Objective To evaluate the necessity of indwelling gastrointestinal decompression after gastrectomy. Methods Eight publications on the necessity of gastrointestinal decompression after gastrecomy were colleted, data on recovery time of gastrointestinal function and hospital stay, complications,and motality were Meta-analyzed using fixed effect model and random effect model. Results Eight randomized trails including 975 patients were qualified and included in this study. The differences in time to oral intake ( WMD =0. 61, 95% CI: 0. 17 - 1.05, P ＜ 0. 05 ) and hospital stay ( WMD = 1.20, 95% CI:0. 05 -2. 36, P ＜ 0. 05 ) between the decompression group and non-decompression group were statistically significant, but the difference in time to flatus (WMD = 0. 31,95% CI: -0. 07- 0. 69, P ＞ 0. 05 ) was not significant. There were no significant differences in complications such as nausea and vomiting ( OR = 1.43,95% CI: 0. 61 - 3.31, P ＞ 0. 05 ), pulmonary infection and atelectasis ( OR = 1.43, 95 % CI: 0. 82 - 2. 49,P＞0.05), anastomotic leakage (OR = 1.17, 95%CI: 0.54-2.49, P ＞0.05), abdominal abscess ( OR = 1.08, 95% CI: 0. 50 - 2. 34, P ＞ 0. 05 ), wound dehiscence ( OR = 1.47, 95% CI: 0. 43 - 4. 95,P ＞ 0. 05 ) between the two groups, except for fever ( OR = 1.76, 95% CI: 1.11 - 2. 78, P ＜ 0. 05 ), which was found more frequent in decompression group than in non-decompression group. Conclusions Routine gastrointestinal decompression after gastrectomy was not conductive to the recovery of gastrointestinal function, and could not reduce the incidence of postoperative complications. Postoperative GI decompression increased fever incidence rate and prolonged hospital stay.

ObjectiveTo evaluate the clinical application of bidirectional Glenn shunt without extracorporeal circulation(ECC) on treatment of children with complicated congenital heart disease (CHD).MethodsForty-six patients with complicated CHD(without ECC group) underwent bidirectional Glenn shunt without ECC,and 40 patients with complicated CHD (with ECC group) underwent bidirectional Glenn shunt with ECC.The therapeutic effect was compared between two groups.ResultsThere was no operative mortality in two groups.The pulmonary artery pressure in without ECC group was significantly lower than that in with ECC group [( 16.7 ± 1.2) mm Hg ( 1 mm Hg =0.133 kPa) vs.( 18.9 ± 1.0) mm Hg,t =4.686,P=0.026 ].Duration of respirator assistance after operation in without ECC group was significantly lower than that in with ECC group [ ( 12.2 ± 2.7) h vs.( 19.2 ± 2.8) h,t =2.972,P =0.041 ].There was no significant difference in saturation of blood oxygen and the rate of chylothorax after operation between two groups (P＞0.05).The symptoms and signs including cyanosis and breath were markedly alleviative in all patients.ConclusionBidirectional Glenn shunt without ECC is an effective and safe method for complicated CHD.

OBJECTIVETo explore the changes of blood viscosity and external thrombus in patients with silicosis and silicosis complicated with tuberculosis (TB).

METHODBlood viscosity and external thrombus were measured in 288 patients with silicosis, 178 patients with silicosis complicated by TB and 150 healthy subjects.

RESULTSBlood viscosity and external thrombus value were significantly higher in the patients of silicosis and silicosis complicated with TB than in the healthy controls, except for patients of phase I of silicosis. Blood viscosity in the silicotics increased significantly with the advance of the disease, but no significant difference in external thrombus between patients in different phases. Apparent viscosity of whole blood significantly increased in the high-shear rate (200 s(-1)) and middle-shear rate (30 s(-1)) in patients of silicosis complicated with TB than in those without complication of TB at the same phases, but not seen in the low-shear rate (5 s(-1)) and in plasma viscosity, and the length and dried weight of external thrombus increased significantly too. There was no significant difference in blood viscosity and external thrombus between patients of silicosis at phase III and those of silicosis complicated with TB at the same phase.

CONCLUSIONBlood in patients with silicosis appeared highly viscous and highly coagulant status. Blood viscosity and external thrombus value significantly increased with the advance of the disease, especially in the patients complicated with TB.

