Objective To investigate the effects and mechanism of pitavastatin on monocrotaline ( MTC )-induced pulmonary arterial hypertension ( PAH) in rats. Methods A total of 50 male Sprague-Dawley rats were randomly divided into five groups (n=10 each):pitavastatin treatment at low dose (1 mg·kg-1·d-1),treatment at high dose (3 mg·kg-1·d-1), pitavastatin prevention regimen (1 mg·kg-1·d-1), model control group, and the normol control group. PAH was induced by applying a single subcutaneous injection of MTC(55 mg·kg-1)in the first four groups of rats. The treatment lasted for 8 weeks. At the end of the study, survival rates and mean pulmonary arterial pressure ( mPAP ) among groups were compared. The expression levels of platelet-derived growth factor-B ( PDGF-B) and IL-6, Rac1 mRNA in small pulmonary artery were also detected. Results All rats in the prevention protocol and normal control group survived. Pitavastatin treatment improved survival in the treatment protocol(P<0. 01). The survival rate in the low dose, high dose, and model control group was 60. 0%, 80. 0%, and 40. 0%, respectively. Pitavastatin in both prevention or treatment protocol significantly lowered mPAP (P<0. 01). Pitavastatin also inhibited PDGF-B and IL-6 expression (P<0. 01),and inhibited Rac1 mRNA expression in lung tissues (P<0. 01). Conclusion Pitavastatin reduces mPAP in the MTC-induced PAH rat model, the mechanism of which may be related to inhibition of Rac1 expression,smooth muscle cell proliferation and inflammatory mediator IL-6.

Objective To compare the perioperative outcomes of laparoscopic liver resection (LLR) versus open liver resection (OLR) for hepatocellular carcinoma (HCC).Methods A total of 89 HCC patients undergoing liver resection between January 2012 and November 2016 were enrolled.Nonparametric tests were employed to compare the clinicalpathological characters and preoperative outcomes.Results No significant difference was observed in clinicalpathological features and postoperative morbidity.LLR group had shorter hospital stay (Z =4.642,P ＜0.01),lower serum ALT level in 1st,3rd and 5 day (Z =2.157,3.089,2.384,all P ＜0.05) and AST level in 1st-and 3rd-day postoperatively (Z =2.688,2.566,all P ＜0.05).The growth rate in serum total protein (TP) and albumin (ALB) postoperatively is higher for LLR group (y =2.348 4x + 51.696 vs.y =0.902 9 + 35.532),(y =1.539 9x + 29.68 vs.y =0.732 9x + 30.406).Conclusion LLR allows quicker liver function recovery and shortens patients' postoperative hospital stay.

Objective To investigate the effects of different depth of anesthesia on ScvO2 and ABL in elderly patients with gastrointestinal cancer. Methods Totally 55 elderly patients undergoing gastrointestinal sur-gery were randomly divided into deep anesthesia group(BIS40-49)(group D,n=27)and light anesthesia group (BIS50-59)(group S,n = 28). While SVV value was fixed,fluid management was conducted while monitoring CVP. HR,MAP,the change of central venous oxygen saturation and lactic acid index were recorded in different time points. Results Propofol dosage in group D and group S indicated statistical significance(P<0.05). ScvO2 in group S in T3~T5 was higher than that in T0 and the difference was statistically significant(P < 0.05). Com-pared with ScvO2 in T3 in group D,that in group S was significantly higher and the difference was statistically sig-nificant(P<0.01),but no significant difference was found in other time point in 2 groups(P>0.05). There was no significant difference between and within ABL groups in each time period(P>0.05). There was no significant difference in terms of other indicators between 2 groups. Conclusions For elderly patients with gastrointestinal surgery,shallow anesthesia can improve tissue oxygenation and reduce the amount of anesthetics.

