Safety and benefit of modified mesohepatectomy in the treatment of bilobar involvement congenital biliary dilatation.

BACKGROUND: The diseased bile duct in bilobar congenital biliary dilatation is extensive and often requires major hepatectomy or liver transplantation associated with a higher risk. We aimed to evaluate the safety and benefit of modified mesohepatectomy, in comparison with trisectionectomy, to treat bilobar congenital biliary dilatation. METHODS: This study included 28 patients with type IV and V bilobar congenital biliary dilatation. An innovative mesohepatectomy comprising the hepatectomy technique beyond the P/U point and bile duct shaping was applied to 14 patients to address the extensively diseased bile duct and difficulty in hepaticojejunostomy. Another 14 patients received trisectionectomy. The perioperative and long-term outcomes of these patients were compared. RESULTS: The ratio of residual liver volume to standard liver volume in the mesohepatectomy group was higher (78.68% vs. 40.90%, p = 0.005), while the resection rate of the liver parenchyma was lower (28.25% vs. 63.97%, p = 0.000), than that in trisectionectomy group. The mesohepatectomy group had a lower severe complication (>Clavein III, 0% vs. 57.70%, p = 0.019) and incidence of posthepatectomy liver failure (7.14% vs. 42.86%, p = 0.038). No significant difference was observed in blood loss and bile leakage (p > 0.05). All the patients in the mesohepatectomy group achieved optimal results in the long-term follow-up. CONCLUSIONS: mesohepatectomy provides an efficient treatment option for bilobar congenital biliary dilatation and can achieve radical resection, retain more liver parenchyma, and reduce the difficulty of hepaticojejunostomy, especially for patients that are not eligible for major hepatectomy and liver transplantation.

The correlation of ESCO1 expression with a prognosis of prostate cancer and anti-tumor effect of ESCO1 silencing.

BACKGROUND: Recently, it has been reported that establishment of sister chromatid cohesion N-acetyltransferase 1 (ESCO1) is involved in tumorigenesis. However, its role in prostate cancer remains unclear. In the present study, the association between ESCO1 expression and the prognosis of prostate cancer was investigated, and the potential molecular mechanisms underlying its actions in tumor progression were also examined. METHODS: Immunohistochemical analysis was performed to detect the expression of ESCO1 in benign prostatic hyperplasia (BPH), human prostate cancer, and metastasis tissue samples, and the association between the establishment of ESCO1 expression and the prognosis of prostate cancer was investigated. The effect of ESCO1 expression on the viability, migration, and invasion of prostate cancer cells in vitro was analyzed, along with the effect of ESCO1 silencing on the growth of prostate tumors in vivo. RESULTS: The results demonstrated an increase in the expression of ESCO1 in prostate cancer tissue when compared with BPH, and it was significantly associated with tumor malignancy and poor patient survival. Additionally, knockdown of ESCO1 significantly inhibited the viability and migration of prostate cancer cell. Furthermore, we found that knockdown of ESCO1 significantly inhibited tumor growth in vivo. Pathway analysis identified that the silencing of ESCO1 significantly decreased the phosphorylation levels of protein kinase B. CONCLUSIONS: The results of the present study indicate that ESCO1 plays a vital role in the progression of human prostate cancer; furthermore, ESCO1 may potentially serve as a prognostic marker and a novel therapeutic target for this disease.

Clustering of Non-communicable Diseases Risk Factors in Healthy Adults Aged 35 Years and Older in Shenzhen, China.

We assessed the prevalence of non- communicable diseases (NCDs) risk factors with a focus on their clustering among healthy adults in Shenzhen, China. Data from the 2011 China Health and Nutrition Survey, comprising a regionally representative sample of 806 healthy adults aged 35 years or older, were obtained to determine the prevalence of five risk factors for NCDs. The prevalence of current smoking, central obesity, impaired fasting glucose, borderline hypertension, and borderline high total cholesterol was 19.97%, 28.29%, 4.47%, 10.55%, and 36.10%, respectively. A total 63.77% of participants had at least one risk factor. Upon examination of risk factor clustering, we observed that 7.57% of participants had at least three risk factors. Using this threshold as a cutoff, clustering of risk factors was associated with sex [odds ratio (OR) = 3.336, 95% confidence interval (CI): 1.782 to 6.246], physical activity (OR = 1.913, 95% CI: 1.009 to 3.628), and BMI (OR = 7.376, 95% CI: 3.812 to 14.270). The prevalence of risk factors for NCDs is fairly high among healthy adults in Shenzhen, with a clustering tendency.

