ObjectiveTo investigate the surgical treatment and prognosis of T1b unsuspected gallbladder carcinoma (UGC). MethodsTwenty-two patients with T1b UGC admitted to our hospital were enrolled as subjects. The information on clinical pathology, radiological examination, laboratory tests, surgical treatment, and postoperative follow-up were analyzed in patients. The survival rate and recurrence were compared between patients treated with radical cholecystectomy and laparoscopic cholecystectomy. The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used for survival difference analysis. Comparison of categorical data was made by Fisher′s exact test. ResultsThe 1-, 3-, and 5-year accumulative survival rates in all patients with T1b UGC were 100%, 89.7%, and 82.8%, respectively; there was no significant difference in the 5-year accumulative survival rate between patients treated with laparoscopic cholecystectomy and radical cholecystectomy (84.6% vs 75.0%, χ2=0.000, P=0.991); two (15.4%) out of thirteen patients treated with laparoscopic cholecystectomy respectively; one (12.5%) out of eight patients treated with radical cholecystectomy had recurrence, there was no significant difference between the two groups(P＞005). ConclusionRadical cholecystectomy is a superior therapy for T1b UGC over laparoscopic cholecystectomy.

Objective To evaluate the effectiveness of psychological health intervention in the elderly urban residents living on minimum subsistence allowances, and to search for a suitable psychological health intervention strategy. Methods The 112 elderly persons living on minimum subsistence allowances in Xuzhou were selected by stratified cluster sampling, and they were matched with 112 controls. The elderly persons living on minimum subsistence allowances were divided into intervention group and control group. A general intervention based on community involved psychological health and care lecture, psychodrama treatment and psychological consultancy was made on the intervention. The SCL-90 was used to evaluate the psychological health status and effectiveness of psychological health intervention. Results The elderly persons living on minimum subsistence allowances had higher SCL-90 scores compared with other residents, and their psychological health status was serious. After the psychological health intervention, the SCL-90 scores were all lower in intervention group than in control group [ interpersonal relationship sensitiveness: (1.13 ± 0. 39) vs.(1.26±0.26), t=2.12, P=0.04; gloom: (1.23±0.66) vs. (1.43±0.24), t=2.08, P=0.04;anxiety: (1. 18±0.50) vs. (1.38±0.34), t=2.17, P=0.03; hostility: (1.24±0.49) vs. (1.40±0.28), t=2.03, P=0.04; other factor: (1. 31±0.56) vs. (1.49±0.31), t=2.04, P=0.04; total score: (115.89± 17.21) vs. (122.64± 10.41), t=2.42, P=0.02]. Conclusions The psychological health parameters are improved by psychological health intervention.

OBJECTIVE:To develop a method for simultaneous determination of 12 nonsteroidal anti-inflammatory drugs (NSAIDs) illegally added into antirheumatic TCM preparations.METHODS:UPLC-MS/MS was adopted.The determination was performed on Hypersil Golden C18 column with mobile phase consisted of 5 mmol/L ammonium formate solution-methanol (gradient elution) at the flow rate of 0.2 mL/min.The column temperature was 40 ℃,and the sample size was 2 μL.A tandem quadrupole mass spectrometer equipped with electrospray ionization source was used in positive-negative ion mode:curtain gas of 25 kPa,atomizing gas of 60 kPa,auxiliary gas of 55 kPa,electrospray voltage of 4 500 V,ion source temperature of 650 ℃.The multiple reaction monitoring mode was performed.RESULTS:The linear ranges of acetaminophen,acetylsalicylic acid,aminopyrine,meloxicam,ibuprofen,naproxen,lam acid,nimesulide,diclofenac,indomethacin,ketoprofen and celecoxib were 0.01-2.0 μg/ rnL (r=0.995 6),0.05-5.0 μg/mL (r=0.997 6),0.01-2.0 μg/mL (r =0.998 7),0.02-5.0 μg/mL (r=0.995 0),0.02-5.0 μg/mL (r =0.995 3),0.02-5.0 μg/mL(r=0.996 5),0.05-5.0 μg/mL(r=0.995 4),0.02-5.0 μg/mL(r=0.996 0),0.05-5.0 μg/mL(r=0.995 9),0.02-5.0 μg/mL(r=0.995 7),0.02-5.0 μg/mL(r=0.996 8),0.01-2.0 μg/mL(r=0.998 7),respectively.The limits of quantitation were no more than 0.20 mg/g,and the limits of detection were no more than 0.05 mg/g.RSDs of precision,stability and reproducibility tests were all lower than 5.0％.The recoveries were 80.8％-114.2％ (RSD was 3.85％-7.32％,n=9).CONCLUSIONS:The established method is simple,accurate,stable and reproducible,and can be used for simultaneous determination of 12 NSAIDs illegally added into antirheumatic TCM preparations.

