Objective:To compare the clinical effects robot navigation assisted and conventional proximal femoral nail antirotation (PFNA) implantation and fixation in the treatment of elderly femoral trochanteric fractures.Methods:A total of 86 elderly patients with tuberosity fracture of the femur were admitted as research samples from January to March in 2022 in the Department of Trauma Orthopaedic, Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University, including 37 males and 49 females, who aged from 63 to 92 years, with an average age of (79.6 ± 6.9) years. All patients were treated with intramedullary nails (PFNA), 32 with dimensity robotic-assisted therapy (robot group) and 54 with traditional methods (conventional group). The length of incision, the number of intraoperative fluoroscopy, the amount of intraoperative blood loss, and the operation time were recorded. The occurrence of postoperative complications in the two groups was observed. The rate of excellent hip Harris score at 3 month after surgery was compared between the two groups. Measurement data with normal distribution were represented as mean ± standard deviation( ± s), and the comparison between groups was conducted using the t-test; the comparison of count data were represented as [ n(%)], and was conducted by Chi-square test or Fisher exact probability between groups. Results:All patients were followed up for 9 to 12 months, with an average of (10.6 ± 0.9) months. The incision length and tip apex distance (TAD) of the robot group were (3.40±0.82) cm and (21.85±1.44) mm, which were smaller than (4.82±0.75) cm and (26.83±1.75) mm in the conventional group ( P<0.05 for all). The number of intraoperative fluoroscopy and guide needle adjustment [(14.53±3.26) and 0 times] in the robot group were less than those in the conventional group [(20.67±4.84) and (2.83±1.42)] ( P<0.05). The intraoperative blood loss and drainage rate of the robot group were (87.03±9.41) and (46.40±8.91) mL, which were smaller than that of the conventional group [(110.00±12.52) and (69.62±10.22) mL] ( P<0.05). There was no significant difference in the number of days of hospitalization and operation time between the two groups ( P>0.05). The postoperative complication rate in the robot group was 9.4%, which was lower than that in conventional group (42.6%), and the difference was statistically significant ( χ2=11.88, P=0.036). The excellent rate of postoperative hip joint function in the robot group was 75.0%, and the conventional group was 66.7%, and there was no significant difference between the two groups ( χ2=0.66, P=0.416). Conclusion:Robot-assisted navigation downward PFNA surgery can have good clinical effect in the treatment of femoral tuberosity fracture in the elderly, which can reduce the number of surgical incisions and intraoperative fluoroscopy, and reduce the incidence of postoperative complications, which is helpful to achieve minimally invasive surgery and rapid recovery of elderly patients with femoral tuberosity fracture.

Objective:To understand the positive rate of 2019 novel coronavirus (2019-nCoV) specific IgG antibody induced by Coronavirus Disease 2019 (COVID-19) inactivated vaccine in healthy population in Xizang Autonomous Region, and evaluate the immune effect of the vaccine.Methods:Serum samples were collected from COIVD-19 vaccine immunized health population without history of 2019-nCoV infection from six prefecture-level cities in Xizang Autonomous Region. The IgG antibody against 2019-nCoV were tested by chemiluminescence method. Then, the positive rate of IgG antibody was analyzed for different immunization histories and age groups.Results:A total of 22 255 participants were enrolled in this survey. After full-access (two doses of vaccine) and booster immunization, the overall positive rate of specific IgG antibody against 2019-nCoV was 96.38%. The positive rate of IgG antibody in the booster immunized population was 97.12%, which was much higher than the 88.38% in the full-access immunization population, the difference is statistically significant ( χ2=381.11, P<0.001). There was a significant differences in the positive rates of specific IgG antibodies in different age groups ( χ2=138.28, P<0.001). Especially in the younger age groups, including less than 10 years old and the 11-20 years age group, the positive rate of specific IgG antibody were 93.44% and 89.03% respectively, which were lower than those in other age groups. Except for Naqu city and the age group ≤ 10 years old, the differences in antibody positivity rates were statistically significant between different age groups in the same region and between the different regions in the same age group for the two populations with different immunization histories ( P<0.05). Conclusions:The COVID-19 inactivated vaccine showed a good immune effect in the healthy population in Xizang Autonomous Region, and the booster immunization helps to increase the positive rate of specific IgG antibody in healthy population.

