Objective To explore the clinical result and complications of noncyclic-PPH surgery in treating internal hemorrhoids.Methods In this study,we evaluate the clinical outcome,such as clinical efficacy,operation time,length of hospital stay,postoperative pain degree and incidence of complications in 120 hemorrhoid patients,randomly divided into control group (60 cases) and observation group (60 cases)based on digital table method,receiving respectively noncyclic-PPH,or PPH (procedure for prolapse and hemorrhoids).Results Two groups were similar in average operation time and average length of hospital stay (P ＞ 0.05).The postoperative VAS score at each time point,was significantly lower in noncyclic-PPH group than the control group (P ＜ 0.05).Non-cyclic PPH group were also significantly lower in postoperative complications than the control group (P ＜ 0.05).Conclusion Compared with PPH surgery,patients with noncyclic-PPH have fewer pain complications or trauma.

Objective:To investigate the application value of three-dimensional (3D) printing technology assisted laparoscopic anatomic liver resection of segment 8 (Lap-S8).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 8 liver cancer patients including 7 cases with hepatocellular carcinoma and 1 case with intrahepatic cholangio-carcinoma who underwent 3D printing technology assisted Lap-S8 in the Hunan Provincial People′s Hospital from January 2019 to December 2020 were collected. There were 7 males and 1 female, aged from 49.0 to 80.0 years, with a median age of 56.5 years. Of the 8 patients, 6 cases underwent laparoscopic anatomic liver resection of the entire segment 8, 1 case underwent laparoscopic anatomic liver resection of ventral subsegmental of the segment 8 and 1 case underwent laparoscopic anatomic liver resection of dorsal subsegmental of the segment 8. 3D printing technology was used to assist preoperative evaluation and intraoperative navigation for all 8 patients. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted using outpatient examination, internet or telephone interview to detect survival and tumor recurrence of patients after operation up to March 2021. Measurement data with normal distribution were represented as Mean±SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations: all the 8 patients underwent 3D printing technology assisted Lap-S8 successfully, without conversion to open surgery. The operation time, hepatic portal occlusion time and volume of intraoperative blood loss of the 8 patients were (216±41)minutes, (56±11)minutes and 75 mL(range, 50 to 300 mL), respectively. There was no intraoperative blood transfusion in 8 patients, and the surgical margin of the 8 patients was negative. (2) Postoperative situations: the duration of postoperative hospital stay of the 8 patients were (9±3)days. There was no complication such as postoperative hemorrhage, biliary fistula, liver abscess or abdominal infection occurred. (3) Follow-up: all the 8 patients were followed up for 3.0?24.0 months, with a median follow-up time of 12.5 months. During the follow-up, 1 of 8 patients with preoperative diagnosis of recurrent hepatocellular carcinoma developed tumor recurrence at 5 months after operation. The patient underwent laparoscopic surgery followed with the transcatheter arterial chemoembolization and target therapy, and survived with tumor. There was no tumor recurrence in the other 7 patients.Conclusion:3D printing technology assisted Lap-S8 is safe and feasible.

