Objective To explore the clinical efficacy of different ligation methods in laparoscopic radi-cal resection of rectal cancer and sigmoid colon cancer and the influencing factors of anastomotic leakage.Methods A total of 82 patients who underwent laparoscopic radical resection of rectal cancer and sigmoid co-lon cancer in this hospital from December 2022 to December 2023 were selected and divided into the low-liga-tion group(n=42)and the high-ligation group(n=40)according to different surgical methods.The inferior mesenteric artery(IMA)classification,IMA length,operation time,intraoperative blood loss,total number of lymph node dissections,number of lymph node dissections in group 253,postoperative hospital stay,exhaust time,incidence of urinary retention,incidence of anastomotic leakage,and incidence of preventive stoma were compared between the two groups.Univariate and multivariate logistic regression analyses were conducted to analyze the influencing factors of anastomotic leakage in patients undergoing radical resection of rectal cancer and sigmoid colon cancer.Results There was no statistically significant difference in IMA length,IMA classi-fication proportion,operation time,intraoperative blood loss,the total number of lymph node dissections,the number of lymph node dissections in group 253,and the postoperative hospital stay between the two groups(P>0.05).Compared with the high-ligation group,the low-ligation group had a shorter exhaust time,lower incidence of anastomotic leakage and preventive ostomy,the differences were statistically significant(P<0.05).Anastomotic leakage occurred in 7 patients.Univariate analysis showed that whether left colic artery(LCA)was preserved,tumor location,presence of underlying diseases,and preventive stoma were associated with anastomotic leakage in patients undergoing radical resection of rectal cancer and sigmoid colon cancer(P<0.05).Multivariate logistics analysis showed that whether LCA was preserved,tumor location,presence of underlying diseases,and presence of preventive stoma were not influencing factors for anastomotic leakage in patients undergoing radical resection of rectal cancer or sigmoid colon cancer(P>0.05).Conclusion In laparoscopic radical resection of rectal and sigmoid colon cancer,the clinical efficacy of preserving LCA is com-parable to that of not preserving LCA,and it can reduce the risk of anastomotic leakage and the probability of preventive stoma,promoting the early recovery of intestinal function.

OBJECTIVE To study the best extraction process of β-asarone from Acori Tatarinowii Rhizoma by ethanol heating reflux method, and to explore the antioxidant activity of different segments. METHODS With β-asarone from Acori Tatarinowii Rhizoma as the evaluation index to optimize the extraction method. On the basis of a single factor experiment, the effects of ethanol concentration, solid-liquid ratio and extraction time on the extraction amount of β-asarone from Acori Tatarinowii Rhizoma were investigated by orthogonal design and response surface methodology. After the optimal extraction process was determined, the antioxidant activities of different segments were studied. RESULTS The optimum extraction process of β-asarone from Acori Tatarinowii Rhizoma was as follows: ethanol concentration was 95%, solid-liquid ratio was 1∶20 g·mL–1 and extraction time was 2.5 h. Under these conditions, the extraction amount of β-asarone from Acori Tatarinowii Rhizoma was 0.918 7 mg·g–1. The results of in vitro antioxidant activity showed that the order of antioxidant capacity was ethyl acetate>petroleum ether>ethanol>n-butanol. Among them, the ethyl acetate fraction had the strongest antioxidant activity, with good ability to scavenge DPPH and ABTS free radicals, and had certain reduction ability. CONCLUSION The optimized method is stable, reliable and simple, which can be used for extraction and antioxidant activity determination of β-asarone from Acori Tatarinowii Rhizoma, and provides a basis for the further development of Acori Tatarinowii Rhizoma.

