Reconciling Coulter Counter and laser diffraction particle size analysis for aquaculture monitoring.

The disaggregated inorganic grain size (DIGS) of bottom sediment analyzed with a Coulter Counter (CC) has been used to show that the fraction of sediment deposited in flocs (floc fraction) increased in both the near and far field after the introduction of open cage salmon aquaculture, altering benthic habitat and species composition. As a result, DIGS was identified as a potential indicator of regional environmental changes due to aquaculture. Laser diffraction is an attractive alternative to the CC because of its greater efficiency and larger size range. To determine if a laser diffraction instrument, Beckman-Coulter LS 13 320 (LS), could replace the CC within a Canadian national aquaculture monitoring program, the DIGS of 581 samples from five different regions in eastern Canada were analyzed with an LS and a CC. Results show that the LS could not be used to calculate floc fraction. Instead, % sortable silt and the volume % of inorganic particles < 16 µm were evaluated as alternative proxies for fine sediment properties. LS and CC values for these parameters were correlated, but they were significantly different and the relationship between the instruments was dependent on the area sampled. The LS did not capture variations between areas seen in the CC DIGS data. Where the DIGS from the CC found no sorting in the finest size classes, all the LS samples had similar size distributions characterized by smooth modal peaks. The LS and CC both return values that can be used to monitor changes in the deposition of fine-grained sediment, but the LS cannot determine changes in floc deposition and caution is required if comparing different sedimentary environments.

[Prevalence of Echinococcus infections in wild carnivores based on copro - DNA tests in Serthar County of Sichuan Province].

OBJECTIVE: To investigate the prevalence of Echinococcus infections in wild carnivores in Serthar County, Sichuan Province, so as to provide insights into echinococcosis control in local areas. METHODS: Stool samples were collected from wild carnivores in Serthar County, Sichuan Province in May 2021, and the host sources of stool samples and Echinococcus infections were identified using PCR assays. The prevalence of E. multilocularis, E. granulosus and E. shiquicus infections was estimated in different hosts. RESULTS: A total of 583 stool samples were collected from wild carnivores, including 147 stool samples from fox, 154 from wolf, 227 from wild dogs and 11 from lynx. The overall prevalence of E. multilocularis, E. granulosus and E. shiquicus infections was 5.68%, 0.19% and 14.20% in canine stool samples, and no E. granulosus infection was detected in fox stool samples, while the prevalence of E. multilocularis and E. shiquicus infections was 0.68% and 47.62% in fox stool samples (χ2 = 88.41, P < 0.001). No E. granulosus or E. shiquicus infection was detected in wolf stool samples, and the prevalence of E. multilocularis infection was 10.39% in wolf stool samples. The prevalence of E. multilocularis, E. granulosus and E. shiquicus infections was 5.73%, 0.44% and 2.20% in canine stool samples (χ2 = 12.13, P < 0.01). In addition, the prevalence of E. multilocularis infections was significantly higher in wolf stool samples than in canine and fox stool samples (χ2 = 13.23, P < 0.01), and the prevalence of E. shiquicus infections was significantly higher in fox stool samples than in canine and wolf stool samples (χ2 = 187.01, P < 0.001). No Echinococcus infection was identified in 11 lynx stool samples. CONCLUSIONS: The prevalence of Echinococcus infections is high in wild canines in Serthar County, Sichuan Province. Wolf, wild dog and fox all participate in the wild life cycle of E. multilocularis in Serthar County, and wolf and wild dogs may play a more important role.

[Predictive value of the triglyceride-glucose index on atrial fibrillation recurrence after valvular surgery with concurrent Cox-maze â £ ablation].

Objective: To investigate the predictive value of preoperative triglyceride-glucose (TyG) index on atrial fibrillation recurrence after valvular surgery with concurrent Cox-maze Ⅳ ablation. Methods: The data of the patients who underwent valvular surgery with concurrent Cox-maze Ⅳ ablation from June 2017 to May 2022 in the Department of Cardiac Surgery, Beijing Anzhen Hospital were retrospectively collected, and the patients were divided into the recurrence group and non-recurrence group. Baseline clinical data and results of laboratory tests were collected and TyG index was calculated. The univariate and multivariate Cox proportional regression analysis were used to explore the risk factors of atrial fibrillation recurrence after Cox-maze Ⅳ ablation. The value of TyG index in predicting atrial fibrillation recurrence was obtained by plotting receiver operating characteristic (ROC) curve. Results: A total of 424 patients were in the final analysis, including 300 males and 124 females, with an average age of (58.2±13.4) years. The median follow-up time was 32.7 months (17.3-49.6 months). There were 117 and 307 patients in the recurrence and non-recurrence groups, respectively. Compared with the non-recurrence group, the TyG index in the recurrence group was higher (9.21±0.38 vs 8.34±0.72, P=0.011). The multivariate Cox regression analysis showed that TyG index (HR=2.021, 95%CI: 1.374-3.245, P<0.001), C-reactive protein level (HR=1.127, 95%CI: 1.007-1.535, P=0.026) and mitral stenosis (HR=1.038, 95%CI: 1.004-1.483, P<0.001) were risk factors for atrial fibrillation recurrence after Cox-maze Ⅳ ablation. In addition, TyG index was a predictor of atrial fibrillation recurrence according to ROC curve analysis [area under the curve (AUC)=0.847, 95%CI: 0.796-0.871, P<0.001]. Conclusion: The TyG index is an effective indicator to predict the recurrence of atrial fibrillation after valvular surgery with concurrent Cox-maze Ⅳ ablation.

