Objective To evaluate the combination use of transcatheter arterial chemoembolization (TACE), portal vein embolization (PVE) and high intensity focused ultrasound (HIFU) in treating portal vein tumor thrombus(PVTT). Methods A total of 85 patients with primary hepatocellular carcinoma complicated by PVTT, who were encountered during the period from Jan. 2011 to Feb. 2012 at authors’ hospital, were enrolled in this study. The patients were divided into the study group (n=47) and the control group (n=38). TACE, PVE and HIFU were performed in the patients of the study group, while only TACE and PVE were carried out in the patients of the control group. The therapeutic process was as follows: PVE was carried out 2 weeks after TACE was performed, and for the patients of the study group additional HIFU was conducted about 10 days after PVE procedure. Results The short-term effective rate in the study group and the control group was 89.4% (42/47) and 39.5% (15/38) respectively, and the difference between the two groups was statistically significant (P< 0.05). The 6-month, one-year, and two-year survival rate in the study group were 87.2%(41/47), 66.0%(31/47) and 27.7%(13/47) respectively; the median survival time was 15.4 months. In the control group, the 6-month, one-year, and two-year survival rate were 55.3% (21/38), 39.5% (15/38) and 10.5%(4/38) respectively;the median survival time was 10.3 months. The differences between the two groups were statistically significant (P< 0.05). Conclusion For the treatment of primary hepatocellular carcinoma associated with portal vein tumor thrombus, transcatheter arterial chemoembolization, portal vein embolization together with high intensity focused ultrasound is an safe and effective therapy as it can significantly improve the therapeutic effect and prolong the survival time.

Objective:To investigate the clinical efficacy of modified vaginal hysterectomy in the treatment of uterine prolapse.Methods:A total of 60 patients with uterine prolapse who received treatment in Fengtai County People's Hospital from July 2017 to October 2021 were included in this study. They were divided into control and observation groups ( n = 30/group) according to different treatment methods. The patients in the control group were treated with traditional vaginal hysterectomy (vaginal hysterectomy + vaginal anterior and posterior wall repair). The patients in the observation group were treated with modified vaginal hysterectomy (vaginal hysterectomy + vaginal anterior and posterior wall repair + autologous ligament suspension). The changes in surgical indicators and treatment effectiveness were evaluated between the two groups. All patients were followed up at 3, 6, and 12 months. Vaginal fornix prolapse and quality of life score were compared between the two groups. Results:The average drainage volume, average anal exhaust time, the average time to get out of bed, and the average length of hospital stay in the observation group were (520.13 ± 52.14) mL, (36.47 ± 5.72) hours, (32.48 ± 7.12) hours, and (16.48 ± 2.67) hours, respectively, which were significantly less or shorter than those in the control group ( t = 19.35, 18.25, 17.56, 17.35, all P < 0.05). The total response rate in the observation group was 93.3% (28/30), which was significantly higher than 80.0% (24/30) in the control group ( χ2 = 6.32, P = 0.005). At 3, 6, and 12 months after surgery, vaginal fornix prolapse did not occur in any patient in the observation group, but it occurred in two, three, and seven patients in the control group at the corresponding time points. Treatment efficiency was superior in the observation group to that in the control group ( χ2 = 4.21, P = 0.001). At 3, 6, and 12 months after surgery, quality of life score in the observation group was significantly higher than that in the control group [3 months: (60.71 ± 7.58) points vs. (50.69 ± 2.89) points; 6 months: (76.42 ± 3.50) points vs. (63.31 ± 8.67) points; 12 months: (81.30 ± 2.64) points vs. (70.72 ± 6.51) points], and the differences were statistically significant ( t = 7.21, 7.10, 6.31, all P < 0.05). Conclusion:The modified vaginal hysterectomy for the treatment of uterine prolapse has an ideal effect. It can effectively reduce the amount of drainage, shorten the exhaust time and the length of hospital stay, improve quality of life, and thereby is worthy of clinical promotion.