Objective To investigate the feasibility and safety of surgical device closure of doubly committed sub-arterial ventricular septal defect via left sub-axillary.Methods A total of 45 patients diagnosed as doubly committed sub-arterial ventricular septal defect (dcVSD) with transthoracic echocardiography (TTE) and transesophageal echocardiography(TEE) were enrolled from June 2014 to August 2016 in Henan Children Heart Center,Henan Provincial People's Hospital.There were 39 males and 6 females,with the mean age of (2.2 ±2.1) years old(0.5-8.0 years),the body weight (13.8 ± 7.1) kg(7.0-34.1 kg),the defect size (4.5 ± 1.0) mm (3.0-8.0 mm).After general anesthesia,the patients were in supine and evaluated by TEE which indicated whether they were fit to closure.Then,they were turned to the right lateral position while this technique was determined.A vertical incision of 2-3 cm was made between the third and the fifth intercostal space and invasion in thoracic space via fourth intercostal space.Puncture was done at the anterior surface of right ventricular outlet tract to build a delivery tract.The occluder was released and the VSD was occluded under transesophageal echocardiography guidance.Results Forty-one patients had a successful surgical dcVSD closure with asymmetric occluders sized (6.0 ± 1.5) mm(4-10 mm).Among 4 failure cases,2 cases (4.4％) were switched to open-heart surgical repair,1 case (2.2％) due to device related aortic regurgitation,the rest 1 case (2.2％) experienced a dislocation of occluder into pulmonary artery and was converted to surgical repair after retrieve of occluder.Trivial residual shunt was detected in 2 cases (4.4％) postoperatively,a spontaneous closure was observed by 1 month follow-up and 3 months follow-ups,respectively.All the patients were discharged 5 to 8 days after the operation.With a follow-up of (10.4 ±5.0) months [3-24 months],there were no complications such as pericardial effusion,displacement of device,atrioventricular block or new valvular dysfunction.Conclusions Minimally invasive device closure of doubly committed sub-arterial ventricular septal defect via left sub-axillary is a feasible and safe treatment for closure of dcVSD.This technique has advantages of minor wound,less exudation,covert incision,however,long term follow-up is necessary.

To examine the feasibility of using a computer tool for stratifying the severity of Coronavirus Disease 2019 (COVID-19) based on computed tomography (CT) images. We retrospectively examined 44 confirmed COVID-19 cases. All cases were evaluated separately by radiologists (visually) and through an in-house computer software. The degree of lesions was visually scored by the radiologist, as follows, for each of the 5 lung lobes:0, no lesion present;1,<1/3 involvement;2,>1/3 and<2/3 involvement;and 3,>2/3 involvement. Lesion density was assessed based on the proportion of ground-glass opacity (GGO), consolidation and fibrosis of the lesions. The parameters obtained using the computer tool included lung volume (mL), lesion volume (mL), lesion percentage (％), and mean lesion density (HU) of the whole lung, right lung, left lung, and each lobe. The scores obtained by the radiologists and quantitative results generated by the computer software were tested for correlation. A Chi-square test was used to test the consistency of radiologist- and computer-derived lesion percentage in the right/left lung, upper/lower lobe, and each of the 5 lobes. The results showed a strong to moderate correlation between lesion percentage scores obtained by radiologists and the computer software (r ranged from 0.7679 to 0.8373, P < 0.05), and a moderate correlation between the proportion of GGO and mean lesion density (r=-0.5894, P<0.05), and proportion of consolidation and mean lesion density (r=0.6282, P<0.05). Computer-aided quantification showed a statistical significant higher lesion percentage for lower lobes than that assessed by the radiologists (x2 = 8.160, P = 0.004). Our experiments demonstrated that the computer tool could reliably and accurately assess the severity and distribution of pneumonia on CT scans.