Importance analysis of medical equipment procurement bidding parameters and considerations during their formulation / 医疗卫生装备

Objecive To discuss the importance of medical equipment procurement bidding parameters and to enhance their formation.Methods The whole course was described for medical equipment bidding,and the importance and problems of medical equipment bidding parameters were analyzed in detail.The considerations during the parameters formation were explored including the elements,skills,methods,announcements and etc.Results The bidding parameters were of great importance for the quality of procured medical equipment and the satisfaction of equipment user.Conclusion Rational bidding parameters contribute to enhancing medical equipment quality and medical institution benefit.

Importance analysis of medical equipment procurement bidding parameters and considerations during their formulation / 医疗卫生装备

Objecive To discuss the importance of medical equipment procurement bidding parameters and to enhance their formation.Methods The whole course was described for medical equipment bidding,and the importance and problems of medical equipment bidding parameters were analyzed in detail.The considerations during the parameters formation were explored including the elements,skills,methods,announcements and etc.Results The bidding parameters were of great importance for the quality of procured medical equipment and the satisfaction of equipment user.Conclusion Rational bidding parameters contribute to enhancing medical equipment quality and medical institution benefit.

Serum lipids and associated factors of dyslipidemia in the adult population in Shenzhen.

BACKGROUND: Dyslipidemia is one of the most important independent modifiable risk factors for cardiovascular diseases. The objective of this study was to determine the prevalence and risk factors for dyslipidemia in Shenzhen, a special economic zone and large metropolitan area neighboring Hong Kong. METHODS: A cross-sectional survey of 1,995 adults with a mean age of 46.56 years was conducted between February and July 2011 using a multistage stratified cluster random sampling. All the subjects were administered questionnaires regarding socio-demographic characteristics and other possible factors associated with the prevalence of dyslipidemia. Fasting venous blood samples were collected to assess the lipid profile. Weight, height, waist circumference, and blood pressure were measured. RESULTS: The mean concentrations of total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were 5.11 ± 1.15 mmol/L, 1.59 ± 1.47 mmol/L, 1.42 ± 0.33 mmol/L, and 3.22 ± 0.84 mmol/L, respectively. High values of TC, TG, low HDL-C, and high LDL-C were obtained in 14.49%, 16.14%, 8.82%, and 12.13 % of the 1,995 participants, respectively. The prevalence of dyslipidemia was 34.64%, among which 25.04% of subjects were aware. Presence of dyslipidemia was significantly associated with increasing age, smoking status, hypertension, diabetes, and body mass index. CONCLUSIONS: High prevalence of dyslipidemia with relative low awareness in Shenzhen was found. A comprehensive strategy is required for the prevention, screening, treatment, and control of dyslipidemia in Shenzhen.

Proficiency of virtual reality simulator training in flexible retrograde ureteroscopy renal stone management.

BACKGROUND: Minimally invasive flexible ureteroscopy techniques have widely adopted in the management of patients with renal stones. We performed this study to investigate the value of virtual reality simulator training in retrograde flexible ureteroscopy renal stone treatment for catechumen. METHODS: Thirty catechumen, included 17 attending physicians and 13 associate chief physicians, were selected for study. The trainees first underwent 1-hour basic training to get familiar with the instrument and basic procedures, then followed by 4-hour practice on virtual reality simulators. Before and after the 4-hour training, all trainees undertake an assessment with task 7 program (right low pole calyces stone management). We documented for each trainee the total time of procedure, time of progressing from the orifice to stone, stone translocation and fragmentation time, laser operate proficiency scale, total laser energy, maximal size of residual stone fragments, number of trauma from the scopes and tools, damage to the scope and global rating scale (GRS). The proficiency of this training program was analyzed by the comparison of the first and second assessment outcomes. RESULTS: Significant improvement was observed in retrograde flexible ureteroscopy management of renal stone on virtual reality simulators after finishing the 4 hour special-purpose training. This was demonstrated by improvement in total procedure time ((18.37±2.59) minutes vs. (38.67±1.94) minutes), progressing time from the orifice to stone ((4.00±1.08) minutes vs. (13.80±2.01) minutes), time of stone translocation ((1.80±0.71) minutes vs. (6.57±1.01) minutes), fragmentation time ((4.43±1.25) minutes vs. (13.53±1.46) minutes), laser operate proficiency scale (8.47±0.73 vs. 3.77±0.77), total laser energy ((3231.6±401.4) W vs. (5329.8±448.9) W), maximal size of residual stone fragments ((2.66±0.39) mm vs. (5.77±0.63) mm), number of trauma from the scopes and tools (3.27±1.01 vs. 10.37±3.02), damage to the scope (0 vs. 0.97±0.76) and GRS (29.27±2.95 vs. 9.87±2.21). The differences between the first and the second assessment were all statistically significant (all P < 0.01). CONCLUSION: The virtual reality simulator training program can help the trainees to rapidly improve their retrograde flexible ureteroscopy skill in renal stone treatment.