OBJECTIVE:To systematically evaluate the efficacy of mecobalamin,ganglioside,mixture of calcium and magne-sium,reduced glutathione,mixture of calcium and magnesium combined with reduced glutathione in the prevention of chronic neu-rotoxicity induced by oxaliplatin, and to provide evidence-based reference for clinic treatment. METHODS:Retrieved from PubMed,clinicltrials.gov and CJFD,randomized controlled trials (RCT) about efficacy of 5 interventions in the prevention of chronic neurotoxicity induced by oxaliplatin were collected,and network Meta-analysis were performed by using ADDIS 1.16.5 af-ter extracting data and evaluating quality. RESULTS:A total of 34 studies were included,involving 3 236 patients. 4 studies were three-arm studies,30 studies were two-arm studies,totally 42 arms. Compared with placebo,the incidence of CIPN by 5 interven-tions was significantly reduced. Mixture of calcium and magnesium combined with reduced glutathione was the most effective and the followed by mecobalamin,reduced glutathione,ganglioside and mixture of calcium and magnesium,however,there were no significant differences among 5 interventions(P>0.05). CONCLUSIONS:5 kinds of interventions are all effective in the preven-tion of chronic neurotoxicity induced by oxaliplatin. Mixture of calcium and magnesium combined with reduced glutathione is the most effective. Duo to the low quality of included studies,large-scale and high quality RCTs are required for further validation of the conclusions.

Two hundred and twenty five children aged 4-12 years with phimosis were treated by flexible dilatation combined with topical betamethasone cream from January 2003 to January 2015.Two hundred and eight cases (92.44％) were completely cured and penile edema and urination were returned to normal 7 d after a single operation;while,17 children received 2-3 additional flexible expansion.During follow-up of 2-24 months,221 children achieved the cure standards with an overall cure rate of 98.22％.Flexible dilatation combined with topical betamethasone cream is effective modality for phimosis in children,with less surgical trauma and low complication rate.

Objective:To explore blood type distribution of newborns hemolytic disease ( HDN ) caused by maternal and neonatal blood type incompatibility and analyze the value of hemolysis three trials in the diagnosis of HDN.Methods:Hemolysis three trials of type O or Rh negative maternal cord blood samples and hyperbilirubinemia of the newborn blood samples from January 2014 to 2016 were detected by micro-column gel test cards.Then the results were statistically analyzed.Results:(1) There were 918 cases of maternal and neonatal blood type incompatibility in all 1350 cases.569 cases were detected HDN positive with the rate of 62%( 569/918).Among 569 cases,the positive rate of direct anti-globulin test,free antibody test and antibody released test were 27.9%(159/569),86.5%(492/569) and 100% respectively.There was statistical difference of the combination of direct anti-globulin test negative,free antibody test positive and antibody released test positive compared with other combinations ( P<0.05 ).( 2 ) There was statistical difference of HDN positive rate between ABO 73.8%(551/747) and Rh 10.5%(18/171)in 918 cases of blood type incom-patibility.(3)There was statistical difference between A positive rate of 80%(280/350) and B positive rate of 68.3%(271/397) in 747 cases of ABO incompatibility.(4)There was statistical difference among RhD positive rate of 17.7%(14/79),RhE positive rate of 6.8%(4/59) and RhC positive rate of 0(0/33).Conclusion: Antibody released test was the most sensitive test in hemolysis three trials to diagnose HDN.The probability of HDN positive caused by maternal and neonatal ABO blood type incompatibility was significantly higher than Rh.The probability of HDN positive with type A newborns was significantly higher than type B.The probability of HDN positive caused by RhD blood type incompatibility was significantly higher than RhE and RhC.

OBJECTIVETo investigate the effect of delayed skin grafting combined traction in severe joint cicatricial contracture.

METHODSAt the first stage, the joint cicatricial contracture was released completely with protection of vessels, nerves and tendons. The wound was covered with allogenetic skin or biomaterials. After skin traction for 7-14 days, the joint could reach the extension position. Then the skin graft was performed on the wound. 25 cases were treated from Mar. 2000 to May. 2013.

