Objective To evaluate the effect of probiotics on inducing and maintaining remission of ulcerative colitis (UC). Methods PubMed, EMBase, Web of Science and The Cochrane Central Register of Controlled Trials from 1966 to 2009 (up to August), and China Journal Full-text Database, Chinese Technologic Journal Database (Weipu), Wan Fang Digital Journal Full-text Database from 1978 to 2009 (up to August) were retrieved in order to collect clinical randomized controlled trials regarding the effect of probiotics in remission induction and maintenance in UC patients. Statistical analysis was performed by meta-analysis using Review Manager 4.2.10. Results Eleven randomized controlled trials met the inclusion criteria, of which five studies were included in the control trial of probiotics and placebo to evaluate the clinical remission rate, seven studies were included to compare probiotics with placebo (3 trials) or with mesalazine (4 trials) to evaluate the clinical relapse rate (one of the trials was included in the induction treatment group and the maintenance treatment group). Meta-analysis showed that: a) On the basis of combining with conventional therapy, probiotics were superior to placebo in clinical remission rate (OR=0.28, 95%CI: 0.16-0.49, P

Objective To investigate the clinical effect of ulinastatin in preventing pancreatitis after endoscopic retrograde cholangiopancre-atography (ERCP).Methods The Cochrane Library,PubMed,EMBASE,CNKI,VIP,and Wanfang Data were searched for randomized controlled trials (RCTs)on ulinastatin for the prevention of post -ERCP pancreatitis published from 1970 to June 2016.Two researchers se-lected RCTs,extracted data,and evaluated methodological quality independently,and RevMan 5.3 software was used for the meta -analy-sis.The chi -square test was used for the heterogeneity analysis of RCTs included,and the funnel plots were used to evaluate publication bi-as.Results A total of six RCTs with 923 patients were included in this analysis.Compared with the placebo,ulinastatin had significantly better effects in preventing post -ERCP pancreatitis (OR =0.26,95%CI:0.13 -0.53,P =0.000 2),hyperamylasemia (OR =0.47, 95%CI:0.33 -0.67,P <0.001),and abdominal pain (OR =0.56,95%CI:0.34 -0.91,P =0.020).Compared with gabexate,uli-nastatin had similar effects in preventing post -ERCP pancreatitis,hyperamylasemia,and abdominal pain (P =0.52,0.13,and 0.79);low -dose ulinastatin also had similar effects as gabexate in preventing post -ERCP pancreatitis and hyperamylasemia (P =0.49 and 0.25).The funnel plots based on the effect of ulinastatin in preventing post -ERCP pancreatitis were slightly asymmetric,which suggested the presence of publication bias.Conclusion Ulinastatin (≥15 ×104 U)can effectively prevent post -ERCP pancreatitis,hyperlipi-demia,and abdominal pain in the general population and it is recommended to start using this drug before surgery.

AIM To study the protection of 6,7 dimethexycoumarin on hypoxic animals. METHODS The effect of 6,7 dimethexycoumarin on survival time and survival rate of mice subjected to hypobaric, normobaric and chemical hypoxia were observed and the oxygen consumption of isolated tissues were measured. RESULTS 6,7 dimethexycoumarin obviously prolonged the survival time and promoted the survival rate of hypoxic mice, increased the mouth opening time of isolated mice and reduced the oxygen consumption of isolated cardiac muscle of mice. This contributes to exploring the mechanism of antiradiation and poison reducing of 6,7 dimethexycoumarin. CONCLUSION 6,7 dimethexycoumarin shows remarkable effect on tolerance to hypoxia in mice.

Objective To investigate the efficacy and safety of percutaneous microwave ablation in the treatment of hypersplenism.Methods From March 2007 to May 2011,38 patients with hepatitis B virus caused liver cirrhosis and complicated with hypersplenism received percutaneous microwave ablation treatment for several times.Before percutaneous microwave ablation treatment,the volume of spleen was calculated according to 3D computed tomography (CT) scan.Ultrasound,blood routine,urine routine,liver function test,kidney function test,serum amylase and lipase were also tested.For the first time,1/3 volume of spleen was ablated.If no complication were observed in one week after ablation,then another 1/3 volume of spleen was ablated.Blood routine and liver function test were checked on the 1st,3rd and 5th day after microwave ablation.Blood routine,liver function test and ultrasound were examined on 7th and 14th day after microwave ablation.On the 30th day CT examination was conducted.Ultrasound,blood routine,urine routine,liver function test,kidney function test,serum amylase and lipase were detected at one month,three month and every three month after microwave ablation.The follow up duration was over two years.The t-test was performed for clinical data comparison.Results The mean ratio of ablated spleen was (47 ±5)％ (range 41％ to 57％).Preoperative white blood cell count was (2.46±0.78)× 109/L,which gradually increased after operation and peaked on the 3rd day after operation ((5.34 ± 2.10) × 109/L).Then gradually decreased,which was (3.16 ± 1.02) × 109/L at 24 month and the difference was statistically significant compared with that of preoperation (t=-3.349,P＜0.01).Preoperative platelet count was (46.58 ± 17.30) × 109/L,which gradually decreased after operation and was lowest on the 3rd day after operation.Then gradually increased,which peaked at 30 days after operation ((101.79 ± 25.80) × 109/L) and then gradually decreased,which was (61.97 ± 15.09) × 109/L at 24 month and the difference was statistically significant compared with that of preoperation (t＝-4.135,P＜0.01).The inner diameter of portal vein was (14.66±0.88) mm preoperation,which was (13.22±0.64) mm at three month after operation and the difference was statistically significant compared with that of preoperation (t=8.145,P＜0.01).It was (14.64±0.81) mm at six month after operation and the difference was not statistically significant compared with that of preoperation (P＞ 0.05).The major adverse effects were fever,left upper abdominal pain,left shoulder pain,pleural effusion,intraperitoneal hemorrhage and temporary hemoglobinuria which all recovered after symptomatic treatment.No severe complication such as uncontrollable bleeding,splenic abscess,spleen rupture and the surrounding organ injury and treatment related death were observed.Conclusion Percutaneous microwave ablation for several times could safely destroy suitable volume of spleen,increase platelet and white blood cell count,improve portal hypertension and with rare complications,which might be a minimally invasive techniques with clinical application value in the treatment of the hypersplenism.