Relationship between in feed drugs, antibiotics and organic enrichment in marine sediments at Canadian Atlantic salmon aquaculture sites.

The presence of in-feed anti-sea lice drugs and their relationship with organic enrichment is poorly understood in sediment surrounding salmon farms. Using data from an aquaculture monitoring program (2018-2020), we describe this relationship at ten sites in four Canadian provinces. Three anti-sea lice pesticides (lufenuron, teflubenzuron, emamectin benzoate and metabolite desmethyl emamectin benzoate), and one antibiotic (oxytetracycline) were detected. Concentrations were often below limits of quantification. Values are also lower than those reported in other aquaculture salmon-producing countries. Highest concentrations, along with organic enrichment, were observed ~200 m of cages with lower concentrations detected up to 1.5 km away. Most samples had at least two drugs present: 75.2 % (British Columbia), 91.4 % (Newfoundland), and 54.8 % (New Brunswick/Nova Scotia) highlighting the potential for cumulative effects. Emamectin benzoate and oxytetracycline were detected four and three years respectively after last known treatments, demonstrating the need for research on overall persistence of compounds.

His452Tyr 5-HT2A polymorphism and intravaginal ejaculation latency time in Dutch men with lifelong premature ejaculation.

Lifelong premature ejaculation (LPE) may have heritable components. Selective serotonin reuptake inhibitors have been proven effective in prolonging intravaginal ejaculation latency time (IELT). Given that serotonergic pathways are involved in the ejaculation mechanism, we aimed to investigate whether His452Tyr, also known as the C1354T (RS6314) polymorphism of the 5-HT2A receptor, contributes to LPE pathogenesis and IELT differences among patients with LPE. Dutch Caucasian men with LPE (n = 65) attending the Outpatient Department of Neurosexology, HagaZiekenhuis for drug treatment for LPE in 2009 were selected and included in this case-control study. IELT during coitus was measured using a stopwatch, and all men were genotyped for the His452Tyr polymorphism. Analysis of variance (ANOVA) was performed to determine the association between the genotypes and IELTs. Mean IELTs with standard deviations were 29.7 (±20.9), 31.5 (±14.7), and 26.0 s, and the frequencies were 83.1%, 15.4%, and 1.5% for the CC, CT, and TT groups, respectively, with an average IELT of 29.9 s. No difference in mean IELT was observed between these groups. In the affected group, the frequencies of alleles C and T were 90.8% and 9.2%, respectively; whereas those among randomly selected European Caucasian male controls (n = 503) from the CEPH database were of 92.0% and 8.0%, respectively. No significant difference was observed between the groups. Therefore, no correlation was found between the His452Tyr polymorphism and IELT distribution in patients with LPE.

[Study on the dynamic changes of peripheral platelet-to-lymphocyte ratio in the prognosis of neoadjuvant chemotherapy patients with gastric cancer].

