Function-preserving gastrectomy has been gradually implemented in China. Under the premise of oncologic safety,such surgery is crucial for improving patients′ postoperative quality of life. Although proximal gastrectomy is a classic surgical method for the adenocarcinoma of esophagogastric junction,no consensus exists on the vagus nerve preservation and digestive tract reconstruction. How to preserve the vagus nerve and pyloric function, and avoid postoperative gastroesophageal reflux after proximal gastrectomy has consistently been the focus of clinical research on proximal gastrectomy. This study introduces the application of laparoscopic proximal gastrectomy with nerve vagus preservation combined with double-flap anastomosis in proximal early gastric cancer. The hepatic branches and the celiac branches are both preserved during the surgical procedure,and the manufacture of double-flap is completed through auxiliary incisions. The anastomosis of the esophagus and the remnant stomach is performed under laparoscopy. It conforms to the physiological structure and preserved the functions of the stomach,which avoided weight loss and nutritional absorption disorder after total gastrectomy. Additionally, it reduces the incidence of reflux esophagitis following traditional esophagogastrostomy, thereby improving patients′ postoperative quality of life.

Function-preserving gastrectomy has been gradually implemented in China. Under the premise of oncologic safety,such surgery is crucial for improving patients′ postoperative quality of life. Although proximal gastrectomy is a classic surgical method for the adenocarcinoma of esophagogastric junction,no consensus exists on the vagus nerve preservation and digestive tract reconstruction. How to preserve the vagus nerve and pyloric function, and avoid postoperative gastroesophageal reflux after proximal gastrectomy has consistently been the focus of clinical research on proximal gastrectomy. This study introduces the application of laparoscopic proximal gastrectomy with nerve vagus preservation combined with double-flap anastomosis in proximal early gastric cancer. The hepatic branches and the celiac branches are both preserved during the surgical procedure,and the manufacture of double-flap is completed through auxiliary incisions. The anastomosis of the esophagus and the remnant stomach is performed under laparoscopy. It conforms to the physiological structure and preserved the functions of the stomach,which avoided weight loss and nutritional absorption disorder after total gastrectomy. Additionally, it reduces the incidence of reflux esophagitis following traditional esophagogastrostomy, thereby improving patients′ postoperative quality of life.

ObjectiveTo construct an evaluation index system for the development of district-level disease prevention and control centers according to the requirements of the modernization of Shanghai’s disease control system and public health work practices， and to comprehensively assess the construction and development of district-level disease prevention and control institutions. MethodsAccording to the national and municipal requirements for the development of disease prevention and control institutions， an index framework was proposed through literature search and expert interviews. 39 representative experts in the field of public health at the national， provincial， and municipal （district） levels were selected to participate in the consultation and construction of the index system. The authority coefficient， the coefficient of variation， etc. were used to carry out quality control and determination of each index on the Delphi method. ResultsThe questionnaire response rate was 100%， the expert authority coefficient was 0.86，the degree of familiarity was 0.79， and the judgment basis was 0.92. The coefficients of variation of the necessary indicators in the index system were all <0.25 in the dimension of importance， and there were statistical differences in the statistical test of Kendall’s W coordination coefficients at all levels and dimensions （all P<0.001）. After multiple rounds of consultation， experts reached a consensus， forming a development evaluation index system of district-level CDCs with 6 first-level indicators， 24 second-level indicators， and 105 third-level indicators （including 63 necessary indicators and 42 recommended indicators）. ConclusionThe evaluation index system of Shanghai district-level CDCs based on the Delphi method has good authority， reliability， sensitivity and operability. This indicator system can effectively support the development of Shanghai district-level CDCs， and can be used for evaluation at multiple levels and in an all-round way in the future. The evaluation results can provide an evidence-based basis for the modernization of the disease prevention and control system and the continuous and dynamic updating of the development goals in the future.

