Background and Aims:Whether to close mesenteric fissures during laparoscopic radical resection of colorectal cancer remains controversial.Traditional suture closure is technically demanding and may injure mesenteric vessels.This study aimed to evaluate the safety and efficacy of using α-cyanoacrylate medical glue to close mesenteric fissures during laparoscopic colorectal cancer surgery.Methods:A retrospective analysis was conducted on patients who underwent laparoscopic radical resection of colorectal cancer in the Department of Colorectal Surgery,the Sixth Affiliated Hospital of Sun Yat-sen University,from January 2022 to December 2023.Seventy-eight patients who received intraoperative α-cyanoacrylate glue closure of mesenteric fissures were included as the observation group,and 74 patients without fissure closure were selected as the control group using the propensity score matching method.Perioperative parameters,postoperative recovery,and complications were compared between the two groups.Results:No significant differences were observed in baseline characteristics or main intraoperative variables between groups(all P>0.05).The observation group had significantly less ascitic drainage within 3 days after operation[(203.14±116.44)mL vs.(384.53±243.89)mL,P<0.01]and shorter postoperative gas passage,defecation,and drainage tube removal times(all P<0.01).The incidence of postoperative complications and intestinal obstruction was comparable between groups(all P>0.05).Multivariate analysis showed that intraoperative application of α-cyanoacrylate glue was an independent promoting factor for intestinal exhaust within 3 days after surgery(OR=5.739,P=0.000).Conclusion:The use of α-cyanoacrylate medical glue for closing mesenteric fissures during laparoscopic radical resection of colorectal cancer is safe and feasible.It effectively reduces postoperative ascitic drainage and accelerates bowel recovery,offering a simple and reliable alternative to traditional suture closure.

Object·To explore the effects of comorbid obsessive-compulsive personality disorder(OCPD)on the behavioral inhibition system(BIS)/behavioral activation system(BAS)in patients with obsessive-compulsive disorder(OCD).Methods·A total of 247 patients with unmedicated OCD diagnosed in the Mental Health Center,Shanghai Jiao Tong University School of Medicine from 2014 to 2018 were included and divided into an OCD group(n=202),and an OCD+OCPD group(n=45),and 107 healthy controls were recruited as a comparison group.Yale-Brown Obsessive-Compulsion Scale(YBOCS),BIS/BAS Scale,Hamilton Depression Scale(HAMD),and Hamilton Anxiety Scale(HAMA)were used to assess psychopathological features.Gender differences among the three groups were analyzed using the x2 test.One-way analysis of variance(ANOVA)was used to compare differences in demographic characteristics,psychopathological features,and BIS/BAS scores,followed by the least significant difference(LSD)test for pairwise comparisons.Regression analysis was conducted to explore the relationships between psychopathological features and BIS/BAS scores.Results·There were no significant differences in gender,age,and years of education among the three groups.The scores of YBOCS(t=2.925,P=0.004),HAMD(t=2.130,P=0.034)and HAMA(t=2.568,P=0.011)in the OCD+OCPD group were significantly higher than those in the OCD group.There were statistically significant differences in BIS and BAS scores among the three groups(BIS:F=39.573,P＜0.001;BAS:F=3.915,P=0.021).The results showed that for BIS,there were statistically significant differences in pairwise comparisons among the three groups(OCD+OCPD vs OCD:P=0.002;OCD+OCPD vs HC:P＜0.001;OCD vs HC:P＜0.001),and the scores were OCD+OCPD＜OCD＜HC from low to high.For BAS,the OCD group scored significantly higher than the OCD+OCPD and HC groups(OCD+OCPD vs OCD:P=0.018;OCD vs HC:P=0.043),but there was no significant difference between the OCD+OCPD and HC groups.Regression models of BIS and BAS were constructed for OCD patients with OCPD,and the results showed that the overall prediction effect of the model was significant for BIS total scores(F=2.599,P=0.013).Only the severity of OCPD symptoms can significantly predict BIS scores(t=-2.282,P=0.023).For BAS total scores,the overall prediction effect of the model was not significant(F=1.438,P=0.191).Conclusion·Comorbid OCPD may be an adverse factor for abnormal BIS and a protective factor for abnormal BAS in patients with OCD.