Objective To investigate the impact of transvaginal natural orifice transluminal endo-scopic surgery(NOTES)-assisted laparoscopic nephrectomy on female sexual function and quality of life . Methods This was a prospective study on the change of female sexual function and quality of life of female patients who underwent transvaginal NOTES-assisted laparoscopic nephrectomy from May .2011 to Nov. 2012.A total of 42 cases were included in this study (28 of them with severe hydronephrosis , non-functio-ning kidney , 11 with pyelonephrosis , 1 with renal tuberculosis , 1 with duplex kidney complicated with hy-dronephrosis, and 1 with renal angiomyolipoma ).The mean age was 36.9±5.3 (26-45) years, and the mean body mass index was 21.7±2.6 (14.7 to 27.1) kg/m2.Twenty-four cases were operated on the left side, 18 cases on the right .The female sexual function and quality of life were assessed before and 4 months, 7 months and 1 year after surgery using the Female Sexual Function Index (FSFI) questionnaire and the MOS 36-item Short-Form Health Survey (SF-36), respectively. Results The mean FSFI of 42 cases preoperatively and 4 months, 7 months and 1 yr postoperatively were 27.74 ±4.34, 27.19 ±4.49, 28.54±4.23, and 28.68 ±4.19, respectively.There was no statistically significant difference among them (F=1.111, P=0.346).Compared with that of preoperation , the physical function, vitality, metal health, body pain, and general health of the patients were improved , but the role-physical, role-emotion and social function were not improved at postoperative month 4 and month 7 (P<0.05).Each item of SF-36 was im-proved after postoperative 1 year ( P<0.05) . Conclusions Transvaginal NOTES-assisted laparoscopic ne-phrectomy does not cause negative effect on the female sexual function .The quality of life can be improved after operation .The physical function is improved at early stage , and the psychological function as well .

Objective To analyze the complications of transvaginal natural orifice transluminal endoscopic surgery( TV-NOTES) nephrectomy, and to explore effective measures to prevent and manage those complication.Methods From May 2010 to January 2015, a total of 178 females who had been married and given birth underwent TV-NOTES nephrectomy in our center.The average age was 47 ( ranging 23 to 71 ) years and the average BMI was 23.6 ( ranging 14.7 to 31.9 ) kg/m2.Pathological diagnosis included 142 cases of non-functional kidneys, 29 cases of renal tumors ( T1 N0-1 M0 25 cases, T2 N0-1 M0 4 cases) , and 7 cases of renal tuberculosis.One hundred and sixty hybrid TV-NOTES nephrectomy procedures (simple in 132, radical in 28) and 18 pure TV-NOTES nephrectomy procedures (simple in 17, radical in 1) were performed.Intraoperative and postoperative complications were graded according to Satava and Clavien-Dindo grade classifications.The major complications and relative treatments were analyzed.Results Among the 178 TV-NOTES nephrectomy procedures, there were 40 ( 22.5%) complications occurred, including 13 (7.3%) major complications, in which there were 11 cases of intraoperative complications (6.2%),2 cases of postoperative complications (1.1%).All the complications were successfully managed using organ repair or resection, embolectomy, hemostasis, and so on.No intraoperative and postoperative deaths occurred.There was no significant difference in major complications between hybrid TV-NOTES and pure TV-NOTES nephrectomy (6.9%vs.11.1%, P=0.620).The intraoperative major complications in the early developmental stage of TV-NOTES nephrectomy were more than that of the late stage (20.0%vs.3.4%, P=0.004).There was no significant difference in postoperative complications between the early and late developmental stage of TV-NOTES nephrectomy (13.3%vs.10.8%, P=0.751).Conclusions TV-NOTES nephrectomy is safe and feasible, but there are some major complications worthy of attention.Personal prevent and treatment strategy should be considered.