Objective: To investigate the significance of platelet lymphocyte ratio (PLR) before and after neoadjuvant chemotherapy in advanced gastric cancer (AGC). Methods: The medical records of 247 AGC patients who underwent surgery between May 2015 and October 2016 were retrospectively reviewed. The relationship between PLR value and its changes before and after neoadjuvant therapy and clinicopathological features and prognosis was further analyzed. Results: △PLR was defined according to the different states of PLR before and after neoadjuvant therapy. If negative value was defined as"Reduced Group"(138) and positive value or 0 was defined as "Unreduced group"(109). There were statistical differences between the two groups of△PLR in tumor size, nerve invasion, presence or absence of vascular tumor thrombus, ypT staging, ypN staging, ypTNM staging, and pathological response (all P<0.05), but there was no statistical difference between age, gender, and postoperative adjuvant chemotherapy (all P>0.05). Survival analysis showed that the 5-year disease-free survival rates between the two groups were 39.0% and 54.0%, respectively (P=0.025); the 5-year overall survival rates between the two groups were 41.8% and 58.1%, respectively (P=0.035); the difference were statistically significant. Multivariate analysis showed that ypT3-4 stage, ypN3b stage and △PLR were independent risk factors for 5-year disease-free survival rate (HR=2.731/2.676, 95%CI: 1.026-7.268/1.014-6.985; HR=4.717, 95%CI: 1.922-11.579; HR=2.854, 95%CI: 1.117-4.124; all P<0.05) and 5-year overall survival rate (HR=3.226/2.655, 95%CI: 1.280-9.227/0.945-7.548; HR=4.550, 95%CI: 1.842-11.239; HR=2.897, 95%CI: 1.049-5.251; all P<0. 05). Conclusion: △PLR can better predict the prognosis of AGC patients receiving neoadjuvant chemotherapy.

Standard practice of presacral exposure during transvaginal natural orifice transluminal endoscopic surgery for sacrocolpopexy.

We describe the standard practice of presacral exposure during transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for sacrocolpopexy in women with uterine prolapse. In this video, we demonstrate the key techniques: identifying the right hypogastric nerve (rHN) before opening the pelvic peritoneum; removing the fat and loose connective tissue along the rHN to expose the presacral fascia; incising the presacral fascia to reach the presacral space to expose the middle sacral vasculature and the anterior longitudinal ligament (ALL) of the first sacral vertebra (S1) below the promontory; attaching the mesh to the ALL to avoid vessel injury; and completing the peritonealisation.

The extracellular vesicular pseudogene LGMNP1 induces M2-like macrophage polarization by upregulating LGMN and serves as a novel promising predictive biomarker for ovarian endometriosis recurrence.

STUDY QUESTION: How does ectopic endometrial stromal cell (Ecto-ESC)-derived extracellular vesicular Legumain pseudogene 1 (EV-LGMNP1), a newly identified pseudogene of Legumain (LGMN), contribute to M2-phenotype macrophage polarization, and does it predict recurrence in patients with ovarian endometriosis (EMs)? SUMMARY ANSWER: EV-LGMNP1, which is abundant in Ecto-ESCs and serum from ovarian EMs, can direct macrophages towards an M2 phenotype by upregulating LGMN expression and is a promising biomarker for predicting ovarian EMs recurrence. WHAT IS KNOWN ALREADY: Extracellular vesicles (EVs) can mediate cell-to-cell crosstalk to promote disease progression via cargo molecule transport. Recently, LGMNP1, a newly identified pseudogene of LGMN, has been reported to promote cancer progression by upregulating LGMN. LGMN is a well-studied protein that can induce M2-like polarization. STUDY DESIGN, SIZE, DURATION: An in vitro study was conducted with Ecto-ESCs isolated from ectopic endometrial samples, collected from two patients with ovarian EMs (diagnosed by laparoscopy and histological analysis). A clinical retrospective cohort study of 52 ovarian EMs patients and 21 controls with available preoperative serum samples was carried out (2013-2017). The follow-up period ended either at the time of recurrence or on 31 December 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS: Ecto-ESC-derived EVs (EV/Ecto-ESCs) were characterized by nanoparticle tracking analysis, transmission electron microscopy and western blotting. EV internalization by THP-1 cells, which are the most widely used primary human macrophages model, was detected by fluorescence labelling. After EV treatment, THP-1 cell polarization was detected by quantitative real-time PCR (qRT-PCR) and western blot analyses of CD86 (M1-related marker) and CD206 (M2-related marker). LGMNP1 mRNA expression level in EVs from both primary ectopic endometrioc stromal cells and serum was examined using qRT-PCR. Additionally, the expression of LGMN, the downstream target gene of LGMNP1, in THP-1 cells was evaluated using qRT-PCR and western blotting. Kaplan-Meier and multivariate Cox regression analyses were applied to evaluate the independent predictive factors of EMs recurrence-free survival. A novel nomogram model based on serum EV-LGMNP1 was then formulated to predict EMs recurrence. MAIN RESULTS AND THE ROLE OF CHANCE: In vitro assays demonstrated that EV/Ecto-ESCs drove macrophages towards an M2-like phenotype. Moreover, LGMNP1 contributed to EV/Ecto-ESC-induced M2 macrophage polarization by upregulating LGMN mRNA expression levels. Clinically, serum EV-LGMNP1 was more highly expressed in recurrent EMs patients than in controls and EMs patients without recurrence. Survival analysis and our novel nomogram reconfirmed that serum EV-LGMNP1 was a novel promising and meaningful non-invasive biomarker for predicting EMs recurrence. LARGE SCALE DATA: N/A. LIMITATIONS, REASONS FOR CAUTION: In vitro experiments were only performed on samples from two patients with ovarian endometriosis, and a larger sample size is needed. ESCs isolated from the eutopic endometrium of EMs and non-EMs patients should be studied in the future. Additionally, in vitro experiments should be performed using endometrial epithelium cells and further in vivo experiments, such as using mice endometriotic models to investigate whether EV/Ecto could induce M2 macrophage polarization, should be conducted. Moreover, multicentre, large-sample data are needed to validate our predictive nomogram model. WIDER IMPLICATIONS OF THE FINDINGS: Our study provides novel insights into the mechanism of M2 polarization involved in ovarian EMs progression mediated by an 'EV-shuttled pseudogene LGMNP1' mode. In addition, serum EV-LGMNP1 may serve as a novel non-invasive biomarker for predicting recurrence, providing a new therapeutic target for ovarian EMs. STUDY FUNDING/COMPETING INTEREST(S): This project was supported by funding from the National Natural Science Foundation of China (81971361), the Natural Science Foundation of Shanghai Science and Technology (19ZR1406900), the Shanghai 'Rising Stars of Medical Talent' Youth Development Program (AB83030002019004), the Clinical Research Plan of SHDC (SHDC2020CR4087), the Shanghai Municipal Health Commission (202040498), the Research and Innovation Project of the Shanghai Municipal Education Commission (2019-01-07-00-07-E00050) and the Clinical Research Plan of SHDC (SHDC2020CR1045B). There are no competing interests to declare.