Adult ; Aged ; Aged, 80 and over ; Blood Viscosity ; Humans ; Male ; Middle Aged ; Severity of Illness Index ; Silicosis ; blood ; complications ; pathology ; Thrombosis ; etiology ; Tuberculosis ; complications

Objective:To investigate the efficacy of bare stent implantation alone and stent assisted coiling in the repair of isolated superior mesenteric artery dissection (ISMAD) false lumen.Methods:Clinical data of 50 patients with ISMAD who underwent endovascular treatment between December 2012 and March 2021 were analyzed retrospectively. Depending on the endoluminal treatment methods, they were divided into the bare stent implantation alone group (29 cases) and the stent assisted coiling group (21 cases), and the rates of complete postoperative dissection remodeling, stent restenosis, and symptom recurrence were compared between the two groups.Results:The rates of complete remodeling of the dissection in the immediate postoperative period, 3 months and 6 months in the bare stent placement alone group were 13.8% (4/29), 51.7% (15/29) and 75.9% (22/29), respectively, which were lower than that of the stent assisted coiling group 71.4% (15/21), 85.7% (18/21), and 100% (21/21), and the difference was statistically significant (χ 2=17.17, 6.27, 4.06 respectively, and P=0.001, 0.012, 0.044 respectively). While the rates of complete remodeling of the dissection were 82.8%(24/29), 100%(21/21) in the two groups at 12 months after surgery, respectively, and the difference was not statistically significant (χ 2=2.34, P=0.126). There was no significant difference in stent patency rate and symptom recurrence rate between the two groups ( P>0.05). Conclusions:The efficacy of bare stent implantation alone and stent assisted coiling in the treatment of ISMAD is definite. Although the rate of complete remodeling of the dissection with bare stent placement alone is low in the short term, the rate of complete remodeling of the dissection with bare stent implantation alone gradually increases with the extension of time, which is worthy of clinical application and promotion.

BackgroundSleep disturbances in children and adolescents have become a global public health concern， with pronounced issues in the Western China. Despite this， research on the prevalence of insomnia and its influencing factors among children and adolescents in Chongqing is still lacking. ObjectiveTo understand the prevalence of insomnia and analyze its influencing factors among children and adolescents in Chongqing， so as to provide references for clinical interventions and preventive strategies of insomnia. MethodsA stratified random sampling method was used to select 9 969 children and adolescents in Chongqing from November to December 2021. Insomnia Severity Index （ISI） and a self-designed questionnaire on awareness of core mental health knowledge were administered. Binary Logistic regression analysis was used to identify the influencing factors of insomnia in this population. ResultsA total of 3 578 children and adolescents （35.89%） were found to have insomnia symptoms. There were statistically significant differences in the detection of insomnia symptoms among gender， ethnicity， education level， domicile， only-child status， parental education level， introversion/extroversion， parental relationship， average monthly per capita income， family history of mental illness， medical insurance coverage， living situation and understanding of mental health knowledge （P<0.05 or 0.01）. Binary Logistic regression analysis identified several risk factors for insomnia， including female gender （OR=1.301， 95% CI： 1.192~1.419）， ethnic minority status （OR=1.163， 95% CI： 1.015~1.333）， junior high school for education level （OR=1.985， 95% CI： 1.774~2.220）， senior high school for education level （OR=3.085， 95% CI： 2.749~3.462）， non-only-child status （OR=1.127， 95% CI： 1.013~1.253）， degree of harmony between parents is not high or not harmonious ［（OR=1.846， 95% CI： 1.669~2.041 for relatively harmonious； OR=2.524， 95% CI： 2.214~2.877 for generally harmonious； OR=2.452， 95% CI： 1.999~3.007 for not very harmonious； OR=2.926， 95% CI： 2.307~3.710 for very discordant）］ and incomplete medical insurance coverage （OR=1.218， 95% CI： 1.093~1.358） . Protective factors included an extroverted personality （OR=0.838， 95% CI： 0.766~0.917）， absence of family history of mental illness （OR=0.719， 95% CI： 0.549~0.941）， junior high school for mother's education level （OR=0.822， 95% CI： 0.734~0.920）， senior high school or secondary specialized school for mother's education level （OR=0.862， 95% CI： 0.752~0.988）， college and above for mother's education level （OR=0.748， 95% CI： 0.633~0.884） and knowledge of mental health （OR=0.854， 95% CI： 0.778~0.937）. ConclusionThe problem of insomnia among children and adolescents in Chongqing is quite serious. Risk factors for insomnia include female gender， ethnic minority status， higher education levels， being a non-only child， poor family relationships and incomplete medical insurance. Conversely， an extroverted personality， absence of family history of mental illness， higher maternal education and knowledge of mental health serve as protective factors against insomnia. ［Funded by Chongqing Science and Technology Plan Project （number， CSTB2022TFII-0IX0074）］

