Objective To investigate the causal relationship between circulating metabolites and non-alcoholic fatty liver disease(NAFLD)using Mendelian randomization analysis.Methods Summary statistics from genome-wide association study provided by Nightingale Health and the FinnGen Consortium were retrospectively collected.A two-sample Mendelian randomization analysis was performed to assess the causal effects of 233 blood metabolites on NAFLD,with the inverse-variance weighting method as the primary analytical approach.Results Elevated levels of glycoprotein acetylation(OR=3.30,95％CI:1.64-6.62,P=0.0008),the ratio of free cholesterol to total lipids in very low-density lipoprotein(VLDL)(OR=3.50,95％CI:1.63-7.48,P=0.0013),serum total triglycerides(OR=2.26,95％CI:1.38-3.70,P=0.0012),saturated fatty acids(OR=2.47,95％CI:1.40-4.36,P=0.0018),total cholesterol in VLDL(OR=2.20,95％CI:1.36-3.59,P=0.0015),the ratio of triglycerides to total lipids in very large high-density lipoprote(HDL)(OR=2.91,95％CI:1.53-5.55,P=0.0011),and triglycerides in very small VLDL(OR=2.27,95％CI:1.43-3.62,P=0.0006)were positively associated with NAFLD.Conversely,total cholesterol in high-density lipoprotein 2(OR=0.44,95％CI:0.27-0.71,P=0.0007)and total cholesterol in HDL(OR=0.44,95％CI:0.28-0.72,P=0.0009)were inversely associated with NAFLD.Heterogeneity tests indicated no significant heterogeneity among instrumental variables,confirming the robustness of the findings.Conclusion This study identified seven metabolites associated with an increased risk of NAFLD and two metabolites linked to a reduced risk,highlighting their potential roles in the pathogenesis and progression of NAFLD.

Objective To investigate the causal relationship between circulating metabolites and non-alcoholic fatty liver disease(NAFLD)using Mendelian randomization analysis.Methods Summary statistics from genome-wide association study provided by Nightingale Health and the FinnGen Consortium were retrospectively collected.A two-sample Mendelian randomization analysis was performed to assess the causal effects of 233 blood metabolites on NAFLD,with the inverse-variance weighting method as the primary analytical approach.Results Elevated levels of glycoprotein acetylation(OR=3.30,95％CI:1.64-6.62,P=0.0008),the ratio of free cholesterol to total lipids in very low-density lipoprotein(VLDL)(OR=3.50,95％CI:1.63-7.48,P=0.0013),serum total triglycerides(OR=2.26,95％CI:1.38-3.70,P=0.0012),saturated fatty acids(OR=2.47,95％CI:1.40-4.36,P=0.0018),total cholesterol in VLDL(OR=2.20,95％CI:1.36-3.59,P=0.0015),the ratio of triglycerides to total lipids in very large high-density lipoprote(HDL)(OR=2.91,95％CI:1.53-5.55,P=0.0011),and triglycerides in very small VLDL(OR=2.27,95％CI:1.43-3.62,P=0.0006)were positively associated with NAFLD.Conversely,total cholesterol in high-density lipoprotein 2(OR=0.44,95％CI:0.27-0.71,P=0.0007)and total cholesterol in HDL(OR=0.44,95％CI:0.28-0.72,P=0.0009)were inversely associated with NAFLD.Heterogeneity tests indicated no significant heterogeneity among instrumental variables,confirming the robustness of the findings.Conclusion This study identified seven metabolites associated with an increased risk of NAFLD and two metabolites linked to a reduced risk,highlighting their potential roles in the pathogenesis and progression of NAFLD.