[Short-term effect of thoracoscopy-assisted mitral valvuloplasty in patients with mitral valve prolapse].

The data of 56 patients with mitral valve prolapse undergoing thoracoscopy-assisted mitral valvuloplasty in the Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University from May 2019 to December 2020 were retrospectively analyzed. Among them, 31 cases were male and 25 cases were female, with a mean age of (45±14) years. There was no death during perioperative period. No patient was converted to median sternotomy. The duration of cardiopulmonary bypass (CPB), aortic cross-clamp and operation was (207±58) min, (134±59) min, and (374±90) min, respectively. The intraoperative blood loss was (690±268) ml, and 5 (8.9%) patients required blood transfusion. Postoperative mechanical ventilation duration was (19±9) h, and 24-hour pleural fluid drainage volume was (460±247) ml. The length of intensive care unit (ICU) and hospital stay was (25±6) h and (13±4) d, respectively. Therefore, thoracoscopy-assisted mitral valvuloplasty has the advantages of reliable curative effect, less trauma, less complications, fast recovery and satisfactory perioperative outcomes.

Assessing trace-elements as indicators of marine finfish aquaculture across three distinct Canadian coastal regions.

Several trace-elements have been identified as indicators of finfish aquaculture organic enrichment. In this study, sediment sampling at finfish farms was completed as part of an Aquaculture Monitoring Program in three distinct Canadian regions. Despite diverse datasets, multivariate analyses show a consistent clustering of known direct (Cu and Zn) and indirect (Cd, Mo and U) tracers of aquaculture activities with sediment organic matter (OM) and/or total dissolved sulfides concentrations. OM content was also a predictor of Cu, Zn, Mo and U concentrations according to decision tree analyses. Distance from cages did not emerge as a strong driver of differences among sampling points; however, a tendency towards negative associations is clear especially for Zn. Enriched stations as determined after geochemical normalization were mostly localized within 150 m of net-pens. Selected trace-elements (in particular Zn) can be useful indicators of aquaculture organic enrichment in different ecosystems and valuable tools for monitoring programs.

[Short-term and long-term outcomes of tricuspid valve replacement in patients with left ventricular dysfunction].