Objective To investigate the therapeutic effect of silencing fibrinogen-like protein 2 (FGL2) gene on acute necrotic pancreatitis (ANP) mice.Methods Eighteen C57/BL mice were randomly divided into SO (sham operation) group,ANP group and Ad-FGL2-siRNA group carrying FGL2 siRNA adenovirus,with 6 in each group.Sodium taurocholate was retrogradely injected into the biliopancreatic ducts of the mice to induce ANP mice model.The mice in Ad-FGL2-siRNA group were injected intravenously in the tail vein with Ad-FGL2-siRNA befor the model establishment.The mice were sacrificed 6 h later,and then the pancreatic tissue and blood were collected.TNF-α and IL-1β expression were measured with ELISA,pancreatic tissue was examined with routine pathological examination,FGL2 mRNA and protein expression were measured with reverse transcription-PCR,western blotting and immunohistochemical staining,and cell apoptosis was assessed by TUNEL method.Results The pathological score of the pancreatic tissue in SO group,ANP group and Ad-FGL2-miRNA group was(1.33 ±0.21),(9.17 ±0.98) and (6.26 ±0.52),respectively.The serum TNF-α level in SO group,ANP group and Ad-FGL2-miRNA group was(63.8 ± 4.2),(240.4 ± 18.6)and(123.0 ± 10.3)ng/L,respectively.The serum IL-1β level was (43.6 ±4.4),(186.6 ± 18.7)and (92 ±10.9)ng/L.The mRNA expressions of FGL2 was 1.20 ±0.22,4.40 ± 1.21 and 2.15 ± 0.56.The protein expressions of FGL2 was 0.33 ± 0.08,1.23 ± 0.24 and 0.68 ± 0.09.The rate of FGL2 positive cells was (2.56 ± 0.31) ％,(15.10 ± 3.23) ％ and (8.68 ± 1.81) ％.The number of apoptotic cells was (4.51 ±1.21),(35.81 ± 4.11) and (11.79 ± 3.02) / × 200HPF,which in the ANP group was higher than that in SO group,and in the Ad-FGL2-siRNA group was significantly lower than that in ANP group and higher than that in SO group.All the differences were statistically significant (all P values ＜ 0.05),except that on the FGL2 mRNA expression between Ad-FGL2-siRNA group and SO group.Conclusions Silencing FGL2 gene may alleviate pancreatic injury in ANP by reducing the release of inflammatory factors and inhibiting cell apoptosis.

Objective To evaluate the effects of early oral feeding on postoperative recovery of patients undergoing gastrointestinal surgery.Methods CNKI, China Biology Medicine database (CBM), PubMed, Embase, The Cochrane Library and Web of Science databases were screened. Randomized controlled trials (RCTs) and their references from 2006 to 2016 were recruited using Meta-analysis. RevMan 5.3 software was used for data processing.Results A total of 11 RCTs containing 2188 patients were included in the study. In patients with early oral feeding compared to patients with traditional fasting, there were statistically significant differences in first time of flatus [MD=-0.90 d, 95%CI (-1.12, -0.67),P<0.05], first time of stools [MD= -0.89 d, 95%CI (-1.11, -0.79),P<0.05], nasogastric tube reinsertion rate [RR=0.57, 95%CI (0.36, 0.90), P<0.05], fist time of regular diet [RR=0.57 d, 95%CI (0.36, 0.90),P<0.05], and infective complications rate [RR=0.45, 95%CI (0.28, 0.74),P<0.05]; No significant differences were observed for vomiting [RR=1.44, 95%CI (0.69, 3.19),P>0.05], abdominal distension [RR=1.29, 95%CI (0.70, 2.36),P>0.05], the total incidence rate of postoperative complications [RR=0.82, 95%CI (0.59, 1.15),P>0.05]and non-infective complications [RR=0.78, 95%CI (0.49, 1.25),P>0.05].Conclusions Early oral feeding is beneficial to the recovery of gastrointestinal function in patients with digestive system diseases, and significantly reduces the infective complications.

Objective:To explore the effect of attribution training on cancer-related fatigue, quality of life and psychological state of patients after lung cancer surgery.Methods:From July 2019 to July 2020, convenience sampling was used to select 89 postoperative patients with lung cancer who were admitted to Peking Union Medical College Hospital. Patients were divided into the control group ( n=44) and the observation group ( n=45) with random number table method. The control group conducted routine nursing, and the observation group carried out attribution training on the basis of the control group. The general information of the two groups of patients was collected, and the Cancer Fatigue Scale (CFS) , WHO Quality of Life Scale-100 (WHOQOL-100) and Hospital Anxiety and Depression Scale (HADS) scores were compared between the two groups. Results:The WHOQOL-100 scores of the observation group were higher than those of the control group at one and three months after the intervention, and the differences were statistically significant ( P<0.05) . After the intervention, the CFS scores of the two groups of patients were lower than those before the intervention, and the CFS scores of the observation group was lower than that of the control group, and the differences were statistically significant ( P<0.05) . The HADS scores of the observation group were lower than those of the control group at one and three months after the intervention, and the differences were statistically significant ( P<0.05) . Conclusions:Attribution training can effectively improve the cancer-related fatigue, anxiety and depression in patients with lung cancer, and improve the quality of life of patients. It is worthy of clinical promotion.

