Background and Aims:There is currently no consensus on whether the pancreaticoduodenectomy with Heidelberg triangle operation(PDTRIANGLE)or the standard radical pancreaticoduodenectomy(PDSTANDARD)is more beneficial for patients with pancreatic cancer,and no large-scale multicenter studies have confirmed this.Therefore,this study was conducted to compare the clinical efficacy and safety of PDTRIANGLE and PDSTANDARD for treating pancreatic cancer through a Meta-analysis. Methods:Relevant literature comparing the two surgical approaches comparing the two surgical approaches for treating pancreatic cancer was screened from Chinese and English databases based on inclusion criteria.The search timeframe extended from the inception of the databases to May 2024,and Review Manager 5.3 software was used for Meta-analysis of the extracted outcome variables. Results:A total of 6 retrospective studies were included,comprising 658 patients,with 315 in the PDTRIANGLE group and 343 in the PDSTANDARD group.The Meta-analysis results showed that the operative time in the PDTRIANGLE group was longer than that in the PDSTANDARD group(OR=1.52,95％CI=0.42-2.61,P=0.007),the lymph node dissection rate was higher in the PDTRIANGLE group(OR=0.70,95％CI=-0.4-1.01,P＜0.000 01),and the R0 resection rate was also higher in the PDTRIANGLE group(OR=1.63,95％CI=1.03-2.58,P=0.04).The incidence rates of postoperative lymphatic fistula and diarrhea were higher in the PDTRIANGLE group compared to the PDSTANDARD group(OR=5.60,95％CI=1.81-17.29,P=0.003;OR=0.13,95％CI=0.07-0.20,P＜0.000 1).The length of hospital stay was longer in the PDTRIANGLE group(OR=0.40;95％CI=-0.14-0.65,P=0.003).The overall survival rates at 1 and 2 years were significantly better in the PDTRIANGLE group compared to the PDSTANDARD group(OR=2.19,95％CI=-1.27-3.76,P=0.005;OR=1.65,95％CI=-1.01-2.67,P=0.04),and the 1-year disease-free survival rate was also significantly higher in the PDTRIANGLE group(OR=3.71,95％CI=2.27-6.07,P＜0.000 01),although the difference in the 2-year disease-free survival rate between the two groups was not statistically significant(OR=2.63,95％CI=-0.91-7.59,P=0.07). Conclusion:PDTRIANGLE is a safe and effective treatment for pancreatic cancer.Compared to PDSTANDARD,PDTRIANGLE significantly improves the R0 resection rate,thereby enhancing the postoperative disease-free survival rate and achieving a better long-term prognosis.

Objective:To compare the clinical efficiency and safety between intravitreal injection of conbercept with and without macular photocoagulation for diabetic macular edema (DME).Methods:A non-random controlled study was conducted.Sixty patients (60 eyes) with DME treated in Shenzhen People's Hospital from January 2017 to January 2020 were enrolled.The patients receiving intravitreal injection of conbercept alone were divided into conbercept injection group (33 cases, 33 eyes), and those who underwent macular photocoagulation combined with intravitreal injection of conbercept were divided into combined treatment group (27 cases, 27 eyes). Best corrected visual acuity (BCVA) was examined using Early Treatment of Diabetic Retinopathy Study.The BCVA, central macular thickness (CMT) and fluorescein fundus angiography (FFA) examination were performed to observe the changes of macular edema and leakage area before and at 1, 3, 6, 9 and 12 months after treatment.The injection frequency, ocular and systemic complications were recorded.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Shenzhen Pepole's Hospital (No.LL-YK-20170405). Written informed consent was obtained from each patient prior to any medical examination.Results:There were better mean BCVA and lower CMT at 1, 3, 6, 9 and 12 months after treatment compared with the BCVA and CMT before treatment in the two groups (all at P<0.05). At 12 months after treatment, FFA showed that the improvement rate of macular edema was 91.0% (30/33) in the conbercept injection group and 96.3% (26/27) in the combined treatment group, showing a statistically significant difference between them ( χ2=3.430, P<0.05). The injection frequency was (4.36±1.62) times in the conbercept injection group, which was significantly higher than (3.41±0.64) times in the combined treatment group ( t=9.211, P<0.05). No ocular adverse events, including ocular hypertension, endophthalmitis and retinal pigment epithelial tears or systemic complications were found during the follow-up. Conclusions:Intravitreal injection of conbercept with or without macular photocoagulation can both maintain or improve visual acuity and alleviate exudative macular edema.They both show good safety, and the combined therapy has better long-term efficacy than conbercept alone.