Objective:To investigate the incidence of complications related to thread lift in the treatment of facial rejuvenation.Methods:The databases of China National Knowledge Infrastructure (CNKI), VIP Chinese Science and Technology Journal Full-text Database (VIP-CSJFD), Wanfang Data, China Biology Medicine (CBM), PubMed, The Cochrane Library and Embase were searched from database establishment to April 20, 2022. The inclusion and exclusion criteria were developed to include relevant studies that met the criteria. Two investigators independently performed literature screening and data extraction; the STROBE statement scored the quality of inclusion criteria for cross-sectional studies, the total score was 0-22 points, and the research of which score >11 points was considered as high-quality research; data analysis was performed using Stata16.0 software; Egger test and funnel plot analysis were used to evaluate the publication bias of literature.Results:Thirty-three articles involving 8 919 patients were included in this meta-analysis. The quality scores of 28 articles were > 11 points, and the remaining 5 articles were exactly 11 points, indicating that the overall quality of the articles was acceptable. The outcome measures of this meta-analysis included 11 indicators such as paresthesia, infection, facial asymmetry, facial nerve injury, mild unevenness or irregular contour, postoperative allergy, postoperative hematoma, pain, wire exposure or visibility, bruising, and swelling. The complication rates for each outcome measure were: paresthesia (1%), infection (0), facial asymmetry (2%), facial nerve injury (0), mild unevenness or contour irregularity (7%), postoperative allergy (0), postoperative hematoma (0), pain (17%), exposed or visible wire (7%), bruising (28%), swelling (55%). Egger test and funnel plot analysis showed that there was no publication bias in sensory abnormalities, facial asymmetry, postoperative allergy and pain. There may be some publication bias in the other 7 indicators.Conclusion:Among the complications related to thread lift, postoperative swelling, pain and bruising are the most common, while the incidence of serious complications is rare. Most complications are transient and self-resolving, and in general, thread lift is a relatively safe treatment modality.

Objective:To investigate the incidence of complications related to thread lift in the treatment of facial rejuvenation.Methods:The databases of China National Knowledge Infrastructure (CNKI), VIP Chinese Science and Technology Journal Full-text Database (VIP-CSJFD), Wanfang Data, China Biology Medicine (CBM), PubMed, The Cochrane Library and Embase were searched from database establishment to April 20, 2022. The inclusion and exclusion criteria were developed to include relevant studies that met the criteria. Two investigators independently performed literature screening and data extraction; the STROBE statement scored the quality of inclusion criteria for cross-sectional studies, the total score was 0-22 points, and the research of which score >11 points was considered as high-quality research; data analysis was performed using Stata16.0 software; Egger test and funnel plot analysis were used to evaluate the publication bias of literature.Results:Thirty-three articles involving 8 919 patients were included in this meta-analysis. The quality scores of 28 articles were > 11 points, and the remaining 5 articles were exactly 11 points, indicating that the overall quality of the articles was acceptable. The outcome measures of this meta-analysis included 11 indicators such as paresthesia, infection, facial asymmetry, facial nerve injury, mild unevenness or irregular contour, postoperative allergy, postoperative hematoma, pain, wire exposure or visibility, bruising, and swelling. The complication rates for each outcome measure were: paresthesia (1%), infection (0), facial asymmetry (2%), facial nerve injury (0), mild unevenness or contour irregularity (7%), postoperative allergy (0), postoperative hematoma (0), pain (17%), exposed or visible wire (7%), bruising (28%), swelling (55%). Egger test and funnel plot analysis showed that there was no publication bias in sensory abnormalities, facial asymmetry, postoperative allergy and pain. There may be some publication bias in the other 7 indicators.Conclusion:Among the complications related to thread lift, postoperative swelling, pain and bruising are the most common, while the incidence of serious complications is rare. Most complications are transient and self-resolving, and in general, thread lift is a relatively safe treatment modality.

