Objective:To investigate the clinical effectiveness analysis on biliary stent combined with 125I seed implantation in the treatment of malignant obstructive jaundice.Methods:98malignant obstructive jaundice patients undergoing percutaneous transhepatic biliary drainage requirement of biliary stent were divided into combined group(n=53) and simple group(n=45).Patients in combined group were taken biliary stent combined with 125I seed implantation,while in simple group were only taken biliary stent.All patients were followed up for 4 to 28 months.The changes of total bilirubin were recorded before percutaneous bile duct drainage,7 d,30 d and 90 d after biliary stent implantation.The recurrences of biliary obstruction of the two groups were recorded.The changes of T lymphocyte subsets in peripheral blood were detected before percutaneous bile duct drainage and after biliary stent implantation 7 d.The survival times of the two groups were compared.Results:All patients were successfully completed biliary stent implantation,surgical success rate was 100％.The total bilirubin levels of patients in combined group 30 d and 90 d after stent implantation were significantly lower than the simple group,the differences were statistically significant (P＜0.05).After surgery 7 d,the CD4 level and CD4/CD8 ratio in combined group were increased compared with before surgery,while in the simple group were declined,the differences were statistically significant (P＜0.05).Compared with the simple group,the CD4 level and CD4/CD8 ratio in combined group after surgery 7d were significantly increased (P＜0.05).2 cases (3.8％) of patients were recurrence of biliary obstruction,which were lower than 17 cases (37.8％) in the simple group,the difference was statistically significant (P＜0.001).The median survival time in combined group was 10.6 months,which was significantly longer than 7.5 months in the simple group,the difference was statistically significant (P＜0.05).Conclusion:Biliary stent combined with 125I seed implantation in the treatment of malignant obstructive jaundice might relieve the symptom of biliary obstruction,and helped to improve cellular immune function of patients and reduce the recurrence of biliary obstruction.It had great significance to improve the quality of life of patients and prolong the survival time.

Objective To explore the executive function in patients with mild traumatic brain injury (mTBI). Methods The evaluation of executive function was conducted in 63 mTBI patients in 1 week, 1, 3 and 6 month after injury and 60 health controls. The executive function was evaluated using Trail Making Test (TMTA), Hopkins Verbal Learning Test-revised (HVLT-R), Brief Visuospatial Memory Test-revised (BVMT-R), Stroop Color Word Tes and Con-tinuous Performance Test (CPT). Results There were significant differences between mTBI patients and controls in TM-TA, HVLT-R, BVMT-R, Stroop Color Word Test and CPT a week following TBI (P<0.05). There were a significant in-crease in scores of TMTA and a significant decrease in HVLT-R, BVMT-R, stroop and CPT-IP at 1, 3 and 6 month compared with 1 week following TBI (P<0.05). There were a significant decrease in TMTA and a significant increase in BVMT-R and stroop 1 month compared with 1 week following TBI (P<0.05). There were a significant increase in stroop, BVMT-R and CPT-IP at 3 month compared with 1 month following TBI (P<0.05). There was a significant increase in stroop and CPT-IP at 6 month compared with 3 month following TBI (P<0.05). Conclusions Patients with mTBI have executive function impairment. The recovery times of different executive function are different in patients with mTBI.

Objective Proper selection of reconstruction method is the key point to get a successful result in nasal reconstruction.The purpose of the article is to evaluate the results of repairing the partial nasal defect with different surgical strategies.Methods Different surgical methods were used according to the area and type of nasal defects of nasal defects,the different sub-unit of nasal de fects and the different tissue damage levels.Local skin flaps,auricular composite tissue flaps,nasolabial skin flaps and superficial temporal artery pedicle flaps were used in these patients.Results 23 cases suffering from partial nasal defects were repaired with flaps or tissue graft,including 4 auricular composite tissue flap,5 nasolabial skin flap,3 forehead island flap with a pedicle of superficial temporal vessels,7 local flap,and 1 skin graft.After 5-16 months of follow-up,the color and texture around the nose were basically consistent,the appearance of nose was satisfactory,and the postoperative effect turned out fine.Conclusions The method of surgical reconstruction of partial nasal defects should be considered carefully according to the area of nasal defects,sub-unit of nasal defects and the different tissue damage levels.