Objective:To investigate the application value of self-pulling and latter transection (SPLT) technique in double anti-reflux double-tract reconstruction of totally laparoscopic proximal gastrectomy.Methods:The retrospective cohort study was conducted. The clinicopatholo-gical data of 103 patients with Siewert type Ⅱ adenocarcinoma of esophagogastric junction in clinical stage Ⅰ-Ⅱ who were admitted to Shanxi Cancer Hospital from January 2018 to January 2020 were collected. There were 65 males and 38 females, aged from 45 to 79 years, with a median age of 59 years. Of 103 patients, 49 cases undergoing totally laparoscopic proximal gastrectomy with double-tract reconstruction of SPLT were assigned into the SPLT group, 54 cases undergoing totally laparoscopic proximal gastrectomy with conventional double-tract reconstruction were assigned into the traditional group. Observation indicators: (1) intraoperative situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted by outpatient examination and telephone inter-view to detect postoperative reflux esophagitis of patients up to December 2021. Measurement data with normal distribution were represented as Mean± SD, and the t test was used for comparison between groups. Measurement data with skewed distribution were represented as M(range) or M( Q1, Q3), and the Wilcoxon test was used for comparison between groups. Count data were described as absolute numbers or percentages, and comparison between groups was performed using the chi-square test. Comparison of ordinal data was analyzed using the non-parameter rank sum test. Results:(1) Intraoperative situations: the operation time, digestive tract reconstruction time, volume of intraoperative blood loss, the number of inferior mediastinal lymph nodes dissected, cases with auxiliary incisions for the SPLT group were (261±48)minutes, (26±4)minutes, (114±42)mL, 8.0(6.5,9.5), 1, respectively. The above indicators were (244±42)minutes, (30±6)minutes, (118±46)mL, 5.5(4.0,8.0), 9 for the traditional group, respectively. There were significant differences in the digestive tract reconstruction time, the number of inferior mediastinal lymph nodes dissected and cases with auxiliary incisions between the two groups ( t=-3.34, Z=-4.05, χ2=4.72, P<0.05). There was no significant difference in the operation time or volume of intraoperative blood loss between the two groups ( t=1.87, -0.47, P>0.05). (2) Postoperative situations: duration of postopera-tive hospital stay and cases with postoperative complications were (11.5±2.7)days and 4 for the SPLT group, versus (12.5±4.3)days and 9 for the traditional group, showing no significant difference between the two groups ( t=-1.47, χ2=1.68, P>0.05). There were 13 of 103 patients with postopera-tive complications, including 5 cases of left pleural effusion, 4 cases of anastomotic leakage, 2 cases of mild pneumonia, 1 case of incision infection, 1 case of chylous leakage. Four patients had anasto-motic leakage at the esophagojejunostomy, the abdominal esophagus of whom was invaded by more than 1 cm. During the operation, mediastinal drainage tubes were placed through the abdominal wall. The 4 patients were cured after enteral and parenteral nutrition support and adequate drainage, and the remaining patients with complications were cured after symptomatic treatment. (3) Follow-up: of 49 patients in the SPLT group, 43 cases were followed up for (18±4)months. During the follow-up, 1 case showed reflux esophagitis by gastroscopy, with the incidence of 2.33%(1/43). Of 54 patients in the traditional group, 53 cases were followed up for (17±4)months. During the follow-up, 4 cases showed reflux esophagitis by gastroscopy, with the incidence of 7.55%(4/53). There was no significant difference in the incidence of reflux esophagitis between the two groups ( χ2=0.47, P>0.05). Conclusions:SPLT technology is feasible for double anti-reflux double-tract reconstruction of proximal gastrectomy. Compared with traditional double-tract reconstruction of totally laparos-copic proximal gastrectomy, SPLT technology can reduce the auxiliary incisions, increase the number of lower mediastinal lymph nodes dissected, and shorten the digestive tract reconstruction time.

