[This corrects the article DOI: 10.1016/j.apsb.2019.01.013.].

Updates to the modern diagnosis of GERD:Lyon consensus 2.0 was published online in Sep-tember 2023.It presents 23 consensus statements that update the modern definition of gastro-esophageal reflux disease(GERD)and optimize the diagnosis and management of GERD,providing an up-to-date basis for the diagnosis and treatment of GERD.The international consensus is based on the evaluation of studies conducted since the original consensus was published.However,due to the limitations of evidence-based evidence and the differences in national conditions,populations,and economic levels of different countries,it is necessary to in-terpret its applicability in China,so as to better promote the dissemination of its content and its implementation,and provide patients with the most appropriate guidance for clinical practice.

Updates to the modern diagnosis of GERD: Lyon consensus 2.0 was published online in September 2023. It presents 23 consensus statements that update the modern definition of gastro-esophageal reflux disease (GERD) and optimize the diagnosis and management of GERD, providing an up-to-date basis for the diagnosis and treatment of GERD. The international consensus is based on the evaluation of studies conducted since the original consensus was published. However, due to the limitations of evidence-based evidence and the differences in national conditions, populations, and economic levels of different countries, it is necessary to interpret its applicability in China, so as to better promote the dissemination of its content and its implementation, and provide patients with the most appropriate guidance for clinical practice.

Objective:To investigate the epidemiology features, intervention effects and influencing factors of thrombosis in arteriovenous graft (AVG), and to provide reference for optimizing vascular access scheme in hemodialysis patients.Methods:It was a retrospective study. The clinical and follow-up data of patients with AVG constructed in the Blood Purification Center, the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2022 were analyzed. According to whether AVG thrombosis occurred during the follow-up period, they were divided into thrombosis group and non-thrombosis group, and the epidemiology status, influencing factors and patency rates of AVG thrombosis were analyzed. AVG was followed up until June 30, 2023 or abandonment or death of patient or loss of follow-up. Kaplan-Meier method was used to analyze the patency rates of AVG. Log-rank test was used to compare the differences of patency rates between groups. Logistic regression model was used to analyze the influencing factors of AVG thrombosis.Results:The study included 475 AVG from 464 patients, with age of (55.50 ± 11.85) years old, 193 males (40.6%), 185 diabetes patients (38.9%) and dialysis age of 24 (1, 68) months. One hundred and fifty-four AVG (32.4%) had a total of 307 AVG thrombotic events during the follow-up of 602 (380, 920) days, with a standardized incidence of 0.34 times per patient-year. Among them, 60 cases (19.5%, 60/307) had frequent thrombosis. Kaplan-Meier survival analysis showed that AVG secondary patency rates at 2-years and 3-years in the thrombosis group and frequent thrombosis subgroup were inferior to those in the non-thrombosis group (84.0% vs. 92.5%, P=0.017; 66.5% vs. 85.7%, P<0.001; 78.9% vs. 92.5%, P=0.030; 54.6% vs. 85.7%, P<0.001). Two hundred and sixty-nine AVG thrombotic events were analyzed to evaluate the treatment effects. Endovascular interventional surgery was used for thrombectomy in 215 cases (79.9%), and hybrid surgery (endovascular interventional surgery combined with surgical incision) was used in 54 cases (20.1%), with a technical success rate of 98.9% (266/269) and a clinical success rate of 98.1% (264/269). Kaplan-Meier survival analysis showed that there were no statistically significant differences in the primary post-intervention patency rates at 90 days and 365 days, respectively (all P>0.05), and there was statistically significant difference in the primary post-intervention patency rate at 180 days (45.1% vs. 26.5%, Z=2.563, P=0.015). Multivariate logistic regression analysis showed that graft-applied type (intering as the reference, propaten OR=1.953, 95% CI 1.139-3.350, P=0.015; acuseal OR=2.628, 95% CI 1.438-4.800, P=0.002), body mass index < 18.5 kg/m 2 (18.5-24.0 kg/m 2 as the reference, OR=0.291,95% CI 0.090-0.943, P=0.040), serum albumin < 40 g/L ( OR=1.579, 95% CI 1.019-2.445, P=0.041), serum ferritin < 200 μg/L ( OR=1.818, 95% CI 1.162-2.845, P=0.009) and mean arterial pressure < 70 mmHg ( OR=7.180, 95% CI 1.339-38.501, P=0.021) were the independent influencing factors of AVG thrombosis. Conclusions:The incidence of AVG thrombotic events is 0.34 times per patient-year, mainly concentrated in a small number of patients. Thrombosis reduces the secondary patency rate of AVG. AVG thrombosis treatment with endovascular interventional surgery or hybrid surgery has a high technical success rate and a clinical success rate. The thrombosis is related to graft-applied types, nutritional status of patients and mean arterial pressure level.

