Objective: To explore the efficacy and feasibility of transanal hand-sewn reinforcement of low stapled anastomosis in preventing anastomotic leak after transanal total mesorectal excision (taTME). Methods: A descriptive cohort study was conducted. Clinical data of 51 patients with rectal cancer who underwent taTME with transanal hand-sewn reinforcement of low stapled anastomosis at Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University from January 2019 to December 2020 were retrospectively collected. Inclusion criteria: (1) age >18 years old; (2) rectal cancer confirmed by preoperative pathology; (3) distance from tumor to anal verge ≤ 8 cm according to pelvic MR; (4) the lesion was evaluated to be resectable before operation; (5) with or without neoadjuvant chemotherapy and radiotherapy; (6) taTME, end-to-end stapled anastomosis, and reinforcement in the anastomosis with absorbable thread intermittently were performed, and the distance between anastomosis and anal verge was ≤ 5 cm. Exclusion criteria: (1) previous history of colorectal cancer surgery; (2) emergency surgery due to intestinal obstruction, bleeding or perforation; (3) patients with local recurrence or distant metastasis; (4) the period of postoperative follow-up less than 3 months. The procedure of transanal hand-sewn reinforcement was as follows: firstly, no sign of bleeding was confirmed after checking the anastomosis. Then, the anastomosis was reinforced by suturing the muscle layer of rectum intermittently in a figure-of-eight manner using 3-0 single Vicryl. The entry site of the next suture was close next to the exit site of the last one. Any weak point of the anastomosis could also be reinforced according to the specimen from the circular stapler. The primary outcome were the incidence of anastomotic leak, methods of the secondary operation, anastomotic infection, anastomotic stricture, and conditions of Intraoperative and postoperative. Results: All the 51 enrolled patients completed surgery successfully without any conversion to open surgery. The median operative time was 169 (109-337) minutes, and the median intraoperative blood loss was 50 (10-600) ml. The median postoperative hospital stay was 8 (5-16) days. The mssorectum was complete and distal resection margin was negative in all patients. Postive circumferential resection margin was observed in 1 patients (2.0%). Twelve (23.5%) patients underwent prophylactic ileostomy. One patient developed anastomosis stricture which was cured by digital dilatation of the anastomosis. ISREC grade C anastomotic leak was observed in 3 (5.9%) male patients, of whom 2 cases did not received prophylactic ileostomy during the operation, and were cured by a second operation with the ileostomy and anastomotic repair. The other one healed by transanal repair of the anastomosis and anti-infection therapy. One (2.0%) patient suffered from perianal infection and healed by sitz bath and anti-infection therapy. No death was reported within 30 days after operation. Conclusion: Transanal hand-sewn reinforcement in low rectal stapled anastomosis in preventing anastomotic leak after taTME is safe and feasible.
Adolescent ; Anal Canal/surgery* ; Anastomosis, Surgical ; Anastomotic Leak/prevention & control* ; Cohort Studies ; Humans ; Laparoscopy ; Male ; Postoperative Complications/prevention & control* ; Rectal Neoplasms/surgery* ; Rectum/surgery* ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To explore the regulation effect of myeloid leukemia No.1 Chinese herb medicine prescription combined with chemotherapy on Th17 cells in bone marrow fluid of AML patients, so as to provide guidance for improving AML treatment effect and patients' long-term survival. METHODS: Seventy patients with AML who were hospitalized in Department of Hematology, Wuwei People's Hospital from April 2017 to August 2019 were selected and enrolled in AML group, 25 healthy volunteers were selected and enrolled in control group; then according to therapeutic regimen, AML patients were divided into 2 groups: combined therapy group (myeloid leukemia NO.1 Chinese herb medicine prescription combined with chemotherapy) and non-combined therapy group (chemotherapy alone). Flow cytometry was used to detect the ratio of CD3 RESULTS: The ratio of CD3 CONCLUSION Th17 cells expression in bone marrow of newly diagnoses and relapsed AML patients significantly increase, and decrease significantly after treatment. Myeloid leukemia No.1 Chinese herb prescription combined with chemotherapy can significantly increase the CR rate and reduce the RL rate for AML.
Bone Marrow ; China ; Humans ; Leukemia, Myeloid, Acute/drug therapy* ; Medicine ; Prescriptions ; Th17 Cells ; Vascular Endothelial Growth Factor A

OBJECTIVE: To detect the level of vascular endothelial growth factor (VEGF) in bone marrow of patients with non-M3 acute leukemia (AL), and estimate its relationship with prognosis. METHODS: From January 2016 to December 2019, 114 patients with AL in department of Hematology, Wuwei People's Hospital were selected as study group, and 25 healthy volunteers were enrolled as control group. The concentration of VEGF in bone marrow was detected by ELISA. The patients were divided into high and low concentration group according to the level of VEGF. The overall survival (OS) and event-free survival (EFS) were compared among different groups. RESULTS: The level of VEGF in patients with AL was significantly higher than that in the control group. The median OS and EFS in the low concentration group was 34.5 and 32 months, respectively, while, in the high concentration group was 30 and 26 months, respectively. The differences between the two groups were statistically significant (P=0.010). There were significant differences in OS rate (P=0.035) and EFS rate (P=0.026) between low and high concentration group. Multivariate analysis showed that high VEGF concentration was an independent risk factor affecting OS (HR=2.619, 95%CI 1.070-6.406, P=0.035) and EFS (HR=2.221, 95%CI 1.074-4.552, P=0.031) in AL patients. CONCLUSION VEGF highly expresses in the bone marrow of patients with AL at initial diagnosis and relapse, and shows adverse effects on the prognosis.
Bone Marrow ; Disease-Free Survival ; Humans ; Leukemia, Myeloid, Acute ; Prognosis ; Vascular Endothelial Growth Factor A

Currently, the systems for culturing buffalo spermatogonial stem cells (SSCs) in vitro are varied, and their effects are still inconclusive. In this study, we compared the effects of culture systems with undefined (foetal bovine serum) and defined (KnockOut Serum Replacement) materials on the in vitro culture of buffalo SSC-like cells. Significantly more DDX4- and UCHL1-positive cells (cultured for 2 days at passage 2) were observed in the defined materials culture system than in the undefined materials system (p < 0.01), and these cells were maintained for a longer period than those in the culture system with undefined materials (10 days vs. 6 days). Furthermore, NANOS2 (p < 0.05), DDX4 (p < 0.01) and UCHL1 (p < 0.05) were expressed at significantly higher levels in the culture system with defined materials than in that with undefined materials. Induction with retinoic acid was used to verify that the cultured cells maintained SSC characteristics, revealing an SCP3⁺ subset in the cells cultured in the defined materials system. The expression levels of Stra8 (p < 0.05) and Rec8 (p < 0.01) were significantly increased, and the expression levels of ZBTB16 (p < 0.01) and DDX4 (p < 0.05) were significantly decreased. These findings provided a clearer research platform for exploring the mechanism of buffalo SSCs in vitro.

Currently, the systems for culturing buffalo spermatogonial stem cells (SSCs) in vitro are varied, and their effects are still inconclusive. In this study, we compared the effects of culture systems with undefined (foetal bovine serum) and defined (KnockOut Serum Replacement) materials on the in vitro culture of buffalo SSC-like cells. Significantly more DDX4- and UCHL1-positive cells (cultured for 2 days at passage 2) were observed in the defined materials culture system than in the undefined materials system (p < 0.01), and these cells were maintained for a longer period than those in the culture system with undefined materials (10 days vs. 6 days). Furthermore, NANOS2 (p < 0.05), DDX4 (p < 0.01) and UCHL1 (p < 0.05) were expressed at significantly higher levels in the culture system with defined materials than in that with undefined materials. Induction with retinoic acid was used to verify that the cultured cells maintained SSC characteristics, revealing an SCP3⁺ subset in the cells cultured in the defined materials system. The expression levels of Stra8 (p < 0.05) and Rec8 (p < 0.01) were significantly increased, and the expression levels of ZBTB16 (p < 0.01) and DDX4 (p < 0.05) were significantly decreased. These findings provided a clearer research platform for exploring the mechanism of buffalo SSCs in vitro.

【Objective】 To compare clinical outcomes between bipolar umbilical cord coagulation(BCC) and radiofrequency ablation(RFA) after selective fetal reduction in monochorionic diamniotic twin pregnancy. 【Methods】 We retrospectively analyzed all cases of monochorionic diamniotic twin pregnancies who received selective fetal reduction in The First Affiliated Hospital of Sun Yat-sen University from 2009 to 2019. Patient underwent regular antenatal care during the whole pregnancy and finally delivered in our hospital. The impact of basic conditions of the patients, different methods of reduction, gestational weeks of delivery and other factors on the final pregnancy outcomes and neonatal outcomes were studied. The data were analyzed by SPSS20.0. 【Results】 The frequency of tightening feeling of the lower abdomen of RFA group and BCC group after surgery were 65.0% and 61.5%, respectively(P > 0.05). The symptom was relieved after symptomatic treatment. In addition, time of surgery and the hospitalization days were not statistically different between the two groups. The median gestational age at delivery of the RFA group was 36^6/7(26^4/7 ~ 40^6/7) weeks, which was later than 32^4/7 (29^0/7~37^4/7) weeks of the BCC group, without statistical significance(P > 0.05). The proportion of patients who delivered before 37^0/7 weeks in the BCC group was higher than that in the RFA group(100% vs. 62.5%, P = 0.024). In the neonatal outcomes, the rate of low birth weight infants in the BCC group was greater than that in the RFA group(92.31% vs. 52.5%, P = 0.025), but the differences in the rate of very low birth weight infants and the rate of small for gestational age infant were not statistically significant(both P values are greater than 0.05). The rate of neonatal transfer pediatrics or intensive care unit in the BCC group was greater than that of the RFA group(84.62% vs. 30%, P = 0.001). In a multivariate analysis of the effects on neonatal outcomes, multivariate logistic regression was used to analyze the association between different indicators and the incidence of low birth weight infants. The results showed that gestational weeks < 27^0/7 weeks was a risk factor for low birth weight infant(OR = 2.091, 95% CI, 0.312 to 14.162, P = 0.032) . 【Conclusions】 The effects of RFA and BCC on the pregnancy outcome and neonatal outcome are different. We should consider various factors when we choose individualized method of pregnancy reduction.

In recent years, the impact of meteorological factors on health and injury has been paid more and more attention. Severe weather events were considered to be an important risk factor for traffic accident injuries. Evidence from a large number of epidemiological studies suggests that meteorological factors, including high temperatures, rainfall, snowfall, wind and visibility, might be related to the occurrence of traffic accidents. This systematic review attempts to summarize the current research status of meteorological factors on traffic accident injury, systematically review the relationship between meteorological factors and traffic accident injury, and discuss how to further carry out related research.

Buffaloes ; Cells, Cultured ; In Vitro Techniques ; Primary Cell Culture ; Stem Cells ; Tretinoin

OBJECTIVE: To compare the maternal and infant outcomes of pregnant women infected with human immunodeficiency virus(HIV)treated with different regimens of highly active antiretroviral therapy(HAART).METHODS: For pregnant women infected with the human immunodeficiency virus(HIV)who received antiviral therapy and delivered in the Eighth Peple's Hospital of Guangzhu between May 2015 and June 2018,they will be grouped according to different treatment options. The pregnant women's body weight,CD4+T lymphocytes,white blood cells,hemoglobin,serum albumin,neonatal body weight and adverse pregnancy outcomes were compared and analyzed.RESULTS:(1)There was no significantly statistical difference between the two groups of pregnant women in terms of body weight,white blood cells,hemoglobin or serum albumin(P>0.05).(2)The changes of CD4+T lymphocytes in the two groups of pregnant women before and after treatment were statistically different(P<0.05).(3)There was no significant difference in neonatal weight,gestational age or Apgar score between the two groups(P>0.05).(4)There was no significantly statistical difference in the incidence of premature birth,premature rupture of fetal membrane,low birth weight,low amniotic fluid,fetal malformation or neonatal asphyxia between the two groups(P>0.05).Until December 2018,there were no positive reports of HIVRNA and HIV antibody detection in two groups of infants.CONCLUSION: The two HAART schemes have no significant difference in the influence on nutritional status,immune status or maternal and infant outcomes of HIV-infected pregnant women,and they are both effective and feasible,and vertical transmission of HIV from mother to child can be blocked.