Background and Aims:Whether to close mesenteric fissures during laparoscopic radical resection of colorectal cancer remains controversial.Traditional suture closure is technically demanding and may injure mesenteric vessels.This study aimed to evaluate the safety and efficacy of using α-cyanoacrylate medical glue to close mesenteric fissures during laparoscopic colorectal cancer surgery.Methods:A retrospective analysis was conducted on patients who underwent laparoscopic radical resection of colorectal cancer in the Department of Colorectal Surgery,the Sixth Affiliated Hospital of Sun Yat-sen University,from January 2022 to December 2023.Seventy-eight patients who received intraoperative α-cyanoacrylate glue closure of mesenteric fissures were included as the observation group,and 74 patients without fissure closure were selected as the control group using the propensity score matching method.Perioperative parameters,postoperative recovery,and complications were compared between the two groups.Results:No significant differences were observed in baseline characteristics or main intraoperative variables between groups(all P>0.05).The observation group had significantly less ascitic drainage within 3 days after operation[(203.14±116.44)mL vs.(384.53±243.89)mL,P<0.01]and shorter postoperative gas passage,defecation,and drainage tube removal times(all P<0.01).The incidence of postoperative complications and intestinal obstruction was comparable between groups(all P>0.05).Multivariate analysis showed that intraoperative application of α-cyanoacrylate glue was an independent promoting factor for intestinal exhaust within 3 days after surgery(OR=5.739,P=0.000).Conclusion:The use of α-cyanoacrylate medical glue for closing mesenteric fissures during laparoscopic radical resection of colorectal cancer is safe and feasible.It effectively reduces postoperative ascitic drainage and accelerates bowel recovery,offering a simple and reliable alternative to traditional suture closure.

Object·To explore the effects of comorbid obsessive-compulsive personality disorder(OCPD)on the behavioral inhibition system(BIS)/behavioral activation system(BAS)in patients with obsessive-compulsive disorder(OCD).Methods·A total of 247 patients with unmedicated OCD diagnosed in the Mental Health Center,Shanghai Jiao Tong University School of Medicine from 2014 to 2018 were included and divided into an OCD group(n=202),and an OCD+OCPD group(n=45),and 107 healthy controls were recruited as a comparison group.Yale-Brown Obsessive-Compulsion Scale(YBOCS),BIS/BAS Scale,Hamilton Depression Scale(HAMD),and Hamilton Anxiety Scale(HAMA)were used to assess psychopathological features.Gender differences among the three groups were analyzed using the x2 test.One-way analysis of variance(ANOVA)was used to compare differences in demographic characteristics,psychopathological features,and BIS/BAS scores,followed by the least significant difference(LSD)test for pairwise comparisons.Regression analysis was conducted to explore the relationships between psychopathological features and BIS/BAS scores.Results·There were no significant differences in gender,age,and years of education among the three groups.The scores of YBOCS(t=2.925,P=0.004),HAMD(t=2.130,P=0.034)and HAMA(t=2.568,P=0.011)in the OCD+OCPD group were significantly higher than those in the OCD group.There were statistically significant differences in BIS and BAS scores among the three groups(BIS:F=39.573,P＜0.001;BAS:F=3.915,P=0.021).The results showed that for BIS,there were statistically significant differences in pairwise comparisons among the three groups(OCD+OCPD vs OCD:P=0.002;OCD+OCPD vs HC:P＜0.001;OCD vs HC:P＜0.001),and the scores were OCD+OCPD＜OCD＜HC from low to high.For BAS,the OCD group scored significantly higher than the OCD+OCPD and HC groups(OCD+OCPD vs OCD:P=0.018;OCD vs HC:P=0.043),but there was no significant difference between the OCD+OCPD and HC groups.Regression models of BIS and BAS were constructed for OCD patients with OCPD,and the results showed that the overall prediction effect of the model was significant for BIS total scores(F=2.599,P=0.013).Only the severity of OCPD symptoms can significantly predict BIS scores(t=-2.282,P=0.023).For BAS total scores,the overall prediction effect of the model was not significant(F=1.438,P=0.191).Conclusion·Comorbid OCPD may be an adverse factor for abnormal BIS and a protective factor for abnormal BAS in patients with OCD.

Objective:To explore the relevancy between the uridine diphosphate-glucuronylgly-cosyltransferase 1A1 (UGT1A1) gene mutation and the phenotype of indirect hyperbilirubinemia in children.Methods:Sixteen cases with indirect hyperbilirubinemia who visited the Department of Gastroenterology, Children's Hospital of Nanjing Medical University from July 2013 to November 2019 were retrospectively analyzed and were divided into Gilbert syndrome (GS), Crigler-Najjar syndrome type II (CNS-II), and indirect hyperbilirubinemia groups unexplained by UGT1A1 gene mutations. The differences in gene mutation site information and general clinical data were compared. The association between gene mutation spectrum and bilirubin level was explored by t-test analysis.Results:Ten of the sixteen cases with indirect hyperbilirubinemia had GS, three had CNS-II, and three had indirect hyperbilirubinemia unexplained by UGT1A1 gene mutations. A total of six mutation types were detected, of which c.211G?>?A accounted for 37.5% (6/16), c.1456T?>?G accounted for 62.5% (10/16), and TATA accounted for 37.5% (6/16), respectively. Compared with the GS group, the CNS group had early disease onset incidence, high serum total bilirubin ( t ?=?5.539, P ??0.05) and age of onset ( t ?=?0.3611, P ?>?0.05) between the two groups. There was no significant correlation between the number of UGT1A1 gene mutations and serum bilirubin levels. Children with c.1456T?>?G homozygous mutations had the highest serum bilirubin levels. Conclusion:The common pathogenic variants of the UGT1A1 gene sequence are c.1456T?>?G, c.211G?>?A, and TATA, indicating that these site mutations are related to the occurrence of indirect hyperbilirubinemia and have important guiding significance for the etiological analysis of indirect hyperbilirubinemia in children.