Objective: To examine the short-term and long-term outcomes of tricuspid valve replacement (TVR) in patients with left ventricular dysfunction. Methods: The clinical data of 24 patients with left ventricular dysfunction who received TVR at Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University from November 1993 to August 2018 were consecutively enrolled. There were 14 males and 10 females,aged (41.9±13.2) years old (range: 19 to 66 years old). The preoperative ejection fraction was (42.9±6.4)% (range: 21% to 49%), while less than 35% in 3 patients. The scores of Charlson comorbidity index were as follows: 5 patients for 0, 6 patients for 1, 7 patients for 2, 1 patient for 3 and 5 patients for 4. The European system for cardiac operative risk evaluation (EuroSCORE) Ⅰ was 3.6±2.1 (range: 1 to 9). The EuroSCORE Ⅱ was (4.91±2.40)% (range: 1.58% to 11.60%). The model for end-staged liver disease score was 1.8±1.2 (range: 0.2 to 7.1). The simplified model for end-staged liver disease score was 5.6±2.5 (range: 1.5 to 13.4). Follow-up was conducted by clinic. The long-term survival rate was calculated by Kaplan-Meier survival curve. Results: In-hospital mortality was 16.7% (4/24), including 1 patient for multiple organ failure and 3 patients for low cardiac output syndrome (LCOS). One patient needed continuous renal replacement therapy and 6 patients suffered from LCOS. The follow-up time was 1 to 19 years, with a median of 8 years. During the follow-up period, 4 patients died, including 2 deaths for cardiogenic cause, 1 death for anticoagulant complications, and 1 death for lung cancer. The 1, 5 and 10-year survival rates were 76.2%, 71.4% and 64.9%, respectively. Conclusion: The short-term and long-term clinical outcomes of TVR in patients with left ventricular dysfunction are acceptable, but the mortality and morbidity are still high.

[Impacts of incomplete revascularization following off-pump coronary artery bypass grafting on perioperative outcomes in octogenarians].

Objective: To assess the impacts of incomplete revascularization following off-pump coronary artery bypass grafting (OPCABG) on perioperative outcomes in octogenarians. Methods: A retrospective analysis of 242 octogenarian patients with coronary artery disease (CAD) hospitalized in Beijing Anzhen Hospital from June 2008 to July 2016 was performed. These patients were divided into the complete revascularization group (n=181) and the incomplete revascularization group (n=61) depending on whether they underwent complete revascularization. The impacts of incomplete revascularization following OPCABG on perioperative outcomes were summarized and compared between the two groups. Results: Among the 242 patients over 80 years who received OPCABG, there were 198 males (81.8%). Compared to the complete revascularization group, those in the incomplete revascularization group were older [(83.2±1.5) vs (81.5±1.1) years old, P=0.03], with more carotid stenosis (44.3% vs 25.4%, P=0.01), more involved in the diagonal and circumflex branch of coronary artery (49.2% vs 17.1%, P=0.01; 83.6% vs 70.2%, P=0.03), shorter operative time [(4.1±1.7) h vs (4.7±1.2) h, P=0.03), longer preoperative [(7.1±2.3) d vs (5.2±2.0) d, P=0.01] and total hospitalization time [(16.3±6.8) d vs (12.5±4.2) d, P=0.01], however, the differences of the in-hospital mortality and incidence of other perioperative complications were not statistically significant between the two groups (all P>0.05). Conclusion: Compared with complete revascularization, incomplete revascularization following OPCABG in CAD patients over 80 years old does not increase the perioperative mortality and the incidence of other complications, and it reduces the operative time. However, it increases the time of preoperative and total hospital stay.

[Perioperative outcomes in off-pump coronary artery bypass grafting patients older than 80 years with left ventricular dysfunction or left ventricular normal: a comparative study based on propensity score matching].

Objective: To examine the outcome of off-pump coronary artery bypass (OPCAB) in elderly patients with left ventricular dysfunction. Methods: From June 2008 to July 2016, 252 patients aged over 80 years underwent isolated OPCAB at Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, these patients' data were collected. The left ventricular dysfunction group (ejection fraction (EF): 35% to 50%) was comprised of 31 patients aged (82.0±2.1) years (range: 80 to 88 years), including 25 males and 6 females. Through matching one-to-one on propensity scores, 31 patients (EF>50%) were included into the left ventricular normal group. Among them, there were 25 males and 6 females, aged (81.9±1.9) years (range: 80 to 89 years). Postoperative mortality and complications between the matched groups were compared using the t test, Wilcoxon rank-sum test, χ(2) test or Fisher exact test. Results: Between the dysfunction group and normal group, the preoperative serum creatinine was 144.6(66.0) µmol/L vs. 94.9(43.2) µmol/L (M(Q(R)), Z=3.177, P=0.033), respectively, while the pre-discharge serum creatinine was 147.0(59.0) µmol/L vs. 92.0(24.0) µmol/L (Z=-2.685, P=0.007), respectively. In dysfunction group, the perioperative intra-aortic balloon counterpulsation (IABP) utilization rate was higher (25.8%(8/31) vs. 3.2%(1/31), P=0.026), the total hospitalization day was longer (17(15) days vs. 14(8)days, Z=2.054, P=0.012), the preoperative hospitalization day was longer too (7(7) days vs. 5(4) days, Z=-2.457, P=0.014). However, there was no significant difference in the incidence of postoperative mortality (9.7%(3/31) vs. 3.2%(1/31), P=0.612) and other prognostic indicators between the two groups. Conclusions: The elderly patients, with light and moderate left ventricular insufficiency, are characterized by the abnormal increase in renal function and the rise of IABP utilization due to hemodynamic disorder in OPCAB perioperative period. Preoperative treatment for cardiac insufficiency may be the cause of prolonged preoperative and total hospital stay. However, there is no significant difference in the postoperative mortality and other complications compared with the patients of normal left ventricular function.