Objective:To analyze the different clinicopathological features of intrahepatic cholangiocarcinoma with and without viral hepatitis.Methods:The clinicopathological data of 79 intrahepatic cholangiocarcinoma cases from Mar 2012 to Sep 2018 at Henan Provincial People's Hospital were retrospectively analyzed.Results:Twenty-five of the 79 patients with intrahepatic cholangiocarcinoma were accompanied by viral hepatitis. Those with viral hepatitis had a lower mean age at onset than those without [(53±11) years vs. (60±11) years, P=0.011], higher proportion of male patients (80% vs. 52%, P=0.017), higher AFP positive rate (40% vs. 19%, P=0.041), lower CA19-9 positive rate (48% vs. 72%, P=0.036), tend to occur in the right liver lobe (76% vs. 44%, P=0.009), a lower rate of bile duct invasion (16% vs. 41%, P=0.03), and were more likely to be mass type (mass type proportion 96% vs. 72%, P=0.032). Conclusions:Viral hepatitis is common in intrahepatic cholangiocarcinoma. Intrahepatic cholangiocarcinoma with and without viral hepatitis differ in clinicopathology. Intrahepatic cholangiocarcinoma with viral hepatitis is more likely to have the characteristics of hepatocellular carcinoma, while intrahepatic cholangiocarcinoma without viral hepatitis is more likely to have the characteristics of cholangiocarcinoma.

Purpose/Significance To address the challenge of low willingness to share scientific data among stakeholders in the tradi-tional Chinese medicine(TCM)industry,and to promote standardization,aggregation,sharing,and application of scientific data in the field of TCM.Method/Process By adhering to national standards for scientific data submission and management,integrating technologies such as blockchain and digital watermarking,the study aims to establish atrusted process for the exchange of scientific data in the field of TCM and build a TCM scientific data management platform.Result/Conclusion This platform will provide information technology support for regional TCM scientific data exchange,and effectively improve the efficiency and willingness of scientific data exchange within the region.

Background Subways are typical congregate settings and may facilitate aerosol transmission of viruses. However, quantified transmission probability estimates are lacking. Purpose To model spread and diffusion of respiratory aerosols in subways by simulation and calculation of infection probabilities. Methods The internal environment of carriages of Shanghai Metro Line 10 was used to establish a study scene. The movement of tiny particles was simulated using the turbulent model. Trend analysis of infection probabilities and viral quantum doses was conducted in a closed subway carriage scene by a quantum emission-infection probability model. Results Under a typical twelve-vent air conditioning configuration, respiratory droplet aerosols within a subway carriage dispersed rapidly throughout various regions due to airflow, with limited short-term diffusion to other carriages. Concurrently, owing to the uncertainty of airflow patterns, the airflow might circulate and converge within carriages, causing delayed outward dispersion or hindered dispersion of droplet aerosols upon entry into these zones. Passengers boarding the carriage could exacerbate the formation of these zones. When the air conditioning system functioned adequately (air exchange rate=23.21 h⁻¹), the probability of a virus carrier transmitting the virus to other passengers within the same carriage via aerosol transmission was approximately 3.8%. However, in the event of air conditioning system failure (air exchange rate=0.5 h⁻¹), this probability escalated dramatically to 30%. Furthermore, a super-spreader (with virus spreading exceeding 90% of the average) elevated the infection probability to 14.9%. Additionally, due to the complexity of turbulence within the carriage, if local diffusion occurred in 1/2 zones of a carriage, the anticipated infection probability would increase to 8.9%, or during the morning or evening rush hours leading to elevated aerosol concentrations, the infection probability would rise to 4.7%. The subway transmission probability for common coronaviruses diminished to as low as 0.9%. Conclusion Combined computational fluid dynamics and infection probability analysis reveals that in the prevalent twelve-vent air conditioning configurations, despite being a major transportation hub with substantial spatial-temporal overlap, the internal space of subway carriages exhibits a certain level of resistance to virus aerosol transmission owing to built-in ventilation capabilities. However, turbulence and passenger positioning may lead to localized hovering of droplet aerosols, thereby increase the risk of virus transmission. Furthermore, super-spreaders, poor operational status of built-in air conditioning system, and high passenger volume at morning or evening peak hours exert profound effects on virus transmission and infection probability.

Objective:To evaluate the changes of peripapillary retinal and choroid thickness of tail-suspension rats in simulated weightless.Methods:Sixty rats were divided into 2 groups: control group (15 rats) and tail-suspension group (45 rats). The rats in tail-suspension group were tested by -30° tail suspension to simulate the effect of weightlessness for establishing model. The peripapillary retinal thickness of the rats were measured before and after 4- and 8-week tail suspension by enhanced depth imaging-optical coherence tomography (EDI-OCT). The choroid thickness of the rats were measured before and after 4-, 8-, 10-, and 12-week tail-suspension by EDI-OCT.Results:There was a significant difference in the peripapillary retinal thickness among the groups with different suspension time ( F=30.89, P<0.001), and the thickness showed a downward trend with the extension of the tail suspension time. After 8 weeks of tail-suspension, there was a significant difference in the peripapillary retinal thickness between the tail-suspension group and the control group ( t=5.73, P<0.001). After 4, 8, 10, and 12 weeks of tail-suspension, there were significant differences in the choroidal thickness of the rats between the tail-suspension group and the control group ( t=6.32, 12.78, 9.69, 6.39, all P<0.001); there was a significant difference in the choroidal thickness of the rats with different suspension time ( F=51.08, P<0.001). With the time of the tail suspension, the choroidal thickness and its changes compared with before tail suspension showed an upward trend, and reached peak after 8 weeks and then slightly decreased. Conclusions:With the extension of tail-suspension time, the changes of peripapillary retinal thickness of the tail-suspension rats generally show a downward trend, and the changes of choroidal thickness generally increased, and decreased slightly after reaching peak.

Objective:To evaluate the changes of peripapillary retinal and choroid thickness of tail-suspension rats in simulated weightless.Methods:Sixty rats were divided into 2 groups: control group (15 rats) and tail-suspension group (45 rats). The rats in tail-suspension group were tested by -30° tail suspension to simulate the effect of weightlessness for establishing model. The peripapillary retinal thickness of the rats were measured before and after 4- and 8-week tail suspension by enhanced depth imaging-optical coherence tomography (EDI-OCT). The choroid thickness of the rats were measured before and after 4-, 8-, 10-, and 12-week tail-suspension by EDI-OCT.Results:There was a significant difference in the peripapillary retinal thickness among the groups with different suspension time ( F=30.89, P<0.001), and the thickness showed a downward trend with the extension of the tail suspension time. After 8 weeks of tail-suspension, there was a significant difference in the peripapillary retinal thickness between the tail-suspension group and the control group ( t=5.73, P<0.001). After 4, 8, 10, and 12 weeks of tail-suspension, there were significant differences in the choroidal thickness of the rats between the tail-suspension group and the control group ( t=6.32, 12.78, 9.69, 6.39, all P<0.001); there was a significant difference in the choroidal thickness of the rats with different suspension time ( F=51.08, P<0.001). With the time of the tail suspension, the choroidal thickness and its changes compared with before tail suspension showed an upward trend, and reached peak after 8 weeks and then slightly decreased. Conclusions:With the extension of tail-suspension time, the changes of peripapillary retinal thickness of the tail-suspension rats generally show a downward trend, and the changes of choroidal thickness generally increased, and decreased slightly after reaching peak.

OBJECTIVE: To investigate the classification of idiopathic inflammatory myopathies (IIM) based on clinical manifestations and myositis- specific antibodies using cluster analysis. METHODS: We retrospectively analyzed the data of patients with IIM admitted in Nanfang Hospital in 2015-2019. The clinical data of the patients including serum creatine kinase (CK), interstitial lung disease (ILD), cancer, and myositis-specific antibodies were collected for two-step cluster analysis to identify the distinct clusters of patients, whose clinical characteristics were subsequently analysed. RESULTS: A total of 71 patients with IIM were included in this study, including 30 (42.3%) with polymyositis (PM), 20 (28.2%) with classic dermatomyositis (DM), 16 (22.5%) with amyopathic dermatomyositis (CADM), and 5 (7.0%) with immune-mediated necrotizing myopathy (IMNM). Two-step cluster analysis identified 3 distinctive subgroups: Cluster 1 of 15 (51.7%) patients characterized by rash, positive anti-MDA5 antibody and hypoproteinemia ( < 0.05) with normal or slightly elevated CK level, mainly corresponding to CADM; Cluster 2 of 4 (57.1%) patients with significantly elevated CK and positive anti-SRP antibody ( < 0.001) corresponding to IMNM; and Cluster 3 of 17 (48.6%) patients consisting primarily of patients with PM, characterized by positivity for anti- aminoacyl transfer RNA synthetases antibodies (=0.022) corresponding to antisynthetase syndrome (ASS). CONCLUSIONS Patients with IIM can be divided into 3 subgroups based on their clinical and serological characteristics (especially myositis-specific antibodies), and among them ASS may represent an independent IIM subgroup with unique clinical characteristics.
Antibodies ; metabolism ; Humans ; Myositis ; classification ; physiopathology ; Retrospective Studies