Objective To describe the initial clinical experience of transvaginal NOTES-assisted laparoscopic nephrectomy. Methods From May to June 2010, 4 female patients with non-functioning kidney and 1 female patient with renal tuberculosis underwent transvaginal NOTES-assisted laparoscopic nephrectomy. The median age was 41 years (range 36 to 63). Three lesions were on the right side, and 2 on the left. After induction of general anesthesia, the patients were positioned in lithotomy with ipsilateral lumbar at 60° angle to the operating table. A 5 mm Trocar and a 10 mm Trocar were placed through the umbilicus, and a 10 mm Trocar for 30° laparoscope was placed through the posterior vaginal fornix under direct vision. The kidneys were put into a home-made bag and removed via the incision of posterior vaginal fornix after there were completely resected. Results The 5 procedures were successfully finished. The median operative time was 190 (range 150 to 260)min. The median estimated blood loss was 185 (range 150 to 210) ml. There were no intra-operative or postoperative complications. The patients resumed ambulation 1 day after surgery, and resumed nutrition 2 days after surgery. The drainages were removed on postoperactive day 3. The patients were discharged on postoperative day 7. The incision in vagina healed well. Conclusions Transvaginal NOTES-assisted laparoscopic nephrectomy is feasible and reproducible. This novel technique may provide additional benefits related to postoperative pain, recovery, and cosmetic results even when compared to today's minimally invasive procedures.

Misuse and abuse of veterinary antimicrobial agents have led to an alarming increase in bacterial resistance, clinical treatment failure, and drug residues. To address these problems, consistent and appropriate dosage regimens for veterinary antimicrobial agents are needed. Pharmacokinetics/Pharmacodynamics (PK/PD) models have been widely used to establish rational dosage regimens for veterinary antimicrobial agents that can achieve effective prevention and treatment of bacterial diseases and avoid the development of bacterial resistance. This review introduces building methods for PK/PD models and describes current PK/PD research progress toward rational dosage regimens for veterinary antimicrobial agents. Finally, the challenges and prospects of PK/PD models in the design of dosage regimens for veterinary antimicrobial agents are reviewed. This review will help to increase awareness of PK/PD modeling among veterinarians and hopefully promote its development and future use.
Anti-Infective Agents ; Bacterial Infections ; Drug Residues ; Humans ; Treatment Failure ; Veterinarians

Objective:To evaluate the effectiveness and safety of ultrasound-guided percutaneous polidocanol sclerotherapy of the thyroglossal duct cysts in children.Methods:A retrospective analysis of 26 children who were treated with ultrasound-guided percutaneous puncture sclerosis for thyroglossal duct cysts in Beijing Children′s Hospital, Capital Medical University from October 2019 to April 2022, the size of the cyst before treatment was recorded, and the cyst volume in accordance with V(ml) =1/6 πabc cyst volume was calculated. The follow-up time was the 1st, 3rd, 6th, and 12th months after sclerotherapy. And the cyst volume and volume reduction ratio at different time points was calculated. According to changes in the cystic volume, the treatment was considered effective if the cyst volume reduction rate was≥50%. Cosmetic grading scores (CGS) were performed pre-treatment and at the last follow-up after sclerotherapy using the WHO grading system. Complications were recorded during the follow-up period.Results:The cyst volume before treatment was 2.67 (3.78)ml, and the cyst volume at the 1st, 3rd, 6th and 12th month after treatment were 0.66(1.83), 0.45(0.87), 0.40(0.70), 0.38 (0.63)ml, respectively, there were significant differences between pre-treatment and each time point after-treatment (all P<0.001); the volume reduction rate at the last follow-up was (81.48±14.57)%. The reduction rate of cyst volume was more than 50% at the last follow-up in 22 children, the treatment efficiency was 84.62% (22/26). The cosmetic grading scores at the last follow-up after sclerotherapy was 1.74(1.50), and it decreased significantly compared with the pre-treatment score 3.85(0)( P<0.001). There was no skin pigmentation, pain in the injection area, local urticaria and blistering after sclerotherapy, no adverse reactions such as cyst bleeding and drunkenness-like reaction, and no serious complications occurred. There were 2 cases of cysts that presented infection with fever, and no serious complications occurred. Conclusions:Ultrasound-guided percutaneous sclerotherapy is a safe and effective minimally invasive treatment for thyroglossal duct cysts in children.