RESULTSPrimary healing was achieved at the second stage in all the cases. The skin graft had a satisfactory color and elasticity. Joint function was normal. All the patients were followed up for 3 months to 11 years with no hypertrophic scar and contraction relapse, except for one case who didn' t have enough active exercise on shoulder joint.

CONCLUSIONDelayed skin grafting combined traction can effectively increase the skin graft survival rate and improve the joint function recovery.

Biocompatible Materials ; therapeutic use ; Cicatrix, Hypertrophic ; Combined Modality Therapy ; methods ; Contracture ; surgery ; Female ; Humans ; Male ; Recovery of Function ; Recurrence ; Skin Transplantation ; methods ; Tendons ; Traction ; methods ; Wound Healing

Objective To introduce an operative method of rhytidectomy with W-incision and fewer complications for facial rejuvenation.Methods A total of 84 patients were treated with rhytidectomy by multi-methods and followed up from January 2007 to December 2012.The rhytidectomy was done along the temporal hairline edge through the combined procedures,including sharp and blunt separation,liposuction and filling with autologous fat,tighting and fixing the fascial flap of superficial musculoaponeurotic system,as well as the suspension of the zygomatic cheek fiber fat pad.Results Follow-up for 3 moths to 2 years after surgery in 84 patients showed that the wound was healing with good concealment and without complications such as facial nerve injury or local uneven.All the cases achieved good results in facelift with high satisfaction rate after the combined operations.Conclusions This combined rhytidectomy is safe,effective,simple and easy.And it is a good and ideal approach of facial rejuvenation worthy of clinical application.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder, mainly manifested as recurrent abdominal pain, abdominal discomfort and/or changes of defecation habits and stool character, its pathogenesis has not been fully clarified. The pathophysiology is characterized by visceral hypersensitivity, abnormal intestinal motility, and so on. Abnormality of ion channels may be in involved in the pathophysiological mechanism of IBS. This article reviewed the progress in study on ion channels and pathogenesis of IBS.

In order to investigate the species and categorization of Gasterophilus in Ili horse.We analysised the COI gene of the identified Gasterophilus dominant species and constructed NJ phylogenetic tree in the study.The results showed that infection rate was 100％ in total of 16 775 the third phase Gasterophilus instar larvae.Four Gasterophilus species were identified,and showed serious mix infections.Dominant species were Gasterophilus nasalis,its relative dominance were 53.17％,and prefer to live in the cardia,others to irregular live in the pylorus of the horses.COI gene homology of GasterophiIus nasalis,Gasterophilus intestinalis,Gasterophilus pecorum,Gasterophilus haemorrhoidalis (GenBank Accession No.:GU265752.1,KR230402.1,KU578262.1,KT946620.1) were 99％,99％,99％ and 100％ respectively.Phylogenetic analysis results showed that the data were clustered with the Gasterophilus app.which publshed on the GenBank.G.intestinalis and G.haemorrhoidalis cluster together first,and then cluster with G.nasalis,at last all three kinds of Gasterophilus cluster with G.pecorum.When the COI gene is the target,in-group and out-group of the Gasterophilus can forms an independent evolutionary branch.This study provides useful parameters for the classification of Gasterophilus.