Objective:To study the value of myocardial perfusion imaging (MPI) and coronary flow reserve (CFR) combined with coronary artery calcium score (CACS) in the diagnosis of obstructive coronary artery disease (CAD).Methods:From January 2019 to December 2020, 96 confirmed or suspective CAD patients (65 males, 31 females; age: 30-81 years) who completed rest/stress MPI, CFR and CACS defection in Fuwai Central China Cardiovascular Hospital were retrospectively analyzed. Coronary angiography (CAG) was used as the diagnostic standard to calculate the sensitivity and accuracy of MPI, CFR and MPI/CFR combined with CACS in the diagnosis of CAD. The χ2 test was used to compare the diagnostic efficiency of different methods. Results:The diagnostic sensitivity of MPI was 76.06%(54/71), and the accuracy was 75.00%(72/96), while the sensitivity increased to 97.18%(69/71; χ2=13.67, P<0.001) and the accuracy increased to 87.50%(84/96; χ2=4.92, P=0.020) with significant differences after combined with CACS. The sensitivity and accuracy of CFR were 91.55%(65/71)and 87.50%(84/96), which increased to 97.18%(69/71; χ2=2.12, P=0.137) and 89.58%(86/96; χ2=0.21, P=0.411) with no significant differences after combined with CACS. The sensitivity of MPI in the diagnosis of three-vessel CAD was 70.00%(21/30), which increased to 100%(30/30; χ2=7.75, P=0.004) after combined with CACS; while the sensitivity of MPI combined with CACS in the diagnosis of single-vessel and double-vessel CAD were not significantly improved ( χ2 values: 3.29, 1.51, P values: 0.114, 0.416). Conclusion:The combination of MPI and CACS can significantly improve the diagnostic efficiency of CAD, contributed by the improvement of the diagnostic sensitivity in three-vessel disease; whereas the diagnostic efficiency of CFR for CAD is not significantly improved after combined with CACS.

Objective To investigate the clinical features and prognosis of HIV-negative plasmablastic lymphoma (PBL) patients. Methods We collected HIV-negative PBL cases reported in our hospital and other literatures from online databases from January 1, 1997 to March 30, 2020. The data of clinical features, molecular pathology, treatment and prognosis were summarized and analyzed. Results We included 60 PBL patients, average age was 53.06±14.36 years, and most of them had relatively high Ann Arbor stage and Ki-67 expression. The average OS was 13.48±13.21 m. Kaplan-Meier curve revealed Ann Arbor stage, IPI index (3-5), B symptoms and CR in initial treatment were significantly related with patients' survival. Cox regression analysis indicated that the Ann Arbor stage and IPI index were the independent prognostic factors for patients' survival. Conclusion HIV-negative PBL mostly occurs in the middle-age and elderly patients, with advanced diagnosis stage and rapid tumor proliferation. Combination chemotherapy is the main treatment, while the therapeutic response and OS might be heterogeneous, the prognosis of most patients would be poor. The stage and IPI index are significantly related to the prognosis.