Objective To describe our experience with the transvaginal natural orifice transluminal endoscopic surgery (NOTES) in female patients,and to evaluate its clinical value.Methods Between May 2010 and April 2017,a total of 289 female patients underwent transvaginal NOTES in our center,including 31cases of adrenal tumors,46 cases of renal tumors,188 cases of non-functional kidneys,5 cases of renal cysts,4 cases of duplex kidney,7 cases of renal tuberculosis and 8 cases of renal pelvis tumors.Among them,146 cases were on the left side,142 cases on the right side,and 1 case on both sides (renal cysts).The median age was 39.4 (range 23 to 76) years,and the median body mass index was 21.8(range 15.4 to 32.6) kg/m2.After general anesthesia,the patients were positioned in lithotomy with ipsilateral lumbar at 30°-60° angle to the floor.Hybrid and pure transvaginal NOTES were performed.The specimen was removed through an extended incision at the posterior vaginal fornix.Results Transvaginal NOTES was successfully completed in 281 patients.Two patients required conversion to suprapubic-assisted laparoendoscopic single-site surgery because of the rectal injury in pure transvaginal NOTES nephrectomy.Six patients underwent open conversion.The various transvaginal hybrid NOTES procedures included adrenalectomy (31 cases),nephrectomy (206 cases;simple 174 cases,radical 32 cases),partial nephrectomy (13 cases),heminephroureterctomy for duplex kidney (4 cases) and hybrid endoscopy for nephroureterectomy (7 cases).The mean operative time was 105 min (45-310 min),the mean estimated blood loss was 87 ml (20-800 ml),the mean visual analogue score (VAS) of 48 hours after operation was 2.5 (1-4) points and the mean hospitalization was 7.3 d (4-13 d) for transvaginal hybrid NOTES.The various pure transvaginal NOTES procedures included nephrectomy (22 cases;simple 21,radical 1),renal cyst excision (5 cases).The mean operative time was 170 min (60-320 min),the mean estimated blood loss was 140 ml (20-500 ml),the mean VAS of 48 hours after operation was 1.7 (1-3) points and the mean hospitalization was 5.5 d (3-10 d) for transvaginal pure NOTES.Complications occurred in 56 cases (19.38％),including 20 cases (6.92％) of severe complications,and no death occurred.After a mean follow-up of 51 (range 3 to 86) months,umbilicus scar was hidden.The incision in the vagina healed well.No infection in the abdominal or pelvic cavity or celiocele occurred.The umbilicus scar is not obvious after surgery,and 3 months after surgery.The median Patient Scar Assessment Questionnaire (PSAQ) score was 38 (31-58) and the median Female Sexual Function Index (FSFI) score was 28.2 (22.5-32.2),and the quality of life index was significantly higher than that of preoperation.Condusions Transvaginal NOTES could treat variousprimary diseases,and improve the postoperative quality of life.It does not increase the incidence of related complications,or cause negative effect on the female sexual function,pregnancy or fertility.It can lead to good cosmetic outcome and less pain,which is worth applying in clinical practice.

Objective: To investigate the snoring status of school-aged children in Beijing and explore the association of snoring and academic performance. Methods: A total of 7 925 children aged from 6 to 14 were selected from 15 primary and middle schools at 7 districts (Xicheng, Chaoyang, Changping, Shunyi, Fangshan, Huairou and Mentougou) in Beijing in 2015, using multi-stage stratified cluster random sampling method. The recruited children were asked to complete the Pediatric Sleep Questionnaire (PSQ) and a questionnaire related to sleep behavior. The multiplelogistic regression was used to analyze the association of snoring and academic performance. Results: A total of 794 (12.44%) children showed a decline in academic performance among 6 383 eligible respondentsfor data analysis. 580 (9.08%) children with snoring was identified, of which 333 and 247 were in frequency of 1-2 times per week and frequency of ≥3 times per week, respectively; 357, 170 and 53 were in snoring grade Ⅰ, grade Ⅱ and grade Ⅲ, respectively. Compared with the children without snoring, the OR (95%CI) for children with 1-2 times per week and ≥3 times per week was 1.363 (1.000-1.857) and 1.605 (1.135-2.269), respectively; and the OR (95%CI) for children with grade Ⅰ, grade Ⅱ and grade Ⅲ of snoring was 1.226 (0.893-1.683), 1.595 (1.062-2.397) and 2.31 (1.17-4.565), respectively. Conclusion There is a statistical relationship between snoring and the decline of academic performance. The decline of academic performance positively associated with increased frequency and grade of snoring.