Objective:To analyze the influence of vitamin D 3 supplementation on the clinical efficacy of mesalazine in patients with ulcerative colitis (UC). Methods:From January 2015 to December 2020, patients with mild-to-moderate active UC were retrospectively and continuously enrolled, who accepted mesalazine treatment for at least 12 months at the Second Affiliated Hospital of Wenzhou Medical University. According to simultaneous supplement of vitamin D 3 (125 IU/d), the patients were divided into study group and control group. Demographic and disease characteristics, serum 25-hydroxyvitamin D[25(OH)D] levels and other information were collected through retrieving hospital database. Student′s t-test, Mann-Whitney U test and Chi-square test were applied for comparison of disease characteristics. The changes of modified Mayo scores[ΔMayo] and 25(OH)D[Δ25(OH)D] were compared before and after treatment by paired t-test, Wilcoxon signed rank test and Chi-square test. Multiple linear regression model was used to analyze the independent factors affecting ΔMayo and Δ25(OH)D, and variables with P-values less than 0.20 in the univariate analysis were allowed for further multivariate analysis. Results:A total of 74 UC patients (44 males, 30 females), with median age (range) 39.5 (20-76) years old, were analyzed and respectively assigned into study group ( n=36) and control group ( n=38). In study group, the average level of serum 25(OH)D was significantly increased at month 12 compared with that at baseline [(22.87±7.30) μg/L vs. (18.15±7.48) μg/L, P<0.001]. However, no significant elevation of serum 25(OH)D was found in control group [(19.17±8.49) μg/L vs. (19.82±9.47) μg/L, P=0.466]. Furthermore, there was a significant decrease of modified Mayo score [-3(-4.75, -1.25) vs.-2(-3.25, 0), P=0.034] and a higher clinical remission rate (55.6% vs. 28.9%, P=0.020) at month 12 in study group than those in control group. In addition, according to the baseline level of serum 25(OH)D before mesalazine treatment, 74 UC patients were divided into vitamin D deficiency group ( n=38, serum 25(OH)D<20 μg/L) and non-deficiency group ( n=36, serum 25(OH)D≥20 μg/L). At month 12 in vitamin D deficiency group, patients with vitamin D3 supplementation had a greater decline in modified Mayo score [-4(-5.75, -2) vs.-2(-4, 0), P=0.048] and a higher clinical remission rate (60.0% vs. 22.2%, P=0.019) compared with those without. Conclusions:In patients with mild-to-moderate active UC receiving mesalazine treatment, vitamin D3 supplementation may improve the clinical efficacy, especially in patients with vitamin D deficiency.

Objective:To analysis the characteristics and trends of non-martial and non-commercial heterosexual transmission of HIV/AIDS cases in Henan province between 2015 and 2020.Methods:Information of newly reported HIV/AIDS through non-martial and non-commercial heterosexual transmission was collected from National Comprehensive HIV/AIDS Information system, using SPSS 22.0 to analyze the characteristics and tend of cases.Results:During 2015-2020, a total of 10 877 HIV/AIDS cases infected by non-martial and non-commercial heterosexual transmission were newly reported in Henan province. This mode of infection increased from 32.6% in 2015 to 35.5% in 2020 (trend χ2=81.880, P<0.01). The male to female ratio was 1.9∶1 (7 105∶3 772). The mean age was (45.5±15.8) years, increasing annually ( F=5.184, P<0.01). For female cases, the proportion of aged 15-50 years group was decreased annually (trend χ2=69.888, P<0.01). Most HIV/AIDS cases were distributed in the early HIV epidemic areas and Zhengzhou city, the same as the cases of the first CD4 +T cells counts (CD4) below 200 cells/μl. The median ( P 25, P 75) first CD4 count was 298 (143, 462) cells/μl. The proportion of the first CD4<200 cells/μl was no significant change annually, while the proportion of the first CD4≥500 cells/μl was decreasing annually (trend χ2=18.961, P<0.01). Conclusions:The reported cases through non-martial and non-commercial heterosexual transmission increased, with most of them were male, married, junior, farmer, migrant laborer, and aged 40-59 years. It is needed to focus on the rural district and the middle-aged population, combined with biological and social factors to control the prevalence of AIDS through comprehensive prevention and control measures.