Objective:To investigate the effect of different cleaning methods on the cleaning effect of Da Vinci robotic electrosurgical instruments and the feasibility of adenosine triphosphate(ATP) fluorescence detection technology for evaluating the cleaning effect of Da Vinci robotic electrosurgical instruments.Methods:A total of 180 electrosurgical instruments were divided into control group and test group by random digits table method from June 2018 to June 2019 after robotic surgery. For the control group, 90 cases were manually cleaned to complete the device cleaning process, and for the test group, 90 cases were mechanically cleaned to complete the device cleaning process. Through visual observation, magnifying glass examination and ATP fluorescence detection technology, the cleaning effect of the two methods and the correlation between the evaluation results obtained by ATP fluorescence detection technique and traditional inspection method were compared.Results:The qualified rate of visual observation, magnifying lens examination and ATP fluorescence detection in the control group were 95.56%(85/90), 86.67% (78/90) and 84.44% (76/90), respectively, and that in the test group were 100.00% (90/90), 97.78% (88/90) and 98.89% (89/90), respectively. The test group was higher than the control group. The difference between the two groups was statistically significant ( χ2 values were 4.310, 7.745, 12.291, P<0.05 or 0.01). In the control group, there was a positive correlation between the qualified rate of ATP fluorescence detection and visual observation ( r value was 0.374, P < 0.01), and a significant positive correlation between the qualified rate of magnifying lens examination ( r value was 0.538, P < 0.01). In the test group, There was also a significant positive correlation between the qualified rate of ATP fluorescence detection and visual observation ( r value was 0.754, P < 0.01), and between the qualified rate of magnifying lens examination( r value was 0.556, P < 0.01). Conclusions:Mechanical cleaning is used to clean Da Vinci robotic electrosurgical instruments, which is superior to traditional manual cleaning. ATP fluorescence detection technology is feasible for evaluating the cleaning effect of Da Vinci robotic electrosurgical instruments.

[This corrects the article DOI: 10.1016/j.apsb.2019.01.013.].

Bicyclol is a synthetic drug for hepatoprotection in clinic since 2004. Preliminary clinical observations suggest that bicyclol might be active against hepatitis C virus (HCV) with unknown mechanism. Here, we showed that bicyclol significantly inhibited HCV replication and in hepatitis C patients. Using bicyclol as a probe, we identified glycolipid transfer protein (GLTP) to be a novel restrictive factor for HCV replication. The GLTP preferentially bound host vesicle-associated membrane protein-associated protein-A (VAP-A) in competition with the HCV NS5A, causing an interruption of the complex formation between VAP-A and HCV NS5A. As the formation of VAP-A/NS5A complex is essential for viral RNA replication, up-regulation of GLTP by bicyclol reduced the level of VAP-A/NS5A complex and thus inhibited HCV replication. Bicyclol also exhibited an inhibition on HCV variants resistant to direct-acting antiviral agents (DAAs) with an efficacy identical to that on wild type HCV. In combination with bicyclol, DAAs inhibited HCV replication in a synergistic fashion. GLTP appears to be a newly discovered host restrictive factor for HCV replication, Up-regulation of GLTP causes spontaneous restriction of HCV replication.

Objective To explore the method and clinical effect of radial artery pedigreed conjoined perfora-tor flap for repairing cross-joint long-shaped skin and soft tissue defects in fingers. Methods From June, 2015 to June,2017,six patients with cross-joint long-shaped skin and soft tissue defects of the fingers were treated with radial artery pedigreed conjoined flap which axis was the artery superficial line, and carried two radial artery perforators, in order to enlarge flap cut range to repair.The size of flaps ranged from 3.0 cm ×6.0 cm to 3.5 cm ×7.5 cm.The donor site was directly sutured. After operation, all patients were followed up for 3 to 8 months. All the necessary parts are observed, such as the flaps appearances, textures, the donor sites, checked the flap sensation, activity functions of the fingers. Results Six cases of flap all survived.The wounds healed well(phase I),and all patients were followed up for 3 to 8 months, with an average of 5 months. All the flaps do not obviously bloat, the textures were soft,the colors are normal,the appearances of flaps were similar to recipient sites. The donor sites healed well only with linear scars. Conclusion Using radial artery pedigreed conjoined perforator flap to repair cross-joint long-shaped skins and soft tissue defects in fingers that it not only can enlarge the cut range but also cut conveniently, the textures are close to recipient sites.Therefore,it is an ideal repair way.