Objective: To summarize the measures and experience of treatment in mass extremely severe burn patients. Methods: The clinical data and treatment of 8 extremely severe burn patients in August 2 Kunshan factory aluminum dust explosion accident who were admitted in the 100th Hospital of PLA on August 2nd, 2014, were retrospectively analyzed. There were 4 males and 4 females, aging 22-45 (34±7) years, with total burn area of 55%-98% [(89±15)%] total body surface area (TBSA) and full-thickness burn area of 45%-97% [(80±21)%] TBSA. All the 8 patients were accompanied with severe shock, inhalation injury, and blast injury. According to the requirements of former PLA General Logistics Department and Nanjing Military Command, a treatment team was set up including a special medical unit and a special care unit, with Chai Jiake from the First Affiliated Hospital of PLA General Hospital as the team leader, Zheng Qingyi from the 175th Hospital of PLA (the Affiliated Dongnan Hospital of Xiamen University) as the deputy leader, the 100th Hospital of PLA as the treatment base, and burn care, respiratory, nephrology, nursing specialists from the First Affiliated Hospital of PLA General Hospital, and the burn care experts and nursing staff from the 180th Hospital of PLA, 118th Hospital of PLA, 98th Hospital of PLA, and 175th Hospital of PLA, and nurses from the 85th Hospital of PLA, 455th Hospital of PLA, 101th Hospital of PLA, 113th Hospital of PLA as team members. Treatment strategies were adopted as unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns. With exception of one patient who received deep vein catheterization before admission, the other 7 patients were treated with deep vein catheterization 0.5 to 3.0 hours after admission to correct hypovolemic shock as soon as possible. Eight patients received tracheotomy, and 7 patients were treated with mechanical ventilation by ventilator in protective ventilation strategy with low tide volume and low volume pressure to assist breathing. Fiberoptic bronchoscopy was done one to three times for all the 8 patients to confirm airway injuries and healing status. Escharectomy and Meek dermatoplasty in the extremities of all the 8 patients were performed 3 to 6 days after injury for the first time. Escharectomy, microskin grafting, and covering of large pieces of allogeneic skin on the trunks of 4 patients were performed 11 to 16 days after injury for the second time. The broad-spectrum antibiotics were uniformly used at first time of anti-infective therapy, and then the antibiotics species were adjusted in time. The balance of internal environment was maintained and the visceral functions were protected. One special care unit was on responsibility of only one patient. Psychological intervention was performed on admission. The rehabilitative treatment was started at early stage and in company with the whole treatment. Results: Acute renal injury occurred in 5 patients within 36 hours after injury and their renal function was restored to normal 4 days after injury due to active adjustment of fluid resuscitation program. No pulmonary complications, such as severe pulmonary infection and ventilator-associated pneumonia, occurred in the survived patients. One of the 8 patients died, and the other 7 patients were cured successfully. The wounds were basically healed in 2 patients in 26 or 27 days by 2 or 3 times of operation, and in 5 patients by 4 or 5 times of operation. The basic wound healing time was 26-64 (48±15) days for all the 7 patients. Conclusions Treatment strategies of unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns are the bases to successful treatment. Correcting shock as soon as possible is the prerequisite and closing wound as soon as possible is the key to successful treatment. Comprehensive treatment measures, such as maintaining and regulating the function of viscera, improving the body immunity, and preventing and treating the complications, are the important components to successful treatment. It is emphasized that in the treatment of mass extremely severe burn patients, specialist burn treatment should always be in the dominant position, and other related disciplines may play a part in auxiliary function.