OBJECTIVE To provide reference for the regulation of electronic prescription circulation under the mode of “medical science + pharmacy”. METHODS Based on evolutionary game theory， a tripartite evolutionary game model was constructed for related parties of electronic prescription circulation （government agencies， internet hospitals and third-party drug platforms） under the mode of “medical science + pharmacy”. The influential factors of the three parties’ strategy selection were analyzed and verified by simulation. RESULTS & CONCLUSIONS The strategic choices of all parties in the game were affected by the other two parties. Reducing the cost of strict supervision or increasing the punishment for the other two parties would increase the probability of strict supervision of government agencies. Enhancing reputation losses， increasing penalties， and reducing the cost difference when choosing different strategies would have regulatory and binding effects on internet hospitals and third-party drug platforms. It is suggested that government agencies can introduce diversified supervision mode and establish an integrated “intelligent supervision + traceability” system； pay attention to the construction of reputation mechanism， and promote the coordinated linkage of all parties； increase the punishment for violations， provide policy support， reduce the cost of compliance behavior to promote the high-quality development of electronic prescription circulation under the mode of “medical science + pharmacy”.

Objective:To investigate the clinical efficacy of neuroendoscopic hematoma removal versus soft channel drainage in the treatment of chronic subdural hematoma. Methods:The clinical data of 102 patients with chronic subdural hematoma who received treatment in Jincheng People's Hospital from May 2018 to May 2020 were retrospectively analyzed. They were divided into the neuroendoscopy group ( n = 50) and the soft channel group ( n = 52) according to different surgical methods. Perioperative indexes, hematoma clearance rate, China Stroke Scale score, the activity of daily living score, and oxidative stress indexes were compared between the two groups. All patients were followed up for 3 months. The incidence of complications during the follow-up period was calculated. Results:The retention time of the drainage tube in the neuroendoscopy group was shorter than that in the soft channel group [(2.45 ± 0.63) days vs. (3.30 ± 0.78) days, t = 6.06, P < 0.001]. The length of hospital stay in the neuroendoscopy group was shorter than that in the soft channel group [(7.14 ± 1.65) days vs. (9.07 ± 2.11) days, t = 5.15, P < 0.001]. The hematoma clearance rate at postoperative 7 days in the neuroendoscopy group was higher than that in the soft channel group [(93.45 ± 5.50)% vs. (81.86 ± 7.24)%, χ2 = 9.12, P < 0.001]. There were no significant differences in operation time and intraoperative blood loss between the two groups (both P > 0.05). At postoperative 30 days, the China Stroke Scale score in the neuroendoscopy group was lower than that in the soft channel group [(12.74 ± 2.23) points vs. (18.67 ± 2.45) points, t = 12.79, P < 0.001]. The activity of daily life score in the neuroendoscopy group was significantly higher than that in the soft channel group [(77.69 ± 7.11) points vs. (91.35 ± 7.25) points, t = 9.60, P < 0.001]. At postoperative 7 days, glutathione peroxidase level in the neuroendoscopy group was significantly lower than that in the soft channel group [(130.75 ± 13.66) U/L vs. (148.60 ± 14.64) U/L, t = 6.37, P < 0.001]. Malondialdehyde level in the neuroendoscopy group was significantly lower than that in the soft channel group [(5.11 ± 0.65) nmol/L vs. (6.19 ± 0.74) nmol/L, t = 7.83, P < 0.001]. Superoxide dismutase level in the neuroendoscopy group was significantly higher than that in the soft channel group [(275.60 ± 22.33) U/L vs. (254.60 ± 18.55) U/L, t = 5.15, P < 0.001]. There was no significant difference in the incidence of complications between the two groups ( P > 0.05). Conclusion:Compared with soft channel drainage, neuroendoscopic hematoma removal can obtain better short-term curative effects and less oxidative stress response in the treatment of chronic subdural hematoma. Neuroendoscopic hematoma removal does not increase the incidence of postoperative complications and is highly safe.