Objective:To analyze the value of minute ventilation to carbon dioxide production slope (VE/VCO 2 slope) combined with peak systolic blood pressure (SBP) in predicting prognosis for patients with chronic heart failure (CHF). Methods:A total of 170 patients with CHF who visited the Cardiac Rehabilitation Center of Tongji Hospital Affiliated to Tongji University and completed cardiopulmonary exercise test from March 2007 to December 2018 were enrolled in the study. The clinical data, cardiopulmonary exercise testing results and follow-up information of patients were collected to explore the predictors of all-cause mortality in patients with CHF.Results:The median follow-up time was 647 (182-1 764) days. All-cause death occurred in 34 patients. Compared with surviving patients, the proportion of diabetes and angiotensin-converting enzyme inhibitor/angiotensin Ⅱ receptor blocker (ACEI/ARB) use in fatal patients was significantly higher ( P<0.01). The VE/VCO 2 slope and peak SBP*VE/VCO 2 in the fatal patients were significantly higher, and the peak oxygen consumption (peak VO 2) was lower than those in the surviving patients ( P<0.01). The areas under the receiver operating characteristic curve (AUC) of VE/VCO 2 slope and peak SBP*VE/VCO 2 in predicting all-cause mortality in patients with CHF were 0.648 ( P=0.008) and 0.681 ( P=0.001), respectively; the optimal thresholds were >40.95 ( P=0.008) and > 5 423.50 mmHg (1 mmHg=0.133 kPa, P=0.006), the sensitivity was 0.559 and 0.588, and the specificity was 0.728 and 0.735, respectively. Multivariate Cox regression analysis showed that after adjusting for age, gender, diabetes and ACEI/ARB use, VE/VCO 2 slope ( HR=2.12, P=0.036) and peak SBP*VE/VCO 2 ( HR=2.42, P=0.016) were independent risk factors for all-cause mortality in patients with CHF. Conclusion:Compared to the traditional index VE/VCO 2 slope, a novel index peak SBP* VE/VCO 2 provides a relatively better predictive value for all-cause death of CHF patients.

Objective:To investigate the effects of methyltransferase-like protein 14 (METTL14)-mediated long-chain non-coding RNA EIF3J antisense RNA1 (Inc EIF3J-AS1) on the migration and invasion of cholangiocarcinoma cells and its mechanism.Methods:From September 2017 to December 2018, 10 pairs of cholangiocarcinoma and adjacent normal tissues were collected from the First Affiliated Hospital of Naval Medical University, which were surgically resected and pathologically confirmed. The expression of METTL14 mRNA and Inc EIF3J-AS1 in cholangiocarcinoma tissues was detected by fluorescence quantitative PCR, and the protein expression of METTL14 was detected by Western blotting. Cholangiocarcinoma cell lines HUCCTI and RBE were divided into control group and METTL14 or Inc EIF3J-AS1 knockdown group. The corresponding normal lentivirus was transfected in the control group, and METTL14 or Inc EIF3J-AS1 knockdown group was transfected with lentivirus that interfered with the expression of METTL14 or Inc EIF3J-AS1, respectively. Transwell assay was used to detect the ability of cell migration and invasion, and Western blotting was used to detect the expression of epidermal growth factor receptor (EGFR) and AKT protein.Results:The expressions of METTL14 mRNA and lnc EIF3J-AS1 in cholangiocarcinoma tissues were significantly higher than those in adjacent normal tissues (0.075±0.012 vs 0.031±0.006, 0.140±0.032 vs 0.064±0.012), and there was a positive correlation between expression of METTL4 mRNA and expression of lnc EIF3J-AS1 ( r=0.883, P=0.0007). The expression of METTL14 protein in cholangiocarcinoma tissues was higher than that in adjacent normal tissues (0.354±0.131 vs 0.187±0.183). Compared with the control group, the expression of lnc EIF3J-AS1 was significantly lower in METTL14 or Inc EIF3J-AS1 knockdown group (0.217±0.020 vs 1.000±0.052, 0.149±0.066 vs 1.000±0.045). The migration and invasion ability of cell lines HUCCTI and RBE decreased significantly in lnc EIF3J-AS1 knockout group (5.00±0.58 vs 23.33±0.33, 20.33±0.67 vs 70.67±0.33; 12.00±0.58 vs 25.00±2.52, 22.33±0.89 vs 43.67±0.33). The expression of EGFR and p-AKT/AKT protein were also significantly decreased (0.109±0.015 vs 1.000±0.018, 0.226±0.036 vs 1.000±0.051; 0.118±0.052 vs 1.000±0.069, 0.132±0.098 vs 1.000±0.023). The above differences were statistically significant (all P<0.05). Conclusions:Abnormal expression of lnc EIF3J-AS1 in cholangiocarcinoma mediated by METTL14 can promote tumor cell migration and invasion.