The current epidemic situation of coronavirus disease 2019 (COVID-19) still remained severe. As the National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine is the primary medical care center for COVID-19 in Zhejiang province. Based on the present expert consensus carried out by National Health Commission and National Administration of Traditional Chinese Medicine, our team summarized and established an effective treatment strategy centered on "Four-Anti and Two-Balance" for clinical practice. The "Four-Anti and Two-Balance" strategy included antivirus, anti-shock, anti-hyoxemia, anti-secondary infection, and maintaining of water, electrolyte and acid base balance and microecological balance. Meanwhile, integrated multidisciplinary personalized treatment was recommended to improve therapeutic effect. The importance of early viralogical detection, dynamic monitoring of inflammatory indexes and chest radiograph was emphasized in clinical decision-making. Sputum was observed with the highest positive rate of RT-PCR results. Viral nucleic acids could be detected in 10%patients' blood samples at acute period and 50%of patients had positive RT-PCR results in their feces. We also isolated alive viral strains from feces, indicating potential infectiousness of feces.Dynamic cytokine detection was necessary to timely identifying cytokine storms and application of artificial liver blood purification system. The "Four-Anti and Two-Balance" strategy effectively increased cure rate and reduced mortality. Early antiviral treatment could alleviate disease severity and prevent illness progression, and we found lopinavir/ritonavir combined with abidol showed antiviral effects in COVID-19. Shock and hypoxemia were usually caused by cytokine storms. The artificial liver blood purification system could rapidly remove inflammatory mediators and block cytokine storm.Moreover, it also favored the balance of fluid, electrolyte and acid-base and thus improved treatment efficacy in critical illness. For cases of severe illness, early and also short period of moderate glucocorticoid was supported. Patients with oxygenation index below 200 mmHg should be transferred to intensive medical center. Conservative oxygen therapy was preferred and noninvasive ventilation was not recommended. Patients with mechanical ventilation should be strictly supervised with cluster ventilator-associated pneumonia prevention strategies. Antimicrobial prophylaxis was not recommended except for patients with long course of disease, repeated fever and elevated procalcitonin (PCT), meanwhile secondary fungal infection should be concerned.Some patients with COVID-19 showed intestinal microbial dysbiosis with decreased probiotics such as and , so nutritional and gastrointestinal function should be assessed for all patients.Nutritional support and application of prebiotics or probiotics were suggested to regulate the balance of intestinal microbiota and reduce the risk of secondary infection due to bacterial translocation. Anxiety and fear were common in patients with COVID-19. Therefore,we established dynamic assessment and warning for psychological crisis. We also integrated Chinese medicine in treatment to promote disease rehabilitation through classification methods of traditional Chinese medicine. We optimized nursing process for severe patients to promote their rehabilitation. It remained unclear about viral clearance pattern after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Therefore, two weeks' quarantine for discharged patients was required and a regular following up was also needed.The Zhejiang experience and suggestions have been implemented in our center and achieved good results. However, since COVID-19 was a newly emerging disease, more work was warranted to improve strategies of prevention, diagnosis and treatment for COVID-19.
Betacoronavirus ; isolation & purification ; China ; epidemiology ; Coronavirus Infections ; diagnosis ; epidemiology ; therapy ; virology ; Disease Management ; Early Diagnosis ; Feces ; virology ; Humans ; Pandemics ; Pneumonia, Viral ; diagnosis ; epidemiology ; therapy ; virology ; Sputum ; virology