Objective:To observe the effect of mulberry leaf extract on blood glucose and islet β cell proliferation in pregnant diabetic rats.Methods:The rat model of gestational diabetes mellitus was prepared. The 32 model rats were randomly divided into the model group, metformin group, low dose mulberry leaf extract group and high dose mulberry leaf extract group, 8 rats in each group. Eight normal pregnant mice were selected as the control group. The low and high dose groups received gavage of mulberry leaf extract 0.5 and 1.5 g/kg, respectively, the rats in the metformin group received gavage of 200 mg/kg metformin hydrochloride suspension, and the model group and the normal group received gavage of sterile normal saline of equal volume. The intervention continued for 4 weeks. The HE staining was used to observe rat pancreatic tissue pathology change. The fasting blood glucose level was measured by blood glucose meter. The TC, TG, LDL-C and HDL-C levels were measured by automatic biochemical detector. The fasting insulin level was measured by enzyme-linked immunosorbent assay, and the islet resistance index and insulin sensitivity index were calculated. The activity of SOD, CAT, GSH-pX and MDA level in serum were detected by radioimmunoassay. The MTT method was used to detect islet β cell proliferation, and the Western blot method was used to detect CDK4, pRB, E2F1 protein expression.Results:Compared with the model group, the low-dose and high-dose groups showed that the levels of FBG, TC, TG and LDL-C significantly decreased ( P<0.05), and the HDL-C levels significantly increased ( P<0.05). Compared with the model group, the low-dose and high-dose groups showed that fasting insulin and islet resistance index significantly decreased ( P<0.05), and insulin sensitivity index significantly increased ( P<0.05). Compared with the model group, the low-dose and high-dose groups showed that the levels of SOD (360.62 ± 27.96 U/ml, 401.62 ± 25.66 U/ml vs. 293.45 ± 31.36 U/ml), CAT (10.26 ± 2.07 U/ml, 12.26 ± 0.96 U/ml vs. 8.26 ± 2.44 U/ml), GSH-Px (790.23 ± 47.87 U/ml, 880.63 ± 40.62 U/ml vs. 716.62 ± 45.62 U/ml) significantly increased ( P<0.05), MDA (30.89 ± 3.28 mmol/ml, 40.42 ± 2.06 mmol/ml vs. 44.85 ± 5.33 mmol/ml) level significantly decreased ( P<0.05). After 48 h and 72 h of modeling, compared with the model group, the islet proliferation rate of the low-dose group and the high-dose group significantly increased ( P<0.01). Compared with the model group, the low-dose and high-dose groups showed that the CDK4 (1.15 ± 0.42, 1.35 ± 0.59 vs. 0.75 ± 0.22), pRB (1.11 ± 0.58, 1.54 ± 0.64 vs. 0.67± 0.20), E2F1 (1.06 ± 0.39, 1.27 ± 0.18 vs. 0.48 ± 0.12) protein expression significantly increased ( P<0.05). Conclusions:Mulberry leaf extract can effectively improve blood sugar, lipid and insulin levels in gestational diabetic rats, and promote the proliferation of pancreatic beta cells by regulating CDK4-pRB-E2F1 pathway-related proteins.

Acute abdomen is often a general term for abdominal diseases with acute abdominal pain as the main manifestation. Common clinical acute abdomen includes acute appendicitis, acute cholecystitis, acute cholangitis, acute pancreatitis, gastrointestinal perforation, intestinal obstruction and other diseases, its characteristics are great changes, rapid progress, high misdiagnosis rate, high postoperative complication rate and high mortality rate, accurate diagnosis and early treatment can obtain a good prognosis. With our in-depth understanding of the occurrence and development of acute abdomen diseases and the development of evidence-based medicine, minimally invasive technology plays a pivotal role in the diagnosis and treatment of common acute abdomen. Laparoscopy on diagnosis can clarify disease diagnosis to a large extent. For those who cannot undergo surgery, decompression and drainage under endoscopy provides a diversified plan for treatment decisions. In addition, minimally invasive techniques are also used in etiological treatment and complications. Disease, prevention of recurrence in all aspects, Minimally invasive technology is beneficial to the etiological treatment of biliary pancreatitis, appendicitis and cholangitis, and endoscopic technology is more consistent with the minimally invasive concept in the treatment of complications.

Objective:To establish a hydride generation atomic fluorescence method using ammonium persulfate as the digestion reagent for determination of arsenic in urine (hereinafter referred to as this method).Methods:The collected urine samples with ammonium persulfate were heated and digested on the tubular electric heating automatic control constant temperature digester (60 holes), with 5% hydrochloric acid solution as reaction medium and current carrier and 1.5% potassium borohydride solution as reducing agent. Arsenic content was determined with a four-channel atomic fluorescence spectrometer. The arsenic standard solution of 0 - 10 μg/L was prepared to determine the standard curve of this method, and the method was evaluated from the detection limit, linear range, correlation coefficient, precision, standard addition recovery experiment, and urine arsenic quality control sample detection. The standard method "Determination of Arsenic in Urine by Hydride Generation Atomic Fluorescence Spectrometry" (WS/T 474-2015, referred to as the standard method) was used for comparison experiments.Results:When the sampling volume was 1 ml, the detection limit of this method (digest with 1 ml 1.5 mol/L ammonium persulfate) was 0.03 μg/L. In the range of arsenic content from 0 - 10 μg/L, the linear relationship between arsenic content and fluorescence intensity was good, and the correlation coefficients ( r) were all 0.999 9. The relative standard deviations( RSD) of the three replicates of urine samples with different concentrations were 1.00%, 0.89% and 0.49%, respectively. Urine arsenic quality control samples were tested, and the test results were all within the range of public values; the overall average recovery was 102.29%, and the recovery range was 92.10% - 108.15%. Compared with the standard method in the determination results of 20 urine samples, the difference was not statistically significant ( t = - 0.40, P > 0.05). Conclusions:The hydride generation atomic fluorescence spectrometry using ammonium persulfate as digestion reagent for the determination of arsenic in urine has the advantages of low detection limit, good precision, high accuracy, small amount of sampling and digestion reagent, simple operation, and less harmful gas generation in sample pretreatment. It is suitable for rapid determination of arsenic in urine in large quantities.

