Objective:To investigate the completion rate of tumor evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients in the national multicenter real-world database.Methods:The prospective real-world study was conducted. The clinicopathological data of 1 074 patients who underwent surgical treatment for mid and low rectal cancer in 47 national medical institutions, including Peking Union Medical College Hospital et al, from May 12,2023 to May 11,2024 were collected. Observation indicators: (1) clinical characteristics of patients with mid and low rectal cancer; (2) initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer; (3) initial imaging evaluation of patients with mid and low rectal cancer; (4) imaging evaluation after neoadjuvant therapy for patients with mid and low rectal cancer. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3). Count data were described as absoluter numbers and/or percentages. Results:(1) Clinical characteristics of patients with mid and low rectal cancer. Of the 1 074 patients, there were 713 males and 361 females, aged 63(56,70)years. The body mass index of 1 074 patients was 24(21,26)kg/m 2.For American Society of Anesthesiologists classification, there were 147 cases of stage Ⅰ, 641 cases of stage Ⅱ, 157 cases of stage Ⅲ, 2 cases of stage Ⅳ, and there were 127 cases missing data. (2) Initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer. Of the 1 074 patients, there were 787 cases (73.28%) undergoing complete colonoscopy, and there were only 197 cases (18.34%) undergoing immunohistochemical evaluation of all four mismatch repair proteins. (3) Initial imaging evaluation of patients with mid and low rectal cancer. Of the 1 074 patients, there were 842(78.40%) patients completing magnetic resonance imaging (MRI) or ultrasound evaluation, and there were 914(85.10%) patients completing chest, abdomen, and pelvis enhanced computed tomography (CT) evaluation. In the 149 patients completing rectal ultrasound evaluation, there were 122 cases (81.88%) comple-ting T staging evaluation, and there were 81 cases (54.36%) completing N staging evaluation. In the 808 patients completing rectal MRI evaluation, there were 708 cases (87.62%) completing T staging evaluation, and there were 590 cases (73.02%) completing N staging evaluation. (4) Imaging evalua-tion after neoadjuvant therapy for patients with mid and low rectal cancer. Of the 388 patients with neoadjuvant therapy, there were 332 patients (85.57%) completing MRI or ultrasound evaluation, and there were 327 patients (84.28%) completing chest, abdomen, and pelvis enhanced CT evalua-tion. In the 70 patients completing rectal ultrasound evaluation, there were 65 cases (92.86%) com-pleting T staging evaluation, and there were 49 cases (70.00%) completing N staging evaluation. In the 327 patients completing rectal MRI evaluation, there were 246 cases (75.23%) completing T staging, and there were 228 cases (69.72%) completing N staging evaluation. Conclusion:The com-pletion rate of tumor imaging evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients on a national scale is relatively good.

Objective:To investigate variation and correlation of type 2 intrinsic lymphocyte(ILC2)and related factors in acute and chronic brucellosis,to identify immune role of ILC2 in chronic brucellosis.Methods:Forty-three patients with acute brucel-losis and 45 patients with chronic brucellosis were compared with 49 healthy controls.ILC2 level in each group was detected by flow cytometry.mRNA level of GATA3 in PBMC was detected by fluorescence quantitative PCR.Serum IL-33,ST2,IL-4 and IL-13 levels were detected by ELISA.ALT and AST levels were measured by fully automatic biochemical analyzer.Results:ILC2 level,GATA3 mRNA in PBMC,serum IL-33,IL-4 and IL-13 levels in chronic brucellosis group were significantly higher than healthy control group and acute brucellosis group(P<0.01).Correlation analysis showed that ILC2 level was positively correlated with GATA3 mRNA,IL-33,IL-4 and IL-13 levels,while negatively correlated with ST2 level.ROC curve suggested that ILC2,GATA3,IL-33 and ST2 had good predictive ability for severity of brucellosis patients(AUC>0.7).Conclusion:Increase of ILC2 and its related factors are closely related to chronic brucella infection,which may play an important immune role in pathogenesis of brucella infection.