Background/Aims: There may be many predictors of anticoagulation-related gastrointestinal bleeding (GIB), but until now, systematic reviews and assessments of the certainty of the evidence have not been published. We conducted a systematic review to identify all risk factors for anticoagulant-associated GIB to inform risk prediction in the management of anticoagulation- related GIB. Methods: A systematic review and meta-analysis were conducted to search PubMed, EMBASE, Web of Science, and Cochrane Library databases (from inception through January 21, 2022) using the following search terms: anticoagulants, heparin, warfarin, dabigatran, rivaroxaban, apixaban, DOACs, gastrointestinal hemorrhage, risk factors. According to inclusion and exclusion criteria, studies of risk factors for anticoagulation-related GIB were identified. Risk factors for anticoagulant-associated GIB were used as the outcome index of this review. Results: We included 34 studies in our analysis. For anticoagulant-associated GIB, moderate-certainty evidence showed a probable association with older age, kidney disease, concomitant use of aspirin, concomitant use of the antiplatelet agent, heart failure, myocardial infarction, hematochezia, renal failure, coronary artery disease, helicobacter pylori infection, social risk factors, alcohol use, smoking, anemia, history of sleep apnea, chronic obstructive pulmonary disease, international normalized ratio (INR), obesity et al. Some of these factors are not included in current GIB risk prediction models. such as anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction, etc. Conclusions The study found that anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction et al. were associated with anticoagulation-related GIB, and these factors were not in the existing prediction models. This study informs risk prediction for anticoagulant-associated GIB, it also informs guidelines for GIB prevention and future research.

OBJECTIVETo study the effect of Anthocyanin (Ay) on Cadmium-Induced Mouse testis Damage.

METHODSMouse testis damage model were constructed and testis malonaldehyde (MDA) and protein carbonxyl content (PCO), as well as catalase (CAT) and superoxide dismutase (SOD) were determined.

RESULTSThe intoxication of cadmium can cause the increase of MDA and PCO content in mouse testis (P < 0.05), however, the activities of SOD and CAT were altered (P < 0.01).

CONCLUSIONAy have the strong potent to scavenge free radicals, owing to its special chemical structures, and act as a protector to inhibit the oxidative stress induced by cadmium.

Animals ; Anthocyanins ; chemistry ; pharmacology ; Cadmium ; toxicity ; Catalase ; drug effects ; Male ; Malondialdehyde ; analysis ; Mice ; Oxidative Stress ; Protein Carbonylation ; drug effects ; Superoxide Dismutase ; drug effects ; Testis ; drug effects

OBJECTIVETo estimate the value of blastocyst culture for preimplantation genetic diagnosis (PGD).

METHODSDay 3 embryos were biopsied and analyzed with fluorescence in situ hybridization (FISH) technique. Embryos with normal FISH results were cultured into blastocysts, and the ones with better morphology scores were transferred. Fourteen embryos with abnormal FISH results were cultured into blastocysts. Part of the cells taken from the blastocysts were amplified by whole genomic amplification (WGA) and assessed by array-based comparative genomic hybridization (array-CGH) analysis.

RESULTSSix blastocysts with normal FISH results were transferred in 5 cycles. Four healthy babies of 3 cycles were delivered. Another one was a singleton pregnancy but with embryo growth arrest, whose villus karyotype was normal. Fourteen embryos with abnormal FISH results were cultured into blastocysts and analyzed by array-CGH. Six blastocysts were normal by array-CGH.

CONCLUSIONFISH combined with blastocyst culture may further ensure the accuracy of PGD result. Detection at the blastocyst stage can avoid false positive results and mosaic interferences on Day 3 stage and are therefore more authentic.

Adult ; Blastocyst ; cytology ; Comparative Genomic Hybridization ; methods ; Embryo Transfer ; Female ; Genetic Diseases, Inborn ; diagnosis ; embryology ; genetics ; prevention & control ; Humans ; In Situ Hybridization, Fluorescence ; methods ; Male ; Pregnancy ; Preimplantation Diagnosis ; methods

Osteoporotic proximal humeral fracture (OPHF) is one of the common osteoporotic fractures in the aged, with an incidence only lower than vertebral compression fracture, hip fracture, and distal radius fracture. OPHF, secondary to osteoporosis and characterized by poor bone quality, comminuted fracture pattern, slow healing, and severely impaired shoulder joint function, poses a big challenge to the current clinical diagnosis and treatment. In the field of diagnosis, treatment, and rehabilitation of OPHF, traditional Chinese and Western medicine have accumulated rich experience and evidence from evidence-based medicine and achieved favorable outcomes. However, there is still a lack of guidance from a relevant consensus as to how to integrate the advantages of the two medical systems and achieve the integrated diagnosis and treatment. To promote the diagnosis and treatment of OPHF with integrated traditional Chinese and Western medicine, relevant experts from Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine have been organized to formulate Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine ( version 2024) by searching related literatures and based on the evidences from evidence-based medicine. This consensus consists of 13 recommendations about the diagnosis, treatment and rehabilitation of OPHF with integrated traditional Chinese medicine and Western medicine, aimed at standardizing, systematizing, and personalizing the diagnosis and treatment of OPHF with integrated traditional Chinse and Western medicine to improve the patients ′ function.