Objective:Partial stereotactic ablative boost radiotherapy(P-SABR)is a method to deliver SABR boost to the gross tumor boost volume(GTVb), followed by conventionally fractionated radiotherapy to the whole tumor area(GTV). GTVb is the max volume receiving SABR while ensuring the critical organ-at-risk(OAR)falloff to 3 GyE/f. We investigated the potential advantage of proton therapy in treating bulky non-small cell lung cancer(the tumor length greater than 8 cm).Methods:Nine patients with bulky NSCLC treated with photon P-SABR in our institute were selected. For the treatment planning of proton therapy, the GTVb target area was gradually outwardly expanded based on the photon GTVb target area until the dose to critical OARs reached 3 GyE/f. The GTV and CTV areas remained the same as photon plan. A proton intensity-modulated radiation treatment plan(proton-IMPT), a photon intensity-modulated radiation treatment plan(photon-IMRT)and a photon volumetric modulated arc therapy(photon-VMAT)were created for each patient, respectively. The dosimetric parameters of different treatment plans were compared.Results:The volume ratio of GTVb-photon and GTVb-proton to GTV was(25.4±13.4)% and(69.7±30.0)%,respectively( P<0.001). In photon-IMRT, photon-VMAT, and proton-IMPT plan groups, the mean dose of CTV was(76.1±4.9)Gy, (78.2±3.6)Gy, and(84.7±4.9)Gy, respectively; the ratio of tumor volume with Biologic Effective Dose(BED)≥ 90 Gy to GTV volume was(70.7±21.7)%, (76.8±22.1)%,and(97.9±4.0)%,respectively. The actual dose and BED to the tumor area of the proton-IMPT plan group were significantly higher than those of the photon plan group(both P<0.05). Besides, the OARs dose was significantly decreased in the proton-IMPT group, with(49.2±22.0)%, (56.8±19.0)% and(16.1±6.3)% of the whole lung V5 for photon-IMRT, photon-VMAT and proton-IMPT, respectively(all P<0.001). Conclusions:Larger GTV boost target volume, higher BED and reduced OARs dose can be achieved in proton plans compared with photon plans. Proton P-SABR is expected to further improve the local control rate of bulky NSCLC with fewer adverse effects.

Objective To explore the differences between baduanjin and ninth set of broadcast gymnastics in their own pulse parameters before and after intervention for 12 weeks,and to provide objective indicators for the function of Baduanjin from the perspective of pulse diagnosis.Methods 60 healthy subjects were recruited,and 50 subjects were finally included according to the dropout criteria.The subjects were divided into the experimental group and the control group by the random number table method,and different interventions were adopted.Then,the pulse diagnosis of the two groups of subjects was collected,and the impact of the interventions on the viscera was judged by analyzing the Pulse Graph Parameters and contribution.Results The characteristic parameters of the experimental group include 8 time domain parameters(left Chi,left Guan,right Cun,etc.)and 9 frequency domain parameters(left Guan,left Chi,right Guan,etc.),which are mainly distributed in the left Cun,left Guan,left Chi,and right Guan;the characteristic parameters of the control group included 6 time domain parameters(left Cun,left Guan,right Chi,etc.)and 11 frequency parameters(left Guan,left Chi,right Guan,etc.),which were mainly distributed in left Chi,right Chi,and left Guan.Conclusion Practicing Baduanjin can significantly affect pulse diagram,and the accuracy and specificity after intervention are higher than those of the control group.Baduanjin has a certain influence on the circulation of qi and blood in the human meridians,and its mechanism of action may be related to affecting the overall circulation of qi and blood.In the experimental group,Baduanjin had a significant effect on the heart,liver,gallbladder,and kidneys,while the control group had the most obvious changes in the kidneys.For the overall intervention and coordination of the viscera,the Baduanjin group had better effects than the ninth broadcast gymnastics group.