[Oncologic outcomes of early stage cervical cancer performed operation by different laparoscopic surgical procedures: analysis of clinical data from mutiple centers].

Objective: To evaluate the oncologic outcomes of different laparoscopic radical hysterectomy. Methods: From January 2011 to December 2014, the laparoscopic operation cases of cervical cancer at stage Ⅰb1, Ⅰb2, Ⅱa1 and Ⅱa2, including the histologic subtypes of squamous-cell carcinoma, adenocarcinoma and adenosquamous carcinoma, were collected in five clinical centers. The data were divided into two groups according to the surgical procedures, that is, modified laparoscopic-vaginal radical hysterectomy (mLVRH) and total laparoscopic radical hysterectomy (TLRH). The overall survival rate (OS), disease-free survival rate (DFS) at 5 years were retrospectively analyzed in this study. Results: There were 674 cases in total, including 377 cases of mLVRH, 297 cases of TLRH. (1) The OS at 5 years: the mLVRH was 96.1% and the TLRH was 92.0%, and the mLVRH was higher than that of TLRH （P=0.010）. Stratify analysis， including stage of disease （Ⅰb1 and Ⅱa1）， histologic subtypes （squamous-cell carcinoma, adenocarcinoma）， lymph node metastasis， revealed that, ① Stage of disease: in stage Ⅰb1, the OS at five years of mLVRH was higher than that in TLRH group （98.6% vs 93.6%, P=0.012）. In stage Ⅱa1, there was significant difference between the two groups, the OS at five years of mLVRH and TLRH were 93.6% and 77.6% （P=0.007）. ② Histologic subtypes: for the OS at five years of squamous-cell carcinoma, mLVRH and TLRH were 96.1% and 92.3%, and there was significant difference （P=0.046）； for adenocarcinoma, the OS at five years were 91.0% and 88.6%， and there was no difference between two groups （P=0.230）. ③ Lymph node metastasis： the mLVRH and TLRH with lymph node metastasis, the OS at five years were 98.6% and 96.4%; the mLVRH and TLRH without lymph node metastasis, the OS at five years were 89.3% and 80.8%. There were no significant differences between the two groups,respectively (P=0.156， P=0.093）. (2) The DFS at 5 years: there was no significant difference between mLVRH and TLRH (94.1% vs 90.9%, P=0.220). Stratify analysis for stage of disease, the mLVRH group was higher than that in the TLRH group in stage Ⅰb1 (97.0% vs 92.8%, P=0.039). However, for stage Ⅱa1, there was no significant difference between mLVRH and TLRH group （88.2% vs 75.8%, P=0.074）. Conclusions: The results of this retrospective study indicated that different laparoscopy surgical procedures had diverse oncologic outcomes. The OS at 5 years of the mLVRH is superior to the TLRH. The DFS at 5 years in Ⅰb1 stage, the mLVRH is higher than the TLRH. Therefore, the modified laparoscopy is still an alternative surgery for early cervical cancer patients when following the principle of no-tumor-exposure.

[A convenience sampling questionnaire survey of the current status of diagnosis and treatment of endometriosis in China in 2018].

Objective: To further understand the current status of diagnosis and treatment of endometriosis in China, the implementation of guideline in different levels of hospitals, and the need for continuing education in endometriosis among primary doctors. Methods: The survey was conducted in the form of convenience sampling questionnaire among the Wechat public platform. The doctors were free to participate in the investigation without any reward. All questions answered were assessed as valid questionnaire. The datas were collected on the questionnaire network platform and analyzed by SPSS 19.0. Results: Totally 1 494 valid questionnaires were collected in this survey. 60.17% (899/1 494) of them were from tertiary hospital, and 32.60% (487/1 494) were from grade two hospital. Only the hospitals where 9.97% (149/1 494) participants based opened the specialist clinic for endometriosis. 70.35% (1 051/1 494) of participants said they had read the second edition of guideline for the diagnosis and treatment of endometriosis which published in 2015. The American Society for Reproductive Medicine (ASRM) staging system was adopted in the clinical practices of only 25.03% (374/1 494) participants. And 18.74% (280/1 494) participants used the endometriosis fertility index (EFI) scoring during the laparoscopic surgery for endometriosis with infertility. 45.18% (675/1 494) of participants said they had not attended any academic conference on endometriosis in the past six months. 64.46% (963/1 494) of the participants believed their diagnosis and treatment in practice should be improved and standardized. 87.15% (1 302/1 494) of the participants expressed the hope that more conferences or workshops on endometriosis would be held. Conclusions: At presents, the diagnosis and treatment of endometriosis in China has been greatly improved, but the implementation of guidelines and the new concept is still a long-term job. The specialist clinic are held only in a few hospitals. It's the expectation and voice of primary doctors to the association to organize the more academic congresses on endometriosis.