OBJECTIVE：To study the effects of gentiopicroside on the apo ptosis o f human pancreatic cancer cells PANC- 1，and to explore its mechanism from the perspective of IL- 6/JAK2/STAT3 signaling pathway. METHODS ：Using PANC- 1 cells as model ， the proliferation inhibition rate of cells was tested by MTT assay after treated with 0（negative contro ），2，4，8，16，32，64，128 mg/L gentiopicroside for 72 h and IC 50 were calculated. The cells were divided into negative control group ，gemcitabine group （positive control，4 mg/L）and gentiopicroside low-concentration ，medium-concentration and high-concentration groups （15，30，60 mg/L）. After cultured for 1，3，5，7 d，Trypan blue exclusion staining was used to count the survival cell ，and the growth of cells was investigated. After cultured for 72 h，colony formation assay was used to observe colony formation rate of cells ；the apoptotic rate of cells was detected by Hoechst 33258 staining；the mRNA and protein expressions of IL- 6，JAK2，STAT3 in cells were detected by RT-PCR and Western blotting assay. RESULTS ：4-28 mg/L gentiopicroside could inhibit the proliferation of cells （P＜0.05 or P＜ 0.01），in concentration dependent trend ；IC50 was 9.54 mg/L. Compared with negative control group ，survival cell count （cultured from 3，5，7 d），mRNA and protein expressions of IL- 6，JAK2 and STAT 3 in cells were decreased significantly in gemcitabine group ， gentiopicroside medium-concentration and high-concentration groups （P＜0.05 or P＜0.01），while the apoptotic rate was increased significantly （P＜0.01）. The colony formation rate of cellswere decreased significantly in gemcitabine group and gentiopicroside high-concentration group （P＜0.01）. mail：hb.gz@163.com Compared with gemcitabine group ，there was no statistical significance in above indexes of gentiopicroside high- 6716008。 concentration group （P＞0.05）. CONC LUSIONS：30，60 mg/L gentiopicroside could inhibit the proliferation and induce apoptosis of PANC- 1 cells，and 60 mg/L gentiopicroside is similar to gemcitabine in the effects. Its mechanism may be related to inhibiting the activation of IL- 6/JAK2/STAT3 signaling pathway.

Ubiquitination is one of the most important post-translational modification processes in eukaryotic cells,in which the ubiquitin molecules and/or ubiquitin chains are covalently transferred to the substrate after a series of enzymatic cascade reactions involving the activating (E1),conjugating (E2) and ligating (E3) enzymes.Coupling to the 26S proteasome complex to form the Ubiquitin-Proteasome System (UPS),ubiquitination plays an essential role in controlling protein stability,thereby maintaining the dynamic balance of the key cellular proteins.Besides,ubiquitination is also involved in a wide range of protein degradation-independent events,such as gene transcription and translation,signal transduction,DNA repair and endocytoais,exerting a key function in response to exogenous stimuli and the cellular homeostasis.Similar to kinases,components of the ubiquitination system are often dysregulated,leading to a variety of diseases,such as cancer.Recently,accumulating evidence has shown an increasing number of dysregulated ubiquitination processes in osteosarcoma (OS).Herein,this review briefly provides current perspectives on the aberrance of ubiquitination-associated factors and their roles in OS,providing novel insight into potential therapeutic targets of OS.