Objective:To examine the influence of physical function status on supportive care needs (SCNS) in patients with primary liver cancer (PLC) and to explore the mediating roles of perceived social support and anxiety-depression, with the aim of providing evidence for nursing interventions to improve patients' care experience.Methods:A convenience sampling method was used to select PLC inpatients admitted to The First Affiliated Hospital of Jinan University between December 2022 and February 2024. Data were collected using a general information questionnaire, the 34-item Supportive Care Needs Survey-Short Form, the Hospital Anxiety and Depression Scale, the Perceived Social Support Scale, and the Karnofsky Performance Status Scale to conduct a cross-sectional survey. Pearson correlation analysis was performed to examine associations among SCNS, perceived social support, anxiety-depression, and physical function status. Structural equation modeling was used to assess the mediating effects of perceived social support and anxiety-depression on the relationship between physical function status and SCNS.Results:A total of 304 patients were enrolled, including 260 males and 44 females, 31 cases aged 18-40 years old, 160 cases aged 41 to 60 years old, and 113 cases over 60 years old. The mean total SCNS score was (98.32 ± 21.75) points, the mean anxiety-depression score was (23.31 ± 9.64) points, the mean perceived social support score was (56.62 ± 13.05) points, and the mean physical function status score was (66.28 ± 12.31) points. Pearson correlation analysis showed that physical function status was negatively correlated with SCNS and anxiety-depression ( r =-0.509, -0.447; both P<0.05) and positively correlated with perceived social support ( r =0.439, P<0.05). Physical function status had a direct effect of 60.74% on SCNS, with specific mediating effects of perceived social support and anxiety-depression accounting for 23.15% and 11.85%, respectively, and a chain mediating effect of 4.26%. Conclusions:Patients with PLC exhibited a moderately high level of supportive care needs. Physical function status not only exerted a direct negative effect on SCNS but also indirectly influenced SCNS through the chain mediation of perceived social support and anxiety-depression. Clinical medical staff should focus on enhancing patients' perception of social support and effectively alleviating anxiety and depressive symptoms, thereby reducing supportive care needs to some extent.

Objective To explore the correlation between residual cholesterol(RC)and lipoprotein-associated phospholipase A2(Lp-PLA2)in type 2 diabetes mellitus(T2DM).Methods A total of 362 T2DM patients visited our hospital from January 2022 to June 2023 were divided into RC≥0.78 mmol/L(HRC,n=196)group and RC<0.78 mmol/L(NRC,n=166)group based on the levels of RC.The clinical characteristics and related factors were compared between the two groups and the risk factors for RC were analyzed.Results Compared with NRC group,DM duration,SBP,DBP,TC,TG,rate of ACEI or ARBs use,non-HDL-C,Lp-PLA2 and IMT in HRC group increased(P<0.05)and LDL-C decreased(P<0.05).Pearson and Spearman correlation analysis showed that RC was positively correlated with age,DM duration,SBP,DBP,TC,TG,non-HDL-C,Lp-PLA2,IMT(P<0.05)and negatively correlated with LDL-C(P<0.05).Logistic multivariate regression analysis showed that TC,TG,LDL-C,non-HDL-C,Lp-PLA2 and IMT were the influencing factors of RC in T2DM patients.Receiver operating characteristic curve analysis showed that the cutoff value of RC was 0.85 mmol/L,and the cutoff value of Lp-PLA2 was 242 U/L.The predicted AUC of T2DM macroangiopathy respectively was 0.864 and 0.721,and the predicted AUC of RC combined with Lp-PLA2 was 0.896.Conclusions Serum RC is positively correlated with Lp-PLA2 in T2DM patients.The combined detection of these two indicators has a certain predictive value for T2DM macrovascular disease.