Objective To compare the existing evaluation methods of sample's representativeness and provide reference for selection of sample representativeness evaluation methods in clinical research.Methods Simulate the target population of lung cancer patients and select samples with different sample sizes and different degrees of deviation based on the distribution of traits of lung cancer patients in China and the actual situation of sample screening in domestic clinical studies.Calculate sample representativeness using the existing evaluation methods of sample's representativeness,and calculate estimation deviation(bias).By constructing the correlation model between the measured value of each method and bias,analyze the accuracy and stability of each method.Results The overall structural variance rate RV1、RV2、C-statistic based on propensity score、SGCR and K-S distance could well measure the degrees of deviation of different samples.Under different sample sizes,the R2 of RV2 and RV1 are greater than 0.90,and R2 of C-Statistic、SGCR and K-S distance were greater than 0.80.Conclusion The overall structural variance rate is more accurate and stable because the traits weight is taken into account.In particular,RV2 can better measure the representativeness of samples with different degrees of deviation and accurately reflect the estimation deviation.However,when it is difficult to obtain the feature importance information,the reliability of the representative measurement of SGCR as well as C-statistic and K-S distance used the propensity score-based method are acceptable.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Objective:To analyze the clinically acceptable and reproducible bladder and rectum volumes of prostate cancer patients during radiotherapy under bladder and bowel preparation, aiming to provide quantitative indicators for bowel and bladder preparation before and after radiotherapy.Methods:Clinical data of 275 prostate cancer patients with strict bladder and bowel preparation and completion of whole course radical radiotherapy at Sun Yat-sen University Cancer Center from April 2015 to December 2020 were retrospectively analyzed. Patients were scanned with cone beam CT (CBCT) before each treatment and the setup error was recorded. Sixty-six patients were selected by simple random sampling and the bladder and rectum on daily CBCT was outlined using MIM software. The relationship between the ratio of daily bladder or rectum volume to the planned bladder or rectum volume (relative value of volume) and setup error was analyzed. Quantitative data were expressed as mean±SD. Normally distributed data were analyzed by paired t-test while non-normally distributed data were assessed by Kruskal-Wallis test.Results:The bladder and rectum volume on planning CT were (370.87±110.04) ml and (59.94±25.07) ml of 275 patients. The bladder and rectum volumes on planning CT were (357.51±107.38) ml and (65.28±35.37) ml respectively of the 66 selected patients with 1611 sets of CBCT images. And the bladder and rectum volumes on daily CBCT were (258.96±120.23) ml and (59.95 ± 30.40) ml. The bladder volume of patients was decreased by 3.59 ml per day on average during the treatment and 0.37 ml for the rectum volume. According to the bladder volume on planning CT, all patients were divided into three groups: <250 ml, 250-450 ml and >450 ml groups. The relative value of volume in the 250-450 ml group during the course of radiotherapy was the smallest. And the setup error in the superior and inferior (SI) direction was (0.28±0.24) cm and (0.19±0.17) cm in the left and right (LR) direction, significantly lower than those in the other two groups (both P≤0.027). According to the rectum volume on planning CT, all patients were divided into four groups: <50 ml, 50-<80 ml, 80-120 ml and >120 ml groups. The <50 ml group had the smallest relative value of volume during radiotherapy, and the setup error in the SI direction was (0.26±0.22) cm and (0.24±0.22) cm in the anterior and posterior (AP) direction, significantly smaller than those in the other groups (both P≤0.003). The setup errors in the SI, LR, AP directions of the enrolled 66 patients were (0.30±0.25) cm, (0.20±0.18) cm and (0.28±0.27) cm, respectively. Among them, the relative value of bladder volume in the AP direction was (0.73±0.37) in the setup error <0.3 cm group, which was statistically different from those in the setup error 0.3-0.5 cm and >0.5 cm groups (both P<0.05). Conclusion:Under the bladder and bowel preparation before planning CT, the appropriate bladder and rectum volumes are in the range of 250-450 ml and <50 ml, which yields higher reproducibility and smaller setup error.

Objective:To investigate the protective effect and mechanism of Acronychia pedunculata water extracts on UV-induced light damage of human keratinocytes.Methods:The experiment was conducted from December 2018 to April 2020 in the Guangxi Medical University Laboratory of Genetics. The photoaged keratinocyte model was used, the cells were co-cultured with different concentrations of Acronychia pedunculata water extracts. The cell proliferation rate was detected by CCK-8 method. The levels of reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX) and total antioxidant capacity (T-AOC) of cells were detected by a test kit. The levels of IL-1β, IL-6 and tumor necrosis factor-alpha (TNF-α) were determined by ELISA.Results:The proliferation of HaCaT cells was promoted by 0.5 mg/L-2.0 mg/L of the extracts. Compared with control group, the proliferation rate of HaCaT cells in the experimental group was significantly increased ( P<0.05). Compared with control group, the contents of ROS was decreased ( F=214.67, P<0.05), MDA was decreased ( F=811.88, P<0.05), SOD was increased ( F=28.95, P<0.05), CAT was increased ( F=213.31, P<0.05), GPX was increased ( F=65.10, P<0.05), T-AOC was increased ( F=305.58, P<0.05), IL-1β was decreased ( F=15.46, P<0.05), IL-6 was decreased ( F=59.2, P<0.05), and TNF-α was decreased ( F=33.13, P<0.05). Conclusions:The extracts of 0.5-2.0 mg/L of Acronychia pedunculata have protective effects on the photoaging cell model, which may be related to the increase of SOD, CAT, GPX and other antioxidant enzymes and the level of T-AOC in photoaging HaCaT cells, and the decrease of ROS, MDA content and the expression of inflammatory cytokines.