Biology-guided radiotherapy (BgRT) is a novel technique of external beam radiotherapy, combining positron emission tomography-computed tomography (PET-CT) with a linear accelerator (LINAC). The key innovation is to utilize PET signals from tracers in tumor tissues for real-time tracking and guiding beamlets. Compared with a traditional LINAC system, a BgRT system is more complex in hardware design, software algorithm, system integration and clinical workflow. RefleXion Medical has developed the world's first BgRT system. Nevertheless, its actively advertised function, PET-guided radiotherapy, is still in the research and development phase. In this review study, we presented a number of issues related to BgRT, including its technical advantages and potential challenges.
Positron Emission Tomography Computed Tomography ; Radiotherapy Planning, Computer-Assisted/methods* ; Algorithms ; Particle Accelerators ; Biology ; Radiotherapy, Image-Guided/methods* ; Radiotherapy Dosage

BACKGROUND:Adjustable piezoelectric effect can promote tissue regeneration and repair.Piezoelectric materials are widely used in weight-bearing tissue engineering. OBJECTIVE:To prepare a piezoelectric film material that can promote bone regeneration,and to explore its structural characterization,electrical output performance,biocompatibility,and effect of electrical output on osteogenic differentiation of rabbit bone marrow mesenchymal stem cells. METHODS:Using poly-3-hydroxybutyrateco/4-hydroxybutyrate(P34HB)as raw material,barium calcium stannate titanate powder(Ba0.94Ca0.06Sn0.08Ti0.92O3,BCST)was added according to mass ratios of 0%,5%,10%,15%,and 20%.Dichloromethane was added to solve P34HB,and the thickness of 150-200 μm BCST/P34HB piezoelectric film was prepared by vacuum drying method.After polarization in the oil bath,the surface morphology,crystal phase composition,piezoelectric coefficient and open circuit voltage were tested.The effect of BCST/P34HB electrical output at 110 Hz and 0.25 N force on the proliferation and osteogenic differentiation of rabbit bone marrow mesenchymal stem cells was tested. RESULTS AND CONCLUSION:(1)Scanning electron microscopy,X-ray diffraction,water contact angle,piezoelectric coefficient and electrical output performance tests showed that when the mass ratio of BCST increased to 20%,the BCST/P34HB piezoelectric film had good piezoelectric properties(d33=5.9 pC/N)and electrical output performance(180 mV),which was closer to the suitable range of 500 mV for electrical stimulation.(2)Live and dead staining showed that on the first day of co-culture,15%group and 20%group showed less red fluorescence.On the 5th day of culture,the number of green fluorescence in each group was significantly higher than that on the first day,and the red fluorescence was not observed in the 10%,15%and 20%groups,and only a small amount of red fluorescence was observed in the 0%and 5%groups.(3)On the 1st,3rd and 5th days of co-culture with rabbit bone marrow mesenchymal stem cells,Almar blue staining exhibited that the number of cells in each group showed an increasing trend with the increase of time.On the 5th day of culture,the number of cells in the 20%group was significantly more than that in the 0%group(P<0.05).(4)On day 10 of osteogenic induction,alkaline phosphatase staining results showed that the positive rate of the 20%group was significantly higher than that of the 0%group(P=0.000 1).On day 21,alizarin red staining and quantitative analysis of calcium nodules showed a similar trend to alkaline phosphatase staining.Compared with the 0%group,the 15%group and 20%group showed significant differences(P<0.01,P<0.000 1).(5)The results showed that 20%BCST/P34HB films had good piezoelectric properties,electrical output properties,biocompatibility and the ability of promoting osteogenic differentiation of bone marrow mesenchymal stem cells.