Objective: To evaluate the value of MRI-T₂WI texture analysis in the differentiation of atypical medulloblastoma and ependymoma of the fourth ventricle. Methods: Preoperative MRI data of 36 cases of fourth ventricle tumor (19 cases of medulloblastoma and 17 cases of ependymoma) confirmed by the Central Theater General Hospital of the Chinese People′s Liberation Army were retrospectively analyzed. Manually sketch areas of interest (ROI) were made using texture analysis software to get histogram parameters, including mean, median, standard deviation, skewness, kurtosis, maximum, minimum, heterogeneity, entropy, the 5th percentile (T₂WI_5th), the 10th percentile (T₂WI_10th), the 25th percentile (T₂WI_25th), the 50th percentile (T₂WI_50th), the 75th percentile(T₂WI_75th), the 95th percentile(T₂WI_95th). Independent sample t test or mann-whitney U test was used for statistical analysis of each parameter value between the two groups. Logistic regression analysis was used to perform multiparameter joint analysis on meaningful parameters. The area under the curve (AUC) was obtained by using the subject operating characteristic (ROC) curve to determine the threshold and diagnostic efficacy for distinguishing the two group. Results: The mean, median, T₂WI_5th, T₂WI_10th, T₂WI_25th, T₂WI_50th, T₂WI₇5th values of the medulloblastoma group were smaller than those of the ependymoma group, and difference was statistically significant (P<0.05). The T₂WI_5th had the best diagnostic performance. When the critical value was 1 343, the diagnostic specificity was 75.0% and the sensitivity was 92.9%. Logistic regression was used to predict the joint analysis of probability parameters. T₂WI_5th+T₂WI_10th had the best performance, and AUC was 0.928. When the critical value was 0.75, the diagnostic specificity was 75.0% and the sensitivity was 100.0%. Conclusions MRI-T₂WI texture analysis can provide quantitative information for preoperative diagnosis of atypical medulloblastoma and ependymoma and improve the accuracy of preoperative diagnosis, which has obvious clinical value.

BACKGROUND:Fibroblast-like synoviocytes (FLS) in the synovial lining layer are related to the cell proliferation, invasion, migration and apoptosis as well as bone resorption in rheumatoid arthritis. OBJECTIVE:To compare the migration and invasion abilities of FLS (MH7A) in rheumatoid arthritis and normal FLS (HFLS). METHODS:The capacities of cell migration and invasion were evaluated by Transwell cell migration and invasion assays. The primers of the indicated microRNAs were designed and synthesized, and the expression levels of miRNAs were determined by real-time PCR according to the SYBR?PrimeScript?miRNA RT-PCR Kit instruction. RESULTS AND CONCLUSION:MH7A possessed stronger migration and invasion abilities than HFLS. Compared with HFLS, obviously upregulated miR-132, -155, -203, -223 and -124, and significantly downregulated miR-15a, -16, 18a, -19a, -26a and -146a were found in MH7A. These findings suggest that the differentially expressed 11 kinds of rheumatoid arthritis-associated miRNAs participate in the pathogenesis of rheumatoid arthritis probably by enhancing the migration and invasion capacities of MH7A.

OBJECTIVE To investigate the effect and mechanisms of chrysophanol on the expression of c-fos and c-jun mRNA induced by ammonia chloride(NH4Cl) in mouse astrocytes. METHODS Primary mouse astrocytes were cultured with NH4Cl 5 mmol·L-1+chrysophanol 0.1,1.0 or 10.0 mg·L-1 ,or NH4Cl 5 mmol · L- 1+extracellular regulated kinase1/2(ERK1/2) inhibitor UO126 10 mmol · L- 1 and NH4Cl 5 mmol · L-1+p38 mitogen-activated protein kinase(p38 MAPK)inhibitor SB239063 10 mmol · L-1 for 48 h. The levels of glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),malondaldehyde(MDA), nitric oxide(NO)and nitric oxide synthase(NOS)were detected by UV spectrophotometry. The phos?phorylation levels of ERK1/2 and p38 MAPK were detected by Western blotting. The expression of c-fos and c-jun mRNA was detected by RT-PCR. RESULTS Compared with NH4Cl 5 mmol · L- 1 group, ammonia-induced astrocytes oxidative stress was improved by chrysophanol (1.0 and 10.0 mg · L-1). The content of MDA and NO and the activity of NOS were reduced(P<0.05). The activity GSH-Px and SOD was increased(P<0.05). The phosphorylation level of ERK1/2 and p38 MAPK induced by ammonia was reduced in chrysophanol groups (P<0.05). Ammonia-induced c-fos and c-jun mRNA expression downregulation was reversed by chrysophanol (0.1,1.0 and 10.0 mg · L-1)and UO126 and SB239063(P<0.05). CONCLUSION Chrysophanol may improve the downregulated expresion of c-fos and c-jun mRNA in mouse astrocytes exposed to NH4Cl by anti-oxidative stress by inhibiting the ERK1/2 and p38 MAPK phosphorylation.