Rectal cancer has become the second most common gastrointestinal tumor in our country. With the development of comprehensive treatment, the long-term survival rate of patients with rectal cancer has greatly increased, meanwhile, higher postoperative quality of life is required. But the genitourinary dysfunction which is mainly caused by intraoperative pelvic autonomic nerve damage haunts postoperative rectal cancer patients. Traditional pelvic autonomic nerve protection technology born in the 1980s only improves urogenital function in a part of postoperative patients. In recent years, NOME(nerve-oriented mesorectal excision) was proposed, which needed to make pelvic autonomic never exposed. However, recovery of urinary function is not ideal due to difficulty identifying pelvic autonomic nerve and unavoidable damage on pelvic autonomic nerve. In clinical practice, we found that pelvic autonomic nerve can be divided into three parts: abdominal cavity, large pelvis, small pelvis. The pelvic autonomic nerve is closely related to the surrounding fascias in each part. The fascias are not only the protection of pelvic autonomic nerve, but also can be used as a good indicator of location of pelvic autonomic nerve. The relationship of pelvic autonomic nerve with Toldt fascia, presacral fascia, the lateral rectal ligaments, and the Denonvilliers fascia is discussed in this paper. Combined with the above theory, a new technology named FOPANP (fascia-orientation of pelvic autonomic nerve preservation) is proposed. In this technique, the fascia around the rectum is used as a guidance to select the appropriate plane in the operation, and the tumor can be removed without exposing the pelvic autonomic nerve. This technology has three advantages. First, it is not necessary to search and expose the pelvic autonomic nerve, so as to avoid secondary injury to it during the operation. Secondly, the pelvic fascias are natural barriers formed between the surgical plane and the pelvic autonomic nerve retained. They can avoid the stimulation of physical and chemical factors to pelvic autonomic nerve. Thirdly, because the fascias are easier to identify, and the texture is more tough, so the technology is easier to master.

Objective To evaluate the safety and feasibility of cruciform anastomosis in the laparoscopic radical resection of colon cancer.Methods The retrospective descriptive study was adopted.The clinicopathologic data of 9 patients with colon cancer who were admitted to the Shanxi Provincial Caner Hospital between December 2011 to October 2013 were collected.After the laparoscopic free colon and dissection of lymph nodes,the proximal and distal ends of the colon tumor were cut off using an ENDO-GIA,cutting one small incision on the both side of stump,and ENDO-GIA was put into the incision to staple the mesentery of colonic wall,finally,the beak-like common incision was closed by ENDO-GIA and digestive tract construction was conducted.Observation indices:(1)operative indices:operation time,time of cruciform colon anastomosis,volume of intraoperative blood loss,conversion to open surgery.(2)Tumor indices:number of lymph nodes dissected,distance to resection margin,R resection.(3)Surgical complications:anastomotic stoma incompetence,anastomotic leakage,anastomotic stenosis,twisting of bowel,wound liquefaction infection.(4)Postoperative recovery time:time for initial out-of-bed activity,time to anal exsufflation,time for fluid diet intake,duration of postoperative hospital stay.(5)Follow-up situations:follow-up using outpatient examination was conducted up to April 2014.Karnofsky performance status(KPS)score was used to evaluate the health conditions and tumor recurrence of anastomotic stoma and colonic cavity stenosis were detected by fibercoloscope.Measurement data with normal distribution were presented as x±s.Results(1)Operative indices:9 patients received successful total laparoscopic resection of colon cancer+D3 lymph node dissection+cruciform anastomosis,without conversion to open surgery.Operation time,time of cruciform colon anastomosis and volume of intraoperative blood loss were respectively(140±50)minutes,(43±26)minutes and(62±56)mL.(2)Tumor indices:the number of lymph nodes dissected was 17±6 percase.The distance to resection margin was more than 8 cm,and pathological findings showed no residual cancer.(3)Surgical complications:9 patients had no postoperative complications.(4)Postoperative recovery time:time for initial out-of-bed activity,time to anal exsufflation,time for fluid diet intake and duration of hospital stay were respectively(1.8±0.9)days,(2.4±1.2)days,(3.6±1.7)days and(9.6±2.5)days.All the patients were discharged from hospital at postoperative day 12,without the occurrence of readmission within postoperative day 30.(5)Follow-up situations:all the patients were followed up by outpatient examination at postoperative month 6,with KPS score≥90 and without the occurrence of tumor recurrence of anastomotic stoma and colonic cavity stenosis.Conclusion Cruciform anastomosis in the laparoscopic radical resection of colon cancer is safe and feasible.

Denonvilliers fascia locating between the front of the rectum and urogenital organs is an important barrier separating the urogenital organs and the rectum.It has great significance in the clinical treatment of rectal tumors and genitourinary system tumors.However,controversial on the embryological origins and anatomic characteristics of the Denonvilliers fascias still exist.In this article,the embryonic origin,anatomical structure,adjacent structures and clinical applications of the Denonvilliers fascias were introduced.