Objective:To analyze the prognostic factors of robot-assisted radical cystectomy (RARC).Methods:The clinical data of 224 patients underwent RARC from December 2014 to December 2018 in Nanjing Drum Hospital were reviewed. There were 193 males and 31 females, aged 36-92 years, with mean of 68 years. There were 7 patients(3.1%)undergoing neoadjuvant chemotherapy, the ASA scores of 125 patients (55.8%) were more than 2, and the mean body mass index was 23.4(15.4-35.5)kg/m 2. All patients were treated with RARC, with 72(32.1%) patients undergoing intraoperative blood transfusion. Kaplan-Meier method was used to analyze recurrence-free survival rate (RFS), cancer-specific survival rate (CSS) and overall survival rate (OS). Cox multivariate risk ratio model was used to evaluate the correlation between survival outcome and perioperative and pathological factors in patients treated with RARC. Results:For pathological status, there were 82 of ≤T 1, 64 of T 2, 57 of T 3 and 21 of T 4. Of all the patients, 49(21.9%) had lymph node metastasis, 12(5.4%) had positive surgical margin, 82(36.6%) had lymphovascular invasion(LVI), and 41(18.3%) underwent adjuvant chemotherapy. Follow-up time was between 11-60 months, and the median follow-up time was 24 months. The 5-year cumulative OS, RFS and CSS were 57.15%, 48.84% and 59.60%, respectively. Univariate Cox regression analysis showed that T stage( HR=5.764, 95% CI 1.926-17.249, P=0.002; HR=4.086, 95% CI 1.611-10.364, P=0.003; HR=9.391, 95% CI 2.118-41.637, P=0.003), N stage( HR=6.446, 95% CI 3.438-12.087, P<0.001; HR=5.661, 95% CI 3.086-10.385, P<0.001; HR=5.980, 95% CI 2.982-11.992, P<0.001), LVI( HR=3.319, 95% CI 2.008-5.486, P<0.001; HR=2.894, 95% CI 1.782-4.701, P<0.001; HR=3.471, 95% CI 2.017-5.974, P<0.001), American Society of Anesthesia (ASA)score( HR=2.888, 95% CI 1.619-5.150, P<0.001; HR=1.765, 95% CI 1.060-2.940, P=0.029; HR=2.612, 95% CI 1.424-4.792, P=0.002), body mass index( HR=0.886, 95% CI 0.819-0.957, P=0.002; HR=0.885, 95% CI 0.819-0.955, P=0.002; HR=0.862, 95% CI 0.792-0.938, P=0.001), age( HR=1.580, 95% CI 1.250-1.997, P<0.001; HR=1.362, 95% CI 1.088-1.705, P=0.007; HR=1.530, 95% CI 1.190-1.968, P=0.001) and intraoperative blood transfusion( HR=1.899, 95% CI 1.160-3.108, P=0.011; HR=2.218, 95% CI 1.371-3.587, P=0.001; HR=2.227, 95% CI 1.312-3.782, P=0.003) were significantly related to survival outcome. Multivariate Cox regression analysis showed that T stage( HR=4.506, 95% CI 1.433-14.175, P=0.01; HR=3.159, 95% CI 1.180-8.454, P=0.022; HR=7.810, 95% CI 1.674-36.444, P=0.009), N stage( HR=6.096, 95% CI 2.981-12.467, P<0.001; HR=5.368, 95% CI 2.683-10.740, P<0.001; HR=5.539, 95% CI 2.497-12.288, P<0.001) and ASA score( HR=6.180, 95% CI 2.371-16.110, P<0.001; HR=2.702, 95% CI 1.175-6.215, P=0.019; HR=6.471, 95% CI 2.290-18.286, P<0.001) were independent predictors of RFS, CSS and OS, and adjuvant chemotherapy( R=0.434, 95% CI 0.202-0.930, P=0.032) could only predict OS. Conclusion:T stage, N stage and ASA were main independent predictors of postoperative survival outcomes, and adjuvant chemotherapy was independent predictor of OS.