Objective To evaluate the experience of laparoscopic complete mesocolic excision (CME) for right colon cancer.Methods 45 patients with right colon cancer underwent laparoscopic CME were selected as research subjects(laparoscopy group),and 40 patients with right colon cancer underwent open CME were selected as control group(open group).The clinical effects of the two groups were observed .Results All the 45 cases were successfully performed with laparoscopic CME and 40 specimens were evaluated pathologically as mesocolic plane surgery. The average time for passage of flatus in the laparoscopy group [(3.43 ±0.72)d] was less than that in the open group [(4.10 ±0.99)d,P =0.039,P <0.05].The average time of leaving bed [(3.39 ±0.66)d] in the laparoscopy group was significantly less than that in the open group [(4.20 ±0.79)d,P =0.005,P <0.05].The mean operative time of the laparoscopy group [(160.93 ±20.91)min] was longer than that of the open group [(103.00 ±24.29)min,P =0.000,P <0.05].The average number of total lymph nodes removed of the laparoscopy group [(23.16 ±8.21)] was higher than that of the open group [(19.06 ±7.48)],but the difference was not statistically significant between the two groups (P =0.102,P >0.05).The overall postoperative complication rate of the laparoscopy group was 13.33%,which was lower than 22.50% of the open group,but the difference was not statistically significant between the two groups(P =0.268,P >0.05).Conclusion Laparoscope complete mesocolic excision for right colon cancer is safe and feasible.

Objective To investigate the changes of T lymphocyte subsets and quality of life after administrating Aidi injection in patients with colon cancer. Methods A total of 86 patients with colon cancer admitted to our hospital from February 2015 to May 2017 were enrolled in this study. The patients were divided into chemotherapy group (43 patients, conventional therapy) and combination group (43 cases,conventional chemotherapy+Aidi injection) by random number table. Compared the recent curative effect, level of T lymphocyte subsets, changes of quality of life and adverse reactions before and after treatment. Results There were significant differences in the distribution of CR, PR, SD and PD between the combination group and the chemotherapy group(P＜0. 05). The former had a clinical benefit rate of 72. 09％ and the latter was 51. 16％. The difference was statistically significant(P＜0. 05). There was no significant difference in the level of T lymphocyte subsets and quality of life in the combination group after treatment(P＞0. 05). The CD3+, CD4+, CD4+/CD8+ and scores of quality of life in the chemotherapy group were significantly lower(P＜0. 05) after treatment, CD8+ increased in both groups, and there was statistical difference between the combination group and the chemotherapy group after treatment(P＜0. 05). The incidence of adverse reactions in the combination group was lower than that in the chemotherapy group(P＜0. 05) and the difference of classification comparison was also statistically significant(P＜0. 05). Conclusion The use of Aidi injection in colon cancer patients with chemotherapy can improve the short-term curative effect, avoid the damage of immune function and reduction of the quality of life, and relieve and reduce the adverse reactions caused by chemotherapy.

BACKGROUND: Percutaneous vertebroplasty (PVP) is usually used for osteoporotic thoracolumbar fractures,which has various advantages such as easy to operate, short operation time, less trauma, rapid recovery,analgesic effect and so on. But its application is restricted due to nerve compression symptoms and pulmonary embolism caused by bone cement leakage. Thereafter, how to reduce the leakage of bone cement is an issue of concern.OBJECTIVE: To investigate the relationship between the lumbar quantitative computed tomography (QCT) values and contrast agent dispersion in osteoporotic thoracolumbar fractures. METHODS: Sixty cases of osteoporotic thoracolumbar fractures undergoing PVP were enrolled, and received QCT examination before surgery, and contrast agent was injected intraoperatively. X-ray examination was conducted to detect the bone mineral density, contrast agent dispersion and leakage of bone cement, and the relationship between the lumbar QCT values and contrast agent dispersion as well as leakage of bone cement.RESULTS AND CONCLUSION: (1) There were 110 vertebral fractures, and 74 vertebrae with contrast agent diffusing more than vertebral midline, accounting for 67.3%. There was significant difference in the contrast agent dispersion among groups (P < 0.05). (2) The bone cement leakage showed no significant difference among groups after injected with bone cement by unilateral or bilateral approach (P > 0.05). (3) These results suggest that contrast agent dispersion in osteoporotic thoracolumbar fractures has a certain relationship with the lumbar QCT values, and lumbar QCT values with more contrast agent dispersion, but the lumbar QCT values have no correlation with bone cement leakage. Therefore, choosing a appropriate approach based on the QCT values and contrast agent dispersion can reduce leakage and improve the safety of PVP.