To achieve rapid and visual detection of Plasmodium vivax,a detection method based on recombinase polymerase amplification(RPA)technology and lateral flow dipstick(LFD)was established and evaluated.Targeting the conserved sequence of the P.vivax 18S rRNA gene(GenBank:DQ660817.1)as the target sequence,primers and probes were designed with Primer Premier 5,and the P.vivax recombinant plasmid(pUCPv)was constructed as the standard.A sensitive and specific RPA-LFD-based rapid visual detection method for P.vivax nucleic acids was established.The plasmid standard was serially diluted 10-fold to concentrations of 1×103,1×102,1×101,1×10?,and 1×10?1 copies/μL for sensitivity testing.To evaluate specificity,whole blood DNA samples from patients infected with Plasmodium falciparum,Plasmodium malariae,Plasmodium ovale,or Leishmania donovani,as well as healthy participants,were tested by RPA-LFD.Additionally,The assay′s accuracy was evaluated by testing whole blood DNA samples from 24 confirmed P.vivax-infected patients.This study successfully established a sensitive,specific,and rapid visual RPA-LFD method for detecting P.vivax nucleic acids.The assay can complete P.vivax detection within 20 minutes under isothermal conditions at 39 ℃,achieving a sensitivity of 1 copy/μL.There is no significant cross reaction with parasites such as other Plasmodium species and L.donovani,and the specificity is 100%.All 24 DNA samples from confirmed P.vivax patients were detected,showing a 100%detection rate.The developed RPA-LFD assay exhibits excellent sensitivity and specificity,requires only simple heating equipment,and is user-friendly.This rapid visual detection method is particularly suitable for P.vivax screening in low-resource settings.

Objective:To observe the clinical efficacy and Effects on gastrointestinal dynamics and inflammatory factors levels of combined treatment with electromagnetic stimulation and Shugan Qingwei Tang for reflux esophagitis(RE).Methods:142 cases of liver and stomach depression heat type RE patients who were treated in our hospital from April 2021 to May 2023 were selected.The patients were divided into control group(conventional drug therapy combined with electromagnetic stimulation)and study group(Shugan Qingwei decoction was added to the control group)by random number table method,with 71 cases each.The curative effect,gastrointestinal dynamics indexes,inflammatory factors and adverse reactions were observed between the two groups.Results:Compared with control group after treatment,the clinical total effective rate,serum gastrin(GAS),and motilin(MTL)were higher,while serum tumor necrosis factor-α(TNF-α),c-reactive protein(CRP),interleukin-1β(IL-1β),and interleukin-6(IL-6)were lower in the study group(P＜0.05).There were no obvious adverse reactions between both groups.Conclusion:The combination therapy of Shugan Qingwei Tang and electromagnetic stimulation can improve the clinical treatment effect,improve gastrointestinal function,reduce the level of inflammatory factors,and has good safety for RE patients.

OBJECTIVE:To explore the efficacy of different exercise regimens to reduce fall risks in older adults.METHODS:PubMed,Embase,Web of Science,The Cochrane Library,WanFang,and CNKI were searched for studies about exercise interventions on fall risk in healthy older adult individuals at the age of 60 years and above.The search timeframe should cover from the inception of each database to July 2023.Quality assessment and risk-of-bias were assessed using the Cochrane risk of bias tool.Meta-analysis,subgroup analysis,sensitivity analysis,and publication bias were conducted using Review Manager 5.3 and Stata 16.0.RESULTS:A total of 45 papers containing 54 studies with 3 074 participants were included in the analysis.Overall,exercise intervention can improve the interventional effects on balance(the unipedal stance test with eyes open,functional reach,Timed"Up & Go",and Berg balance scale),lower limb muscle strength(30-second chair-stand test,Five-Times Sit-To-Stand Test,and Short Physical Performance Battery),and fall-efficacy(Falls Efficacy Scale-International),leading to reduced fall risk(P＜0.05).The Meta-analysis results revealed a dosage effect of different exercise regimens to reduce fall risk in the elderly.Mind-body exercise could efficiently increase scores of the unipedal stance test[mean difference(MD)=6.81,95％confidence interval(CI)(2.17,11.44),P＜0.01];resistance exercise could efficiently increase the scores of the Timed"Up & Go"[MD=-3.12,95％CI(-5.72,-0.52),P＜0.05]and the 30-second chair-stand test[MD=1.22,95％CI(0.37,2.08),P＜0.01];and multicomponent physical activity could efficiently increase the scores of functional reach[MD=4.50,95％CI(2.58,6.42),P＜0.01],Berg Balance Scale[MD=1.05,95％CI(0.39,1.71),P＜0.01],Five-Times Sit-To-stand Test[MD=-3.15,95％CI(-4.80,-1.50),P＜0.01],Short Physical Performance Battery[MD=0.55,95％CI(0.37,0.74),P＜0.01],and Falls Efficacy Scale-International[MD=-0.41,95％CI(0.69,-0.13),P＜0.01].Conclusion:Exercise interventions can effectively improve balance,enhance limb strength and functional ability,and reduce fear of falling,and lower the risk of falls in older adults.The components of different intervention programs(such as type of exercise,duration,frequency,and session length)have varying dose-response relationships with the results of fall risk screening tests in older adults.