BACKGROUND: Particulate matter (PM) < 2.5 μm (PM METHODS: We obtained DNA methylation and exercise data of 496 participants (aged between 30 and 70 years) from the Taiwan Biobank (TWB) database. We also extracted PM RESULTS: DLEC1 methylation and PM CONCLUSIONS We found significant positive associations between PM
Adult ; Aged ; Air Pollutants/adverse effects* ; DNA Methylation/drug effects* ; Environmental Exposure/adverse effects* ; Exercise ; Female ; Humans ; Male ; Middle Aged ; Particulate Matter/adverse effects* ; Taiwan ; Tumor Suppressor Proteins/metabolism*

Objective:To investigate the impact of multidisciplinary diagnosis and treatment on postoperative 30-day mortality and complications in elderly patients with hip fracture.Methods:A retrospective analysis was conducted of the 260 elderly patients with hip fracture who had been treated by the mode of multidisciplinary diagnosis and treatment at Department of Orthopedics, Shenzhen Second People's Hospital from June 2018 to October 2019. The multidisciplinary group consisted of 66 males and 194 females with an age of 78.7 years ± 5.1 years, and 141 femoral neck fractures, 114 intertrochanteric fractures and 5 subtrochanteric fractures. They were compared with the 242 elderly patients with hip fracture (traditional group) who had been treated by the traditional mode from January 2017 to May 2018. The 2 groups were compared in terms of preoperative waiting time, 48-hour operation rate, 30-day mortality, and incidences of postoperative pneumonia and pressure ulcer.Results:There were no statistically significant differences in the preoperative general data or operative procedures between the 2 groups, showing comparability ( P>0.05). For the multidisciplinary group, preoperative waiting time was 41.9 h ± 36.5 h, significantly shorter than that for the traditional group (71.4 h ± 13.9 h), 48-hour operation rate 66.5% (173/260), significantly higher than that for the traditional group(8.7%, 21/242), incidence of postoperative pneumonia 3.1%(8/260), significantly lower than that for the traditional group(9.9%, 24/242), incidence of postoperative pressure ulcer (5.4%, 14/260), significantly lower than that for the traditional group(11.2%, 27/242), and 30-day mortality(2.3%, 6/260), significantly lower than that for the traditional group(5.8%, 14/242) (all P<0.05). Conclusions:Establishment of a mode of multidisciplinary diagnosis and treatment can significantly reduce the prolonged preoperative waiting time for elderly patients with hip fracture, thereby greatly reducing postoperative complications and postoperative 30-day mortality.

Objective:To investigate the association between levator hiatus area, pelvic organ prolapse quantification (POP-Q) examination and prolapse symptoms.Methods:The prospective multicenter study enrolled 996 female patients between January 2017 and January 2019. All enrolled patients underwent a standard clinical interview, POP-Q examination and transperineal ultrasound examination. Volume data of pelvic floor ultrasound examinations were obtained at rest, during contraction and during maximal Valsalva maneuver. The association between levator hiatus area, POP-Q examination and prolapse symptoms was analyzed. The performance of levator hiatus area on maximal Valsalva for assessing significant POP(POP-Q stage≥2) and prolapse symptoms were also evaluated.Results:There were significant differences of levator hiatus area at rest, during contraction and during maximal Valsalva among patients with different POP-Q stages (all P<0.001). Levator hiatus area during maximal Valsalva showed the highest correlation with abdominal dragging sensation ( r=0.277, P<0.001). The area under the ROC curve (AUC) of levator hiatus area during maximal Valsalva for significant POP (POP-Q stage≥2) was significantly higher than that for prolapse symptoms (AUC: 0.77 vs 0.69, P<0.001). Conclusions:Levator hiatus area on transperineal has moderate correlation with POP-Q examination and their association is stronger than the correlation between ultrasound findings and prolapse symptoms.

Objective:To investigate the feasibility of transperineal ultrasound in quantitative assessment of posterior compartment prolapse among Chinese women.Methods:The prospective multicenter study enrolled 485 women between January 2017 and January 2019. All patients underwent a standard clinical interview, pelvic organ prolapse quantification (POP-Q) examination and transperineal ultrasound examination. Volume data of transperineal ultrasound examinations were obtained at rest and in maximal Valsalva maneuver.Results:The higher POP-Q stage of posterior compartment, the lower rectal ampulla position in maximal Valsalva maneuver (POP-Q stage=0 vs POP-Q stage=1, P<0.001; POP-Q stage=1 vs POP-Q stage≥2, P<0.001), and the greater rectal ampulla hypermobility (POP-Q stage=0 vs POP-Q stage=1, P<0.001; POP-Q stage=1 vs POP-Q stage≥ 2, P=0.007). The rectal ampulla position at rest and in maximal Valsalva maneuver and rectocele depth were correlated with prolapse symptoms ( r=-0.200, P<0.001; r=-0.252, P<0.001; r=0.086, P=0.045). The corresponding cut-off values of rectal ampulla position in maximal Valsalva in diagnosing posterior compartment prolapse (POP-Q stage ≥1) and clinical significant posterior compartment prolapse (POP-Q stage ≥2) were 7.32 mm below the symphysis pubis and 12 mm below the symphysis pubis, respectively, with the area under the ROC curve as 0.75 and 0.85, respectively. Conclusions:The ultrasonic measurements by transperineal ultrasound is significantly associated with POP-Q examination in posterior compartment, and it is demonstrated as a useful tool in quantitative assessment of the severity of posterior compartment prolapse.