[A comparative analysis of quality of life between surgical and interventional treatment in patients with complex coronary heart disease].

Objective: To compare the improvement of quality of life in the patients with left main coronary artery disease and multi-vessel disease between off-pump coronary artery bypass grafting (OPCABG) and percutaneous coronary intervention (PCI) within one year after revascularization. Methods: This study was a prospective study. Between January and July 2018, 840 patients with complex coronary heart disease accepted revascularization therapy, 420 of whom underwent OPCABG and 420 for PCI, with a mean age of 61 years and a male rate of 74% (622/840). European Quality of Life-5 Dimensions (EQ-5D) and Seattle Angina Questionnaire (SAQ) were employed to assess the quality of life and health status of patients. Inverse probability weighting (IPW) was used to adjust treatment selection bias. Results: All-cause mortality (3.6% vs 1.3%, P=0.045), major adverse cardiac and cerebrovascular events (MACCE) (11.3% vs 4.1%, P<0.001) and target lesion revascularization (8.3% vs 1.2%, P<0.001) were higher in PCI group than those in OPCABG group. EQ-5D scores in PCI group were significantly higher than those in OPCABG group at 1 month after operation (P<0.001), but there was no significant difference between the two groups at 12 months after operation (P=0.210). In SAQ scale, the frequency score of angina pectoris in OPCABG group was higher than that in PCI group in 1 month, 6 months and 12 months after operation (all P<0.05). The physical activity limitation score in PCI group was significantly higher than that in OPCABG group at one month after operation (P<0.01). There was no significant difference between OPCABG group and PCI group in terms of stable state of angina pectoris, satisfaction of treatment and the knowledge of disease. Conclusions: In the short term, the quality of life of patients with left main coronary artery disease and multi-vessel disease treated with OPCABG is better than PCI. However, the improvement of quality of life in the medium and long term still needs to be identified in future follow-up study.

Modified Model of Whole Ovary Transplantation in Rats.

OBJECTIVE: A rat model of right whole ovary transplantation is difficult to establish because of an unfit location or absence of the right ovarian artery. The purpose of this study is to develop a rat model of left whole ovary transplantation. METHODS: Two methods of whole ovary transplantation were performed. In Group A (n = 40), the rats underwent right whole ovary grafting via conventional orthotopic allotransplant, with donor abdominal aorta and inferior vena cava end-to-side anastomoses to the recipient abdominal aorta and inferior vena cava. In Group B (n = 40), the rats underwent left whole ovary graft via orthotopic allotransplant, with donor abdominal aorta and left renal vein end-to-side anastomoses to the recipient abdominal aorta and inferior vena cava. Bilateral native ovariectomy in the recipient was performed immediately in both groups. The operative times, recipient survival rates, and transplanted ovarian function were measured. RESULTS: There was no significant difference in the success rates of transplant between the 2 groups, with 92.5% and 90% success, respectively. All the living recipients recovered ovarian function. However, the operative time for the donor, the vein anastomosis time, and the cold ischemia time decreased significantly in Group B (P < .05). CONCLUSION: The modified method of left whole ovary transplantation is reliable and easy to perform, which could significantly shorten the times of graft harvest and cold ischemia. The method is a good supplement and improvement of the conventional model of rat whole ovary transplantation.

[Short-term clinical safety and efficacy of No-touch great saphenous vein harvesting technique for off-pump coronary artery bypass grafting].