ObjectiveTo analyze the surveillance results of influenza-like illness （ILI） cases in a sentinel hospital in Nantong from 2014 to 2021 and to understand the seasonal and etiological characteristics of influenza. MethodsThe routine ILI case information in a sentinel hospital in Nantong from 2014 to 2021 was collected from China Influenza Surveillance Information system， and the surveillance results were described and analyzed. ResultsA total of 64 110 ILI cases were reported in the hospital from 2014 to 2021， and accounted for 3.93% of outpatient and emergency visits. ILI is mainly concentrated in children under 15 years old， accounting for 55.39% of the total ILI cases. ILI% roughly showed two epidemic peaks in spring and winter. A total of 8 639 nasopharyngeal swab samples of ILI cases were collected during 2014‒2021， of which 838 were influenza positive， with an average positive rate of 10.01% （3.27%‒16.75%）. The epidemic strains varied from year to year and in different age groups. In 2014 and 2015， H3N2 influenza was the epidemic strain； in 2016 and 2017， H3N2 influenza and B-Victoria influenza were the co-epidemic strains； in 2018， H1N1 influenza was the epidemic strain； and in 2019‒2021， B Victoria influenza was the epidemic strain. The epidemic strain in 0‒4 years old， 15‒24 years old， 25‒59 years old and >60 years old was H3N2， and the epidemic strain in 5‒14 years old was B Victoria. There was a significant difference in the positive rate between different gender groups （χ²=7.364， P=0.006）. ConclusionInfluenza often occurs in winter and spring in a sentinel hospital in Nantong. Influenza subtypes are prevalent alternately in different age groups and different years. We need to closely monitor the etiology of influenza virus in Nantong to provide a basis for influenza prevention and control.

Activating metabolite glutamate receptor 8 (mGluR8) has anti-hyperpathia effect in central nervous system, however, studies of effects in gastrointestinal tract are rare. Visceral hypersensitivity is one of the pathogenesis factors of irritable bowel syndrome (IBS). Aims: To investigate the effect and potential mechanism of activating mGluR8 on visceral hypersensitivity in neonatal maternally separated (NMS) rats. Methods: Twenty-four male newborn SD rats were randomly divided into normal control (NC) group, NMS group and mGluR8 agonist (S)-3, 4-DCPG group (3, 10 mg/kg). Newborn rats were subjected to 3 hours daily maternal separation on postnatal day 2-14 to establish the NMS model; in (S)-3, 4-DCPG group, (S)-3, 4-DCPG (3 or 10 mg/kg) were administered 1 hour prior to the visceral sensitivity test in NMS rats. Abdominal withdrawal reflex (AWR) score and abdominal electromyography (EMG) activity were used to measure visceral sensitivity. mGluR8 mRNA and protein expressions in colon mucosa were measured by RT-PCR and Western blotting, respectively; TNF-α, IL-1β and IL-6 mRNA expressions in colon mucosa were measured by RT-PCR. The protein expression of myeloperoxidase (MPO) was measured by immunohistochemistry. Results: AWR score and EMG activity in NMS group were significantly higher than those in NC group under different colorectal distension (CRD) pressure. AWR score and EMG activity were significantly decreased in (S)-3, 4-DCPG group. mGluR8 mRNA and protein expressions in NMS group were significantly higher than those in NC group (P<0.05). Compared with NMS group, TNF-α mRNA expression was significantly decreased in 3 mg/kg (S)-3, 4-DCPG group (P<0.05), and MPO protein expression was significantly decreased in 10 mg/kg (S)-3, 4-DCPG group (P<0.05). Conclusions: Activating mGluR8 attenuates visceral hypersensitivity in NMS rats, the mechanism may be related to decrease of pro-inflammatory cytokine TNF-α.

Autoimmune hepatitis (AIH) is a chronic progressive inflammatory disease of the liver caused by the attack of liver cells by the autoimmune system, with the features of positive serum autoantibodies, high IgG, and/or γ-globulinemia. Current studies on pregnancy in patients with AIH mainly focus on labor complications, and there is still a lack of systematic recommendations for the evaluation, treatment, and management of diseases in the progestational stage, during pregnancy, and after delivery. Although immunity is suppressed during pregnancy, poor disease control within one year before pregnancy and spontaneous drug withdrawal during pregnancy can significantly increase adverse pregnancy outcomes. Therefore, this article describes how to implement multidisciplinary collaboration and management of the whole cycle of pregnancy, so as to improve maternal and fetal safety.