The current epidemic situation of corona virus disease-19 (COVID-19) still remained severe. As the National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine is the primary medical care center for COVID-19 inZhejiang Province. Based on the present expert consensus carried out by National Health Commission and National Administration of Traditional Chinese Medicine, our team summarized and established an effective treatment strategy centered on "Four-Anti and Two-Balance" for clinical practice. The "Four-Anti and Two-Balance"strategy included antivirus, anti-shock, anti-hyoxemia, anti-secondary infection, and maintaining of water, electrolyte and acid base balance and microecological balance. Meanwhile, integrated multidisciplinarypersonalized treatment was recommended to improve therapeutic effect. The importance of early viralogical detection, dynamic monitoring of inflammatory indexes and chest radiograph was emphasized in clinical decision-making. Sputum was observed with the highest positive rate of RT-PCR results. Viral nucleic acids could be detected in10% patients'blood samples at acute periodand 50% of patients had positive RT-PCR results in their feces. We also isolated alive viral strains from feces, indicating potential infectiousness of feces.Dynamic cytokine detection was necessary to timely identifyingcytokine storms and application of artificial liver blood purification system. The "Four-Anti and Two-Balance"strategyeffectively increased cure rate and reduced mortality. Early antiviral treatment could alleviate disease severity and prevent illness progression, and we found lopinavir/ritonavir combined with abidol showed antiviraleffects in COVID-19. Shock and hypoxemia were usually caused by cytokine storms. The artificial liver blood purification system could rapidly remove inflammatory mediators and block cytokine storm.Moreover, it also favoredthe balance of fluid, electrolyte and acid-base and thus improved treatment efficacy in critical illness. For cases of severe illness, early and also short periods of moderate glucocorticoid was supported. Patients with oxygenation index below 200 mmHg should be transferred to intensive medical center. Conservative oxygen therapy was preferred and noninvasive ventilation was not recommended. Patients with mechanical ventilation should be strictly supervised with cluster ventilator-associated pneumonia prevention strategies. Antimicrobial prophylaxis should be prescribed rationally and was not recommended except for patients with long course of disease, repeated fever and elevated procalcitonin (PCT), meanwhile secondary fungal infection should be concerned.Some patients with COVID-19 showed intestinal microbialdysbiosis with decreasedprobiotics such as and . Nutritional and gastrointestinal function should be assessed for all patients.Nutritional support and application of prebiotics or probiotics were suggested to regulate the balance of intestinal microbiota and reduce the risk of secondary infection due to bacterial translocation. Anxiety and fear were common in patients with COVID-19. Therefore, we established dynamic assessment and warning for psychological crisis. We also integrated Chinese medicine in treatment to promote disease rehabilitation through classification methods of traditional Chinese medicine. We optimized nursing process for severe patients to promote their rehabilitation. It remained unclear about viral clearance pattern after the SARS-CoV-2 infection. Therefore, two weeks' quarantine for discharged patients was required and a regular following up was also needed.The Zhejiang experience above and suggestions have been implemented in our center and achieved good results. However, since COVID-19 was a newly emerging disease, more work was warranted to improve strategies of prevention, diagnosis and treatment for COVID-19.

Ubiquitination, an essential post-transcriptional modification (PTM), plays a vital role in nearly every biological process, including development and growth. Despite its functions in plant reproductive development, its targets in rice panicles remain unclear. In this study, we used proteome-wide profiling of lysine ubiquitination in rice (O. sativa ssp. indica) young panicles. We created the largest ubiquitinome dataset in rice to date, identifying 1638 lysine ubiquitination sites on 916 unique proteins. We detected three conserved ubiquitination motifs, noting that acidic glutamic acid (E) and aspartic acid (D) were most frequently present around ubiquitinated lysine. Enrichment analysis of Gene Ontology (GO) annotations and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways of these ubiquitinated proteins revealed that ubiquitination plays an important role in fundamental cellular processes in rice young panicles. Interestingly, enrichment analysis of protein domains indicated that ubiquitination was enriched on a variety of receptor-like kinases and cytoplasmic tyrosine and serine-threonine kinases. Furthermore, we analyzed the crosstalk between ubiquitination, acetylation, and succinylation, and constructed a potential protein interaction network within our rice ubiquitinome. Moreover, we identified ubiquitinated proteins related to pollen and grain development, indicating that ubiquitination may play a critical role in the physiological functions in young panicles. Taken together, we reported the most comprehensive lysine ubiquitinome in rice so far, and used it to reveal the functional role of lysine ubiquitination in rice young panicles.
Acetylation ; Lysine/metabolism* ; Oryza/metabolism* ; Plant Proteins/metabolism* ; Protein Interaction Maps ; Protein Processing, Post-Translational ; Proteome/metabolism* ; Ubiquitin/metabolism* ; Ubiquitination