Objective: To evaluated early clinical outcomes of saphenous vein grafts harvested with a No-touch technique in off-pump coronary artery bypass graft (OPCABG) surgery. Methods: A total of 124 patients with three-vessel disease undergoing OPCABG by No-touch technique between June and November 2017 in Beijing An Zhen Hospital were respectively reviewed. Results: The average age of patients was (60.7±10.3) years, and 80 cases (64.5%) were male, with the average body mass index (BMI)of (25.4±2.5) kg/m(2,) the mean preoperative left ventricular ejection fraction (LVEF) of (58.0±7.0%). The operative time was (4.0±0.4) hours, and 16 cases (12.9%) were harvested for whole vein grafts. The number of vein grafts and venous anastomoses was 144 and 284, respectively. There were 16 cases of single bridge NTSVG-LAD, 4 cases of single bridge NTSVG-D, 99 cases of sequential bridge NTSVG-OM-PDA, 5 cases of sequential bridge NTSVG-OM-PLV, 4 cases of sequential bridge NTSVG-OM-RCA, 16 cases of sequential bridge NTSVG-D-OM-PDA. The mean flow volume of No-touch vein grafts was (51.9±2.4) ml/min. There was no death case in hospital. Postoperative re-exploration for hemorrhage of anastomosis happened in 1 case (0.8%), which was caused by pericardial tamponade due to insufficiency of hemostasis in internal mammary bed. There were 1 case of bad wound healing of lower extremity incision (0.8%). A total of 124 cases were followed up after operation, and the follow-up rate was 100%. There was one all-cause death (0.8%) 27 days after the operation. Conclusion: The short-term clinical observation of the application of No-touch great saphenous vein harvesting technique for OPCABG is safe and effective.

[Complete androgen insensitivity syndrome associated with vesical fistula: a case report and literature review].

Androgen insensitivity syndrome (AIS) is a very uncommon genetic disorder that results from the resistance of androgen receptor (AR) to androgen, which influences the formation of the male genitalia and in turn presents with female phenotype. Surgical resection of undesceaded testicle and different kinds of genitoplasty are crucial methods to correct the deformity of reproductive system, as well as hormone replacement therapy, which is an essential therapy for postoperational rehabilitation in AIS patients. A 43-year-old patient, who was socially female, was first admitted to gastroenterology department due to recurrent ascites and occasional abdominal pain with unknown origin. Taking physical examination, ultrasonography, karyotype analysis and sex hormone levels into consideration, the overall manifestations revealed the typical clinical features of complete androgen insensitivity syndrome. After that she was transferred to urology department for laparoscopic gonadectomy. During the surgery, doctors found that there was a vesical fistula on the upper wall near the conjunction between the bladder and ligamenta umbilicale medium, which explained the recurrent ascites for more than 4 years. After resecting the testicles and the tissues around the vesical fistula for histopathology, the result suggested Sertoli cell adenoma, hyperplastic Leydig cells and urothelium atypical hyperplasia. Hormone replacement therapy was given right after discharge. The hormone levels of follicle-stimulating hormone, luteinizing hormone, estradiol and progesterone were modulated by the dysfunction of androgen production after gonadectomy and hormone replacement therapy together with psychotherapy could stabilize her hormone levels and improve the quality of her life. The patient was suspicious of AIS family history and the pedigree was made to analyze her family which was possibly X-linked recessive pattern. We propose three possible hypotheses of the fistula, which are direct surgical injury, recurrence of bladder cancer and congenital urachal anomalies. But whether it is relevant between urachal anomalies and AIS is yet to be discovered.

[Short-term clinical outcomes and risk factors associated with in-hospital mortality in patients undergoing off-pump coronary artery bypass grafting].

Objective: To explore short-term clinical outcomes and risk factors associated with in-hospital mortality in patients undergoing off-pump coronary artery bypass grafting (OPCABG) and establish a prediction model for in-hospital mortality. Methods: The clinical data of patients undergoing OPCABG in Beijing Anzhen Hospital between January 2014 and January 2016 was retrospectively studied. Univariate analysis and logistic regression were applied to determine the potential risk factors, and then a prediction model for mortality was confirmed. The calibration and discrimination of the prediction model was finally tested. Results: A total of 2 546 patients who underwent OPCABG were recruited. In-hospital mortality of OPCABG was 0.7% (17 cases). Seven variables: female, age, left main disease >50%, low left ventricular ejection fraction (LVEF), acute myocardial infarction before surgery, operative status (selective or emergent), moderate concomitant mitral valve regurgitation were independently correlated with OPCABG mortality (all P<0.05). The result of Hosmer-Lemeshow test was χ(2)=5.912, P=0.676. The area under receiver-operating characteristic curve (ROC) was 0.881. Conclusions: OPCABG is safe and effective for myocardial revascularization in a short term. The following risk factors are associated with an increased operative mortality of OPCABG: male, age, left main disease >50%, low LVEF, acute myocardial infarction before surgery, operative status (selective or emergent), moderate concomitant mitral valve regurgitation. The prediction model established by above-mentioned potential risk factors was proven to perform well by statistical tests.