Objective To explore the availability and safety of ileal ureter replacement combined with ileal augmentation cystoplasty in treating ureteral stenosis with contracted bladder.Methods From August 2015 to November 2018,three patients who underwent ileal ureter replacement combined with augmentation cystoplasty were treated with ileal ureter replacement combined with augmentation cystoplasty.There were 1 male and 2 females with the age ranging from 34 to 55 years (mean 39 years).Two patients suffered from left ureter stenosis,and one patient had stenosis on the both sides.The length of the ureter stenosis ranged from 6 to 18 cm (mean 9.8 cm).The preoperative bladder capacity ranged from 60 to 150 ml (mean 103.3 ml).In the surgery,part of ileum was used to replace the ureter,and the distal intestine was made into U-shape to enlarge the bladder.Results All operation were completed successfully.The operation time ranged from 220 to 400 min (mean 303.0 min),and the blood loss ranged from 150 to 500 ml (mean 283.3 ml).Laparoscopic surgery was performed in 1 case and open surgery in 2 cases.Three weeks after the surgery,the bladder volume underwent cystography ranged from 300 to 400 ml (mean 360.0 ml).Three months after the surgery,the postvoid residual urine volume ranged from 20 to 50 ml (mean 33.3 ml).Postoperative frequency and urgency of urine were completely relieved in 1 case,alleviated in 2 cases.Flank pain was completely relieved in 1 case,and alleviated in 2 cases postoperatively.The serum creatinine of 2 patients mildly increased after the surgery,while 1 patient remained stable.For complications,1 patient had urinary infection,and 1 patient suffered from metabolic acidosis.Conclusions Ileal ureteral replacement combined with augmentation cystoplasty can be the choice of treatment for long segment ureteral stenosis and enlarge the bladder simultaneously.The postoperative complications and the kidney functions should be regularly followed up.

Objective To evaluate preoperative three dimensional(3D)reconstruction techniques in perioperative patients of hepatocellular carcinoma (HCC) undergoing hepatectomy.Methods Fifty-eight HCC patients who had undergone hepatectomy between 2015 and 2017 were enrolled.Twenty-three patients underwent hepatectomy based on preoperative 3D reconstruction techniques,while other thirty-five patients were without using it.Results No significant statistical difference was found in clincopathological parameters of patients preoperatively.The patients who underwent hepatectomy based on 3D reconstruction techniques had less operation time (Z =-2.213,P =0.028),hepatic inflow occlusion rate,time (x2 =3.966,P =0.046;Z =-2.371,P =0.018) and blood loss (Z =-2.140,P =0.032) during operation.Totally 23 postoperative complications occurred which were Clavien-Dindo classification grade Ⅰ or Ⅱ.More complications occurred in the not using 3D technique group (x2 =6.061,P =0.014).Conclusion Preoperative 3D reconstruction technique improves the perioperative prognosis of hepatectomy in patients with hepatocellular carcinoma.

Objective:To evaluate the safety and effectiveness of Kangduo endoscopic surgical robot system for partial nephrectomy.Methods:Consecutive patients with stage T 1 renal tumor meeting the inclusion criteria from the Department of Urology, Peking University First Hospital from December 2020 to February 2021 were prospectively enrolled. All patients underwent partial nephrectomy with the Kangduo endoscopic surgical robot system after signing the informed consent. Clinical data including preoperative, perioperative and postoperative pathology and follow-up were collected. Results:Among the 26 patients, there were 16 males and 10 females, with a median age of 53(33-74) years, and a median body mass index of 25.99(20.90-32.91) kg/m 2. There were 12 cases of left kidney tumor and 14 cases of right kidney tumor. The median tumor diameter was 2.2(1.0-3.5) cm. The median time of warm ischemia was 17.7(7.1-29.2) minutes, and all of them were less than 30 minutes. The median docking time was 4.7(2.3-9.9) minutes, and the median time of robotic arm operation was 65.0 (37.0-155.0) minutes. The median National Aeronautics and Space Administration Task Load Index (NASA-TLX) score was 5.3 (2.0-28.0), and no instrument-related adverse events occurred intraoperatively. The median postoperative hospital stay was 4 (4-5) days. All tumor margins were negative on pathologic reports. No Clavien Ⅱ stage operative complications occurred in all patients during perioperative period and 1 month after the surgery. Conclusions:The partial nephrectomy using the kangduo endoscopic surgical robot system were completed successfully, and no instrument-related adverse events and complications occurred, showing that this surgical system used for partial nephrectomy is safe and effective.