Objective To study the feasibility, safety and clinical application value of LRH, comparing with abdominal radical hysterectomy (ARH) . Methods A total of 80 patients' clinical data were collected to analyze the development of LRH in Yunnan Tumor Hospital while compared with another 40 patients between June 2012 to June 2013 of ARH for some associative indexes. Results The patients were divided into group A and B equally.Compared with Grope A, the time of operation decreased 26.9%, 37.2% has been augment for lymph gland sweeping, the amount of bleeding and intraoperative complication reduced 37.3% and 7.5% in Grope D, respectively, with distinctive difference ( >0.05) .Hospitalization expenses had a small degree reduced but no distinctive difference.The learning curve of LRH was 40 approximately.Comparison between LRH and ARH in the same period showed that LRH was more splendid than ARH in several index.1 case relapsed in 2-48 months follow-up in ARH while no relapse in the other group. Conclusion LRH is safe and feasible and has good prospects in clinical application and deserves clinical generalization because of its advantages such as less trauma,less pains, quick recovery,less scars and aesthetical appearance.

Objective: To investigate the impact of temperature changes between neighboring days (TCN) on the mortality risk of respiratory diseases, so as to provide the evidence for the study of deaths from respiratory diseases caused by climate change. Methods: The monitoring data of deaths from respiratory diseases in Zibo City from 2015 to 2019 were collected from Shandong Provincial Management Information System for Chronic Diseases and Cause of Death Surveillance. The meteorological and air pollutant data of the same period were collected from China Meteorological Data Website and ChinaHighAirPollutants dataset. The effect of TCN on the risk of deaths from respiratory diseases was examined using a generalized additive model combined with a distributed lag non-linear model, and subgroup analyses for gender and age were conducted. The disease burden attributed to TCN at different intervals was assessed by calculating attributable fraction. Results: Totally 11 767 deaths from respiratory diseases were reported in Zibo City from 2015 to 2019, including 6 648 males (56.50%) and 5 119 females (43.50%). There were 1 307 deaths aged <65 years (11.11%), and 10 460 deaths aged 65 years and older (88.89%). A monotonically increasing exposure-response relationship was observed between TCN and deaths from respiratory diseases in the general population, females, and the population aged 65 years and older. The 95th percentile of TCN (P95, 3.84 ℃) reached the peak at a cumulative lagged of day 11 (RR=2.063, 95%CI: 1.261-3.376). The results of subgroup analyses showed greater impacts on females and the population aged 65 years and older, with cumulative lagged effects peaking at day 12 (RR=3.119, 95%CI: 1.476-6.589) and day 11 (RR=2.107, 95%CI: 1.260-3.523). The results of attributional risk analysis showed that next-day warming might increase the attributable risk of deaths from respiratory diseases, and next-day cooling might decrease the attributable risk. Conclusion Next-day warming may increase the mortality risk of respiratory diseases, and has greater impacts on females and the population aged 65 years and older.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

A young male diagnosed with severe hemophilia A since childhood, was presented with recurrent joint and urinary bleeding. Annualized bleed rates dropped below five with low dose prophylactic medication.Bleeding in the right knee joint recently aggravated. Due to coexisting HIV infection and advanced hemophilic arthritis, the patient was managed by a multi-disciplinary team(MDT).Total knee arthroplasty was performed by an experienced surgeon using modern prosthesis design and intraoperative navigation technologies.Physical and rehabilitation therapy was provided during the postoperative period, and joint function improved. The MDT managed the young patient with HIV infection and advanced hemophilic arthritis. The patient was diagnosed with osteoporosis thought to have been caused by hemophilia, HIV infection and antiviral drugs; and he received treatment. The treatment of this patient reflects the importance of multidisciplinary cooperation in the management of difficult and rare diseases.