Objective:To explore the clinical value of N terminal pro B type natriuretic peptide (NT-proBNP) in diagnosing or predicting heart failure in peridialysis chronic kidney disease (CKD) population.Methods:It was a single-center retrospective study. Patients with peridialysis CKD who visited the Department of Nephrology, First Affiliated Hospital of Zhengzhou University from January 2021 to June 2021 were collected and divided into 4 groups according to the presence or absence of heart failure and the level of left ventricular ejection fraction (LVEF), namely the non-heart failure group, heart failure with reduced ejection fraction (HFrEF) group (LVEF<40%), heart failure with mid-range ejection fraction (HFmrEF) group (40％≤LVEF<50％), and heart failure with preserved ejection fraction (HFpEF) group (LVEF≥50％). The NT-proBNP, echocardiography and other indicators of the 4 groups were compared. The value of plasma NT-proBNP in diagnosing heart failure, HFpEF, HFmrEF and HFrEF was analyzed by drawing receiver operating characteristic curve (ROC curve). Logistic regression analysis was used to analyze the related factors of heart failure in peridialysis CKD patients.Results:A total of 508 patients were included, including 11 cases in the HFrEF group, 29 cases in the HFmrEF group, 152 cases in the HFpEF group, and 316 cases without heart failure. The differences in age, 24-h urine volume, hemodialysis proportion, non-dialysis proportion, serum creatinine, estimated glomerular filtration rate, hemoglobin, serum albumin, C-reactive protein, NT-proBNP, cardiac troponin I, left ventricular internal diameter, LVEF, pulmonary artery systolic pressure, left ventricular end-diastolic volume, E/A value, septal thickness, and left ventricular posterior wall thickness among the four groups were statistically significant ( P < 0.05, respectively). A two-pair comparison (all P values corrected by Bonferroni method) revealed that the 24-h urine volume was higher in the non-heart failure group than in the other three groups (corrected P<0.05, respectively), while the proportion of hemodialysis patients and the levels of NT-proBNP and C-reactive protein were lower in the non-heart failure group than in the other three groups (corrected P<0.001, respectively); the levels of hemoglobin and serum albumin were lower in the HFpEF group than in the non-heart failure group (corrected P<0.001, respectively); troponin I was lower in the non-heart failure group than in the HFpEF group (corrected P<0.001), HFmrEF group (corrected P=0.001) and HFrEF group (corrected P<0.001), and troponin I was lower in the HFpEF group than in the HFrEF group (corrected P=0.008); LVEF was higher in the non-heart failure group than in the other three groups (corrected P<0.001, respectively), and LVEF in the HFpEF group was higher than in the HFmrEF and HFrEF groups (corrected P<0.001, respectively). For patients with peridialysis CKD, the cut-off values of plasma NT-proBNP for diagnosing or predicting heart failure, HFpEF, HFmrEF and HFrEF were 4 943.33 ng/L, 4 976.83 ng/L, 14 964.5 ng/L and 17 847.55 ng/L, respectively. Multivariate logistic regression analysis showed that NT-proBNP (every 500 ng/L increase, OR=1.390, 95% CI 1.287-1.501, P<0.001), LVEF ( OR=0.747, 95% CI 0.656-0.851, P<0.001) and 24-h urine volume (every 100 ml increase, OR=0.842, 95% CI 0.763-0.929, P=0.001) were independently correlated with heart failure. Conclusions:The cut-off value of plasma NT-proBNP for diagnosing or predicting heart failure in peridialysis CKD patients is much higher than that in patients with normal renal function. NT-proBNP, LVEF and 24-h urine volume are independently associated with heart failure in peridialysis CKD patients.

Objective:To systematically evaluate the effect of couple-centered psychological intervention on breast cancer patients.Methods:Randomized controlled trials published in PubMed, Embase, Web of Science, Scopus, CINAHL, Cochrane Library, JBI, CNKI, Wanfang, Vip and CBM database on the effect of psychological intervention on breast cancer patients with husband and wife as the center were searched by computer. The retrieval time was from the establishment of the database to September 2020. Two reviewer independently conducted literature screening, data extraction and literature quality evaluation according to the inclusion and exclusion criteria, and Meta analysis was carried out using RevMan 5.3 software.Results:A total of 879 patients were included in 11 articles. Meta analysis results showed that the couple-centered psychological intervention not only improved the quality of life, but also improved the anxiety of breast cancer patients ( SMD=1.54, 95% CI 0.22-2.86, P=0.02) and depression ( SMD=1.22, 95% CI 0.12-2.33, P=0.03). Conclusions:After psychological intervention, the anxiety and depression of breast cancer patients were improved and the quality of life was also improved. Due to the inconsistency in the mode, frequency and evaluation index of psychological intervention, more large samples and high-quality studies are needed to further verify the effect of couple-centered psychological intervention on breast cancer patients and spouses centered on husband and wife.