ObjectiveTo investigate the clinical effect and safety of robot-assisted laparoscopic hepatectomy (RALH) versus open hepatectomy (OH) in the treatment of liver diseases. MethodsWeb of Science, PubMed, Cochrane Library, Embase, CNKI, CBM, VIP, and Wanfang Data were searched for Chinese and English articles on RALH versus OH in the treatment of liver diseases published up to February 2020. The quality of the articles included was assessed, and RevMan 5.1 was used to perform the meta-analysis. ResultsSeven studies were included, with a total of 754 patients (328 patients in the RALH group and 426 in the OH group). The meta-analysis showed that compared with the OH group, the RALH group had a significantly longer time of operation (mean difference ［MD］=59.41, 95% confidence interval ［CI］: 9.74-109.08, P=0.02), significantly higher blood transfusion rate (relative risk ［RR］=2.24, 95%CI: 1.04-4.82, P=0.04) and rate of hepatic portal occlusion (RR=2.27, 95%CI: 1.37-3.75, P=0.001), a significantly shorter length of hospital stay (MD=-3.87, 95%CI: -5.63 to -2.12,P＜0.001), and significantly lower overall incidence rate of postoperative complications (RR=0.58, 95%CI: 0.41-0.81, P=0.001) and incidence rates of major postoperative complications (RR=0.45, 95%CI: 0.22-0.91, P=0.03). There was no significant difference in intraoperative blood loss between the two groups (P＞0.05). ConclusionFor hepatectomy, RALF can shorten the length of hospital stay and reduce postoperative complications, creating conditions for minimally invasive hepatectomy and rapid recovery.

Objective：To explore the targeting relationship between miR-377-5p and hypoxia inducible factor-1 (HIF-1α), and investigate the regulatory effect of miR-377-5p on proliferation, invasion and epithelial-mesenchymal transition (EMT) of hepatocellular carcinoma (HCC) cells through vascular endothelial growth factor (VEGF) signaling pathway. Methods： ：The expression of miR-377-5p in 35 pairs of human HCC tissues and para-cancerous tissues was detected by qPCR. Then, HepG2 cells were divided into control group, mimic-NC group and miR-377-5pmimicgroup.qPCRwasusedto detect the transfection efficiency; the effects of miR-377-5p over-expression on proliferation and invasion of HepG2 cells were examined by EdU staining and Transwell assay, respectively; and the effect of miR-377-5p over-expression on the expressions of proliferation-related protein Ki-67, proliferating cell nuclear antigen (PCNA) and epithelial-mesenchymal transition (EMT) markers (E-cadherin and N-cadherin) were detected by Western blotting (WB); the effect of miR-377-5p over-expression on the expression of hypoxia inducible factor-1α (HIF-1α) in HepG2 cells was detected by qPCR and WB; and the targeting relationship between miR-377-5p and HIF-1α gene was determined by Luciferase reporter gene assay. Results: The expression of miR-377-5p in HCC tissues was significantly lower than that in para-cancerous tissues (P<0.01). Compared with the control group, the expression of miR-377-5p in HepG2 cells of miR-377-5p mimic group elevated significantly, and the proliferation, invasion and the expression of N-caderin proteins decreased,significantly (all P<0.01), while the expression of E-caderin increased significantly (P<0.01). At the same time, the mRNA and protein expressions of HIF-1α in miR-377-5p mimic group decreased significantly (P<0.01 or P<0.05). miR-377-5p targetedly inhibited the expression of HIF-1α gene and suppressed the activation of VEGF pathway (all P<0.05). Conclusion: miR-377-5p inhibits the proliferation, invasion and EMT of HepG2 cells via targetedly inhibiting HIF-1α expression and suppressing the activation of VEGF signaling pathway.

Objective: To explore the safety and feasibility of transumbilical single channel laparoscopic cryptorchidopexy with conventional instruments in treatment of cryptorchidism in children. Methods: Thirty-five children with cryptorchidism were treated by transumbilical single channel laparoscopic cryptorchidopexy with conventional instruments from November 2017 to March 2018 at Department of Pediatric Surgery, the First Affiliated Hospital of Guangxi Medical University.Clinical data were recorded including the general information, operation time, intraoperative blood loss, postoperative testicular position and postoperative complications, etc. Results: All 35 patients completed the cryptorchidopexy in one operation.Among those 35 patients, 28 patients had unilateral lesions and 7 patients had bilateral lesions, with a total of 42 sides.Twenty-six patients were of groin type(33 sides), 9 patients abdominal type(9 sides). The average operation time was (40.4±8.2) min for unilateral lesion, and (62.5±15.3) min for bilateral lesions; the average intraoperative blood loss was (3.0±1.8) mL; and the average postoperative hospital stay was (6.4±2.1) h. Testis of 32 patients (40 sides) were fixed in the middle and bottoms of the scrotum, and testis of 2 patients (2 sides) were fixed on the top of the scrotum.One case had poor healing of naval incision, which was recovered in 1 week after dressing change.There were no postoperative complications such as scrotum hematoma, infection of incision, testicular epididymitis, testicular necrosis, testicular retraction or testicular atrophy, etc.No obvious visible scar was found in the abdomen review 2 weeks postoperatively, with the incidence of complications was 2.9%(1/35 cases). Conclusions Transumbilical single channel laparoscopic cryptorchidopexy with conventional instruments in treatment of cryptorchidism is characterized by small trauma, quick recovery, low complication rate and visible scar free result, which is worthy of clinical promotion, but the operation is relatively complex and the correct procedures are required.

Objective To assess the effect of PCI on quality of life in very old CHD patients.Methods One hundred and ninety-six ≥80 years old CHD patients were divided into PCI group (n=92) and drug therapy group (n=104).Their clinical data were retrospectively analyzed.The patients were followed up for 12 months during which non-event survival rate,readmission rate,and incidence of recurrent arrhythmia,cardiogenic death,bleeding events were recorded.Results The incidence of 3-vessel lesions and serum creatinine level were significantly higher in PCI group than in drug therapy group (70.65％ vs 25.00％,82.63±25.35 μmol/L vs 71.09±22.71 μmol/L,P＜0.01).The non-event survival rate was significantly higher while the readmission rate was significantly lower in PCI group than in drug therapy group (66.30％ vs 50.96％,25.00％ vs 44.23％,P＜0.05).No significant difference was found in recurrent arrhythmia and cardiogenic death between the two groups (P＞0.05).Conclusion PCI can effectively improve the quality of life in very old CHD patients.

Objective To investigate effects of polyphylin Ⅰ on the proliferation and apoptosis of human melanoma cell line A375,and to explore their mechanisms.Methods Normal human melanocytes isolated from healthy human foreskin were divided into 6 groups to be treated with 0,1.5,3.0,6.0,9.0,12.0 mg/L polyphyllin Ⅰ respectively.A375 melanoma cells were divided into 4 groups,i.e.,control group,1.5-,3.0-,6.0-mg/L polyphyllin Ⅰ groups,to be treated with 0,1.5,3.0,6.0 mg/L polyphyllin Ⅰ,respectively.Cell counting kit-8 (CCK8) assay was performed to evaluate the effect of polyphyllin Ⅰ on the proliferation of normal human melanocytes and A375 cells.Hoechst 33258 fluorescent staining was conducted to observe the morphology of apoptotic cells,flow cytometry to estimate cell cycle phase distribution and apoptosis rate,dichloro-dihydro-fluorescein diacetate (DCFH-DA) fluorescent probe assay to detect the level of reactive oxygen species (ROS),rhodamine-123 staining to evaluate changes of mitochondrial membrane potential,spectrophotography to detect the level of ATP in A375 cells,as well as levels of lactic acid and glucose in the culture supernatant of A375 cells,and Western blot analysis to determine the protein expression of Bcl-2,Bcl-2-related X protein (Bax),cleaved-caspase-3,cyclin D1 and pyruvate kinase isozyme type M2 (PKM2).Statistical analysis was carried out by using one-way analysis of variance (ANOVA) for comparisons among groups and Student-Newman-Keuls-q (SNK-q) test for multiple comparisons.Results CCK8 assay showed that the treatment with polyphyllin Ⅰ at concentrations of 1.5,3.0,6.0 mg/L for 48 hours had no effects on the proliferation of normal human melanocytes,but significantly inhibited the proliferation of A375 cells.The survival rate of A375 cells was significantly lower in the 1.5-,3.0-,6.0-mg/L polyphyllin Ⅰ groups than in the control group (P ＜ 0.01).After the treatment with polyphyllin Ⅰ,distinct apoptotic morphology of A375 cells was observed under fluorescence microscope.Additionally,along with the increase of polyphyllin Ⅰ concentrations (0,1.5,3.0,6.0 mg/L),there were gradual increasing trends in the apoptosis rate of A375 cells (4.25％ ± 1.27％,10.03％ ± 1.49％,36.62％ ± 1.97％,44.11％ ± 2.47％ respectively,F =665.7,P ＜ 0.01),the percentage of A375 cells at G0/G1 phase (54.13％ ± 2.57％,67.35％ ± 3.79％,74.39％ ± 3.29％,82.29％ ± 3.99％ respectively,F =71.81,P ＜ 0.01),the level of ROS in A375 cells (P ＜ 0.01),the level of glucose in the culture supernatant (P ＜ 0.01),and the protein expression of Bax and cleaved-caspase-3 (both P ＜ 0.01),while gradual decreasing trends were found in the levels of mitochondrial membrane potential and ATP in A375 cells (both P ＜ 0.01),the level of lactic acid in the culture supernatant (P ＜ 0.01),and the protein expression of Cyclin D1,Bcl-2 and PKM2 (all P ＜ 0.01).Conclusion Polyphyllin Ⅰ can effectively induce A375 cell apoptosis by promoting the production of ROS in A375 cells and decreasing the mitochondrial membrane potential,and arrest A375 cells at G0/G1 phase by inhibiting the expression of PKM2 and Cyclin D1.

AIM:To explore the ability of different group B streptococci ( GBS) strains on inducing platelet activation.METHODS:Six strains of GBS, separated from the septic patients with thrombocytopenia, were used as the inducers.Light transmission aggregometry was used to measure platelet aggregation.Scanning electron microscopy ( SEM) was performed to investigate the interaction of platelets with bacteria.The expression of platelet CD62P, Toll-like receptor 2 ( TLR2) and TLR4 was determined by flow cytometry and Western blotting.Furthermore, the activity of platelet TLR2 (or TLR4) was blocked by anti-TLR2 (or anti-TLR4) monoclonal antibody, and the platelet aggregation induced by GBS was detected.RESULTS:Only 3 of 6 GBS strains isolated from the septic patients induced platelet aggregation and up-regulated the expression of CD62P and TLR2 in the platelets (P<0.05), but not TLR4.Incubation with anti-TLR2 anti-body, but not anti-TLR4 antibody, significantly blocked platelet aggregation induced by GBS.CONCLUSION:Some GBS strains from the patients are able to trigger platelet activation in vitro, and platelet TLR2 may play an important role in the interaction between GBS and platelets.

Objective To observe the clinical efficacy of acupuncture at the six mind-calming points plus the four gate points in treating migraine.Method Totally 128 eligible migraine patients were randomized into a treatment group and a control group, 64 cases in each group. The treatment group was intervened by acupuncture at the six mind-calming points plus the four gate points, while the control group was by ordinary acupuncture. The Numerical Rating Scale (NRS), headache attack frequency, headache duration, headache intensity, complicated symptoms, Self-rating Depression Scale (SDS), and Self-rating Anxiety Scale (SAS) were observed before and after treatment and in the follow-up study.Result The NRS scores and the headache symptoms and functions scores were significantly changed respectively after 2-week and 4-week treatment in both groups (P<0.01,P<0.05). The NRS score, headache duration, and headache intensity in the treatment group were significantly different from that in the control group after 4-week treatment and in the follow-up study (P<0.05,P<0.01). The SDS and SAS scores were significantly changed after 2-week and 4-week treatments as well as in the follow-up study in the treatment group (P<0.01). The SDS and SAS scores were significantly changed after 4-week treatment in the control group (P<0.01). There were significant differences in comparing the SDS and SAS scores between the two groups after 2-week and 4-week treatment as well as in the follow-up study (P<0.05,P<0.01). In the treatment group, the SDS and SAS scores in the follow-up study were significantly different from that after 2-week treatment (P<0.01).Conclusion Acupuncture at the six mind-calming points plus the four gate points is an effective method in treating migraine, and it can reduce headache intensity, and improve the anxiety and depression state.

Objective To study the brain functional activation under speech stimulation in presbycusis pa‐tients using blood oxygenation level dependent functional magnetic resonance imaging (BOLD - fMRI) .Methods Eighteen normal hearing young volunteers ,10 normal hearing elderly people and 10 presbycusis patients received fM ‐RI under auditory task .Experimental tasks included monosyllabic verbal stimulating at tone of 1 kHz and sound in‐tensity to 90 dB ± 3 dB(after ambient noise detector Smart Sensor AR844 measurement and calibration) randomly transmitted to left and right ear .Following block design ,each stimulus was repeated twice .The lateralization of brain activation analysis observed changes in hemispheric dominance cases (or ear advantage change) .We observed brain activation analysis and changes of hemispheric lateralization advantage (or ear advantages) .SPM5 software was used to deal with the original pictures in the off - line work station to get fictional maps ,volume and intensity of the acti‐vated brain regions of interest ,and calculate the laterality index (LI) .Results To young people ,regardless of left or right ear stimulation ,the contralateral (region of intrest ,ROI) activation volume and intensity significantly increased compared to ipsilateral ,appearing contralateral hemispheric dominance ,and laterality index were - 0 .58 (left ear stimulation) and 0 .37 (right ear stimulation) .Compared to young people ,elderly people with normal hearing and presbycusis contralateral hemisphere conduction advantage was significantly reduced under monaural stimulation ,and the laterality indexes were - 0 .24 ,0 .28 (the aged group) ,- 0 .18 ,0 .25 (presbycusis group) .Young people received the left and the right ear auditory task respectively ,and the ratio of the total volume of bilateral ROI activation was 1 :2 .06 ,appearing to the right ear advantage (left brain dominance) .While the aged and presbycusis group manifes‐ted as right ear advantage decreased (left ear advantage enhanced) ,whose the total volume ratio was 1 :1 .51 for the old normal subjects and 1 :1 .61 for the hearing impaired seniors .Conclusion Auditory verbal tasks activated brain regions in the superior temporal gyrus and middle temporal gyrus were most obvious .Aging may cause these brain regions to be activated weaker ,appearing to the trend of contralateral hemisphere .The aging and deafness lead to the cortical reorganization .This may be one of the reasons for the declined speech recognition .

This study was aimed to evaluate the feasibility of wind-warm lung-heat disease (non-severe community-acquired pneumonia, CAP) from the clinical curative effect, hospitalization days, medical expenses and other aspects. This study selected 198 wind-warm lung-heat disease (non-severe CAP) inpatients from January, 2012 to December, 2012 with the conventional therapy in the Respiratory Department, Wuhan Integrated Traditional Chinese Medicine (TCM) & Western Medicine Hospital as the control group. And another 179 wind-warm lung-heat disease (non-severe CAP) inpatients were selected from January, 2013 to December, 2013 with the TCM clinical pathway treatment in the Respiratory Department of the same hospital as the treatment group. Retrospective analysis was used to compare the clinical curative effects, hospitalization days, and medical cost differences. The results showed that TCM clinical pathway for wind-warm lung-heat disease (non-severe CAP) can shorten the hospitalization days and reduce patients’ medical costs, and ensure the clinical curative effects. It was concluded that the standardized TCM clinical pathway had positive effect on wind-warm lung-heat disease (non-severe CAP). Therefore, the formulation and implementation of TCM clinical pathway was of great significance in the treatment of wind-warm lung-heat disease (non-severe CAP).

BACKGROUNDOsteoarthritis (OA) is the most common form of human polyarthritis. Many genetic factors have been implicated in OA. It was reported that a polymorphism in the gene of interleukin-6 (IL-6) was associated with OA of knee. The aim of this study was to determine whether functional IL-6 promoter -174G/C (rs1800795) polymorphisms confer susceptibility to knee OA.

METHODSA meta-analysis was conducted on the association between the IL-6 polymorphism and knee OA. Electronic search at PubMed, EMBASE, Weipu database, and Wanfang database was conducted to select studies. Case-control studies containing available genotype frequencies of IL-6 -174G/C were chosen, and odds ratio (OR) with 95% confidence interval (CI) was used to assess the strength of this association.

RESULTSA total of seven studies involving 6 464 subjects (knee OA 3 331 and controls 3 133) were considered in this study. The results suggested that the variant genotypes were not associated with knee OA risk in all genetic models (additive model: OR = 1.144, 95% CI 0.934-1.402, P = 0.194; recessive model: OR = 1.113, 95% CI 0.799-1.550, P = 0.526; dominant model: OR = 1.186, 95% CI 0.918-1.531, P = 0.191). A symmetric funnel plot, the Begg's test (P > 0.05), suggested that the data lacked publication bias.

CONCLUSIONSThis meta-analysis does not support the idea that rs1800795 genotype is associated with increased risk of knee OA. However, to draw comprehensive and more reliable conclusions, further prospective studies with larger numbers of participants worldwide are needed to examine the association between rs1800795 polymorphism and knee OA.

Humans ; Interleukin-6 ; genetics ; Osteoarthritis, Knee ; epidemiology ; genetics ; Polymorphism, Genetic ; genetics ; Promoter Regions, Genetic ; genetics