Objective:To observe the clinical efficacy and Effects on gastrointestinal dynamics and inflammatory factors levels of combined treatment with electromagnetic stimulation and Shugan Qingwei Tang for reflux esophagitis(RE).Methods:142 cases of liver and stomach depression heat type RE patients who were treated in our hospital from April 2021 to May 2023 were selected.The patients were divided into control group(conventional drug therapy combined with electromagnetic stimulation)and study group(Shugan Qingwei decoction was added to the control group)by random number table method,with 71 cases each.The curative effect,gastrointestinal dynamics indexes,inflammatory factors and adverse reactions were observed between the two groups.Results:Compared with control group after treatment,the clinical total effective rate,serum gastrin(GAS),and motilin(MTL)were higher,while serum tumor necrosis factor-α(TNF-α),c-reactive protein(CRP),interleukin-1β(IL-1β),and interleukin-6(IL-6)were lower in the study group(P＜0.05).There were no obvious adverse reactions between both groups.Conclusion:The combination therapy of Shugan Qingwei Tang and electromagnetic stimulation can improve the clinical treatment effect,improve gastrointestinal function,reduce the level of inflammatory factors,and has good safety for RE patients.

Objective:To investigate the characteristics and clinical effects of laparoscopic pneumovesical Cohen and laparoscopic Lich-Gregoir ureteral replantations for the treatment of primary obstructive megaloureter (POM) in children.Methods:A randomized controlled study was conducted.The clinical data of 51 children with unilateral POM admitted to the First Affiliated Hospital of Zhengzhou University from October 2018 to October 2023 were collected.Random number table method was used in the selection of surgical methods.They were divided into the laparoscopic pneumovesical Cohen ureteral replantation group (group A, 22 cases) and the laparoscopic Lich-Gregoir ureteral replantation group (group B, 29 cases) according to the surgical method.The anterior-posterior diameter(APD), maximum ureteral diameter and differential renal function parameters on the affected side were measured by color Doppler ultrasound of the urinary system, and compared between and within the two groups before and after surgery.The operation time, blood loss and postoperative intubation time were compared between the two groups.The incidence of postoperative complications such as reflux, bladder spasm, urinary retention and urinary tract infection was recorded.The independent and paired sample t-tests were used for statistical analysis. Results:The operation time and hematuria duration of group B [(125.7±14.2) min, (1.5±0.6) d] were significantly shorter than those of group A [(142.6±14.7) min, (2.8±0.7) d] (all P<0.05). The APD, maximum ureteral diameter, and differential renal function on the affected side of group A were (21.7±7.9) mm, (11.6±3.2) mm, and (28.2±4.9)% before surgery, and (10.3±4.5) mm, (6.0±2.0) mm and (43.8±4.4)% after surgery, respectively.The APD, maximum ureteral diameter, and differential renal function on the affected side of group B were (21.1±5.6) mm, (11.3±4.6) mm, and (30.2±5.5)% before surgery, and (10.2±4.5) mm, (6.6±2.0) mm, and (42.4±5.2)% after surgery, respectively.There was no statistically significant difference in the values of APD, maximum ureteral diameter, and differential renal function before and after surgery between the two groups of children (all P>0.05). However, there were statistically significant differences in the values of APD, maximum ureteral diameter, and differential renal function before and after surgery between the same group of children (all P<0.01). No significant difference was found in intraoperative blood loss, postoperative intubation time, and postoperative complications between the two groups (all P>0.05). Conclusions:Both surgical methods are effective in the treatment of POM in children.Laparoscopic Lich-Gregoir ureteral replantation has advantages of less operation time compared with laparoscopic pneumovesical Cohen ureteral replantation.

Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans ; Consensus ; Dental Implants ; Mouth Mucosa/surgery* ; Keratins