Objective To investigate the effect of Yipi Rougan recipe comined chemotherapy on quality of life in the treatment of patients with intermediated or advanced-staged primary hepatic carcinoma and its efficacy.Methods From April 2013 to December 2015 in our hospital, 97 patients with advanced primary liver cancer patients were selected, and randomly divided into traditional Chinese medicine group of 48 patients and chemotherapy group of 49 patients, two groups were treated with transcatheter arterial embolization chemotherapy, while the traditional Chinese medicine group were given Yipi Rougan recipe adjuvant therapy, 21 days for a course of treatment, with a total of four courses.Results There was no significant difference in total effective rate between traditional Chinese medicine group and chemotherapy group ( 83.33%vs.77.55%) .After treatment, the quality of life (QOL) score, Karnofsky performance score (KPS) in traditional Chinese medicine group were higher than those in chemotherapy group (P<0.05). The each symptom score in traditional Chinese medicine group was lower than that in chemotherapy group (P<0.05).Conclusion The efficacy of Yipi Rougan recipe combined with chemotherapy is not significant on patients with intermediated or advanced-staged primary liver cancer chemotherapy, but can significantly relieve symptoms and improve the quality of life of patients .

Objective To summarize the clincical experience of transumbilical Laparoendoscopic Single-site (LESS) nephrectomy and to evaluate its safety and efficacy. Methods From December 2008 to August 2010, we have performed 20 cases of transumbilical LESS nephrectomy by Tri-Port system, of which 9 patients underwent LESS radical nephrectomy (left 8, right 1, stage T1 ), 1 patient underwent LESS radical resection of right ureteral carcinoma, 10 patients underwent LESS simple nephrectomy (left 5, right 5). The Tri-Port system was inserted transperitoneally through a 2 cm umbilical incision. A 5-mm 30° telescope was introduced through the port to visualize the operative field. Flexible equipment and standard laparoscopic equipment were used to perform the procedures.The incisions were extended to about 6cm in order to remove the specimens. Results Conversion to open surgery was necessary in one LESS radical resection of right ureteral carcinoma and one LESS simple nephrectomy, while the remaining 18 cases were successful (the addition of a single 5-mm port was necessary in 2 cases of LESS radical nephrectomy). The mean operative time was 197 min (85-510 min), mean estimated blood loss was 126 ml (50-400 ml), without blood transfusion in the perioperative period, mean postoperative hospital stay was 6.3 d (3-14 d), and mean duration of catheter drainage was 3.6 d (0- 14 d). Conclusions Transumbilical LESS nephrectomy is feasible, safe,minimally invasive and cosmetic. Long-term follow-up and a clinical control study are needed for evaluating clinical outcomes.

OBJECTIVE: To evaluate the curative effect of endoscopic surgery (ESS) in the treatment of inverted papillomas in the nasal cavity and paranasal sinus. METHOD: We report on 16 clinicopathologic cases of inverted papilloma. After preoperative endoscopic examination and CT screening, endoscopic sinus surgery was performed under general anesthesia. RESULT: The follow-up period ranged between one year to two years. Recurrence was observed in 2 cases. CONCLUSION The nasal endoscopy is a better method for treating Krouse I-II stage nasal inverted papilloma. The advantages of endoscopic surgery include clear visual field, less bleeding, limited reoccurrence, and avoidance of facial incision.
Adult ; Aged ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Nose Neoplasms ; surgery ; Papilloma, Inverted ; surgery ; Treatment Outcome ; Young Adult