Objective:The hvKP phenotype strains were screened from the sensitive and multi-drug resistant Klebsiella pneumoniae, and the distribution and homology of their clinical infection characteristics were compared. Methods:A total of 158 Klebsiella pneumoniae strains isolated from clinical infection specimens in the Third Affiliated Hospital of Sun Yat-sen University from 2014 to 2018 were retrospectively collected. The string test (ST) was used to screen the hvKP infection, and a total of 65 were screened. The number of patients included 51 males and 14 females, with an average age of 56 years. The composition ratio of Klebsiellapneumoniae was analyzed for clinical infection related information. Matrix assisted laser desorption-ionization time of flight mass spectrometry (MALDI-TOF MS) was used to identify the hypervirulent Klebsiella pneumoniae and establish a new database, and bio-tree cluster analysis and principal component analysis were carried out for all strains that met the experimental conditions by using analysis software and the homology of protein level was obtained. Results:A total of 65 strains hvKP were screened, 62 of which were susceptible strains and 3 were multi-drug resistant strains. The main diseases of infected patients were diagnosed as hepatobiliary disease, encephalopathy and liver abscess. The basic diseases of the population were mainly diabetes and hypertension. Dendrogram cluster analysis divided hvKP into 3 groups at a distance of 550 from the horizontal line; principal component analysis found that some strains were closely related, and the Kc group with the largest proportion was mainly related to hepatobiliary diseases. Ka group was mainly related to infection after surgery.Conclusions:HvKP was highly invasive and the clinical manifestations of infection were diverse. The infected patients were mostly elderly patients with weakened immunity. The rapid homology analysis of MALDI-TOF MS mass spectrometry has important clinical significance for the rapid screening of hvKP infection.

Objective:The hvKP phenotype strains were screened from the sensitive and multi-drug resistant Klebsiella pneumoniae, and the distribution and homology of their clinical infection characteristics were compared. Methods:A total of 158 Klebsiella pneumoniae strains isolated from clinical infection specimens in the Third Affiliated Hospital of Sun Yat-sen University from 2014 to 2018 were retrospectively collected. The string test (ST) was used to screen the hvKP infection, and a total of 65 were screened. The number of patients included 51 males and 14 females, with an average age of 56 years. The composition ratio of Klebsiellapneumoniae was analyzed for clinical infection related information. Matrix assisted laser desorption-ionization time of flight mass spectrometry (MALDI-TOF MS) was used to identify the hypervirulent Klebsiella pneumoniae and establish a new database, and bio-tree cluster analysis and principal component analysis were carried out for all strains that met the experimental conditions by using analysis software and the homology of protein level was obtained. Results:A total of 65 strains hvKP were screened, 62 of which were susceptible strains and 3 were multi-drug resistant strains. The main diseases of infected patients were diagnosed as hepatobiliary disease, encephalopathy and liver abscess. The basic diseases of the population were mainly diabetes and hypertension. Dendrogram cluster analysis divided hvKP into 3 groups at a distance of 550 from the horizontal line; principal component analysis found that some strains were closely related, and the Kc group with the largest proportion was mainly related to hepatobiliary diseases. Ka group was mainly related to infection after surgery.Conclusions:HvKP was highly invasive and the clinical manifestations of infection were diverse. The infected patients were mostly elderly patients with weakened immunity. The rapid homology analysis of MALDI-TOF MS mass spectrometry has important clinical significance for the rapid screening of hvKP infection.

Objective:To observe the macular vascular density and the area of foveal avascular zone(FAZ) in the follow eyes of monocular retinal vein occlusion (RVO) patients.Methods:Retrospective case-control study. From May to November 2018, 78 follow eyes of 78 monocular RVO patients who were clinically diagnosed in Changsha Aier Eye Hospital were