developed into critical conditions such as severe hypoxia,metabolic acidosis and heart failure and were sent to PICU for emergency rescue.Early intervention included maintaining ductus arteriosus open,correcting internal environ-ment disturbances,treatment of heart failure,and surgical treatment as soon as possible.Four cases died before operation and 10 cases were abandoned to continue care,which all died within 12 days after discharge.In 209 cases who received operation,9 cases died.The total operation mortality was 4.3%.Within 3 to 63 month following-up,the late death was in 2 cases,2 cases received two-stage corrective operation,and three for reop-eration.The others all were in normal cardiac function and growth.Conclusion Most of neonatal life-threat-ening congenital cardiac malformations were ductus dependent such as transposition of the great arteries and total anomalous pulmonary venous connection,which the baby needs immediate diagnosis and management for survival.Early recognition,appropriate preoperative management and operation as soon as possible are the key to rescue.

Efficacy and safety of extended-release versus standard-release tacrolimus in kidney transplantation: A meta-analysis / 中华器官移植杂志

Objective To assess the efficacy and safety of extended-release versus standardrelease in kidney transplant recipients.Methods We searched Pubmed,Embase,Medline and Cochrane library databases in English and researched published randomized controlled trials (RCTs)focused on extended-release versus standard-release tacrolimus in renal transplant recipients until March 2016.The risk of bias assessment for RCTs was evaluated using the Cochrane Collaboration's tool,and quality of RCTs was assessed by the modified JADAD scale.Meta-analysis was conducted by Review Manager 5.3 and Stata SE 12.0.Results A total of 12 RCTs were included,involving 3 532 adult kidney transplant recipients.There was no significant difference between the two treatment groups in the endpoints such as acute rejection rate (RR =0.93[0.78 1.11],P =0.40),graft survival (RR=1.04[0.79-1.37],P =0.76),patient survival (RR =1.03[0.67-1.57],P =0.90),patients withdrawn (RR =1.07[0.95-1.22],P =0.26),estimated glomemlar filtration rate (eGFR) (MD =-0.52[-1.95,0.92],P =0.48),creatinine clearance (Ccr) (MD =-0.94 [-1.39,3.28],P =0.43),infection (RR=0.98[0.90-1.06],P =0.57),and new-onset diabetes rate (RR =0.91[0.67-1.23],P =0.53).Meanwhile,subgroup analysis of different patient population (early after transplantation vs.late after transplantation) showed similar results in the protocol.Conclusion The extended-release tacrolimus has similar efficacy and safety to the standard-release in kidney transplantation.

Individualization of tacrolimus dosage based on CYP3A 5 * 3 gene polymorphism——A prospective, randomized controlled study and economics evaluation / 中华器官移植杂志

Objective To investigate the efficacy,safety,economy evaluation of CYP3A5 * 3 gene polymorphism in providing individualized administration for the use of tacrolimus (Tac) in renal transplantation recipients.Method Pyrophosphate sequencing method was used to determine the CYP3A5 * 3 genotype of renal transplant patients in the first day after surgery.Computer-generated random numbers were used to assign 60 patients into experiment group or control group.Both groups of patients were routinely given the initial dose of Tac (4.0 mg/day) in the first day after surgery.The patients in the experiment group were given different doses of Tac based on the different CYP3A5 * 3 genotypes at the third day after surgery [for AA,AG:0.12 mg/(kg day),and for GG:0.06 mg/(kg day)].The patients in the control group were given different dosages of Tac according to drug concentration.The patients were followed up for 12 months,and different parameters were compared between two groups.A decision tree model was populated with data from the study and used to economics evaluation.Result At day 5 after the transplantation,significantly more patients in the experiment group were within the Tac target C0 range [90％ (27/30)] as compared to the control group [46.67％ (14/30) (P＜0.05).At this time point,the median Tac C0was 5.08 [(2.5-8.7) μg/ L] in the experiment group vs.5.29 [(1.3-13.6) μg/L] in the control group (P＜0.05).When C0/ D was analyzed according to CYP3A5 * 3 genotype,we found the mean C0/D in the both groups with CY3A5 * 3/* 3 ＞CYP3A5 * 3/* 1 ＞ CYP3A5 * 1/* 1.It was noted that the time to achieve target Tas was (4.40 ± 0.97) in the experiment group,vs.(7.57 ± 3.42) in the control group.In total,the number of daily dose modifications was 11 in the experiment group and 49 in the control group in two weeks after transplantation (P＜0.05).Renal function at day 14 after transplantation and adverse events during 12 months of follow-up were similar in both groups.In total,10 adverse events were reported in the experiment group and 11 in the control group (P＞0.05).The results of costeffectiveness analysis showed that the cumulative costs and effects in the experiment group were ￥ 38 067 and 0.90 quality-adjusted life years gained,and those in the control group were ￥38 681 and 0.87 quality-adjusted life years gained,respectively.In the base case analyses,experiment group was more cost-effective.Conclusion Individualized adjustment of Tac doses for patients according to recipients different CYP3A5 * 3 genotypes is beneficial for reaching target concentration as soon as possible and more cost-effective.But the demonstration of the clinical relevance of this approach was not achieved.Higher methodological quality,and larger sample size study are still needed.

Risk factors of urethral recurrences following radical cystectomy for bladder cancer / 中华泌尿外科杂志

Objective To evaluated the risk factors of urethral recurrence ( UR) following radical cystectomy ( RC) in patients with bladder urothelial carcinoma.Methods The clinical data of 350 male patients who underwent RC between January 2005 and January 2013 were retrospectively analyzed.The mean age was 63 years (rang 46-76) years.176 cases had the history of non-muscle-invasive bladder cancer.15 cases were were found the tumor invasion into the prostatic urethral.The way of urinary diversion after RC included 172 cases were orthotopic neobladder, 90 cases were cutaneous diversion and 88 cases were ileal couduitin.331 cases underwent preoperation intravesical instillation.36 cases underwent systemic chemotherapy after operation.148 cases were found the multiple tumor lesions, which was more than 2 sites. The pathological stage was more than T2 satge in 189 cases.And 177 cases were diagnosed as high-grade urothelial carcinoma.Multivariate Cox regression analyses were used to evaluate the risk factors associated with the UR.Results There were 350 cases in this study, UR was observed in 28 cases ( 8%).On multivariate Cox regression analyses, previous history of NMIBC (HR=15.205,95%CI 3.718-62.180,P<0.001), prostate urethral involvement(HR=5.233,95%CI 1.106-24.754,P=0.037) and Non-orthotopic neobladder(HR=6.656,95%CI 1.840-24.077,P=0.004)which the operation of cutaneous diversion and ileal couduit , were independent risk factors of UR following RC.Intravesical instillation before operation ( HR =0.470, 95%CI 0.010-0.217, P <0.001 ) was the protective factor of the UR.Conclusions Previous history of NMIBC, prostatic urethral involvement and Non-orthotopic neobladder were independent risk factors of UR.Intravesical instillation before operation was protective factor of UR.Urethrectomy for patients with high risk factors and intravesical instillation before operation were important.

TCM Research Review on the Relationship between Asthma and Leukotrienes and Its Receptor / 浙江中医药大学学报

Objective] Summarize the pathogenesis of asthma and leukotriene receptor in latest research situation. [Methods]Check out the past five years CNKI, VIP data, PUBMED data to leukotrienes and asthma for keyword research literature, and classification, summary. [Results]Numerous clinical studies, in vivo and in vitro experiments showed that leukotrienes and their receptors are involved in the pathogenesis of asthma and progress in a multi-cell, multi-session, and interact with a variety of cytokines.[Conclusion]With concept of wholism as the characteristics of the Genomics technologies, more suitable as a primary means of application in the field of medical research has an overall concept for the regulation of traditional Chinese medicine research in the field of drugs to treat asthma leukotriene pathway and provide a new perspective.

Sirolimus versus Tacrolimus as primary immunosuppressant after renal transplantation: A meta-analysis / 中华器官移植杂志

Objective To evaluate the efficacy and safety of sirolimus and tacrolimus after renal transplantation.Method PubMed,Web of knowledge,Medline and the Cochrane controlled trials register,Chinese Biomedicaldatabase,and Vip database were searched with the terms and Boolean operators as (kidney transplantation OR renal transplantation) AND (sirolimus OR rapamycin OR rapamune) AND (tacrolimus OR FK506 OR prograf).Results retrieved were updated on November,2015.Data were extracted for patient and graft mortality,acute rejection (AR),wound complications,infection,GFR,withdrawl.Professional meta analysis software RevMan 5.3 was employed.Result Altogether,1810 patients from 10 randomized controlled trials (RCTs) were included.Patients in the sirolimus group showed a decreased rate of graft mortality and infection (RR =0.63,95％ CI,0.45-0.89,P=0.009;RR=4.42,95％ CI,1.73-11.31,P=0.002).Patients in the sirolimus group showed an increased rate of AR,wound complications,GFR,withdrawl (SMD=-0.52,95％ CI,-0.73-0.31,P＜0.000 01;RR=0.54,95％ CI,0.40-0.73,P＜0.000 1;RR=0.17,95％ CI,0.11-0.25,P＜0.000 01;RR =0.44,95％ CI,0.37-0.51,P＜0.000 01).The patient mortality was insignificantly different between two groups.Conclusion This meta-analysis concluded that sirolimus showed advantage over tacrolimus about safety when used early after renal transplantation.The options of immunosuppressive regimens after kidney transplantation should be based on the specific condition.To obtain more reliable and accurate clinical data,the RCTs with more rational design,higher methodological quality,larger sample size,including domestic patients,longer follow-up are still needed.

Properties of Hydrogel and Its Applications in Biomedicine / 生物医学工程学杂志

Hydrogel is a creative polymeric biomaterial which can resemble extracellular matrix (ECM) in vitro. Hydrogel is also a material with intrinsic bioinert, but it can offer mechanical support and developmental guide for cell growth and new tissue organization by designing physicochemical and biological properties of hydrogels precisely. This review mainly introduces design of hydrogels, properties and applications in tissue engineering and regenerative medicine, drug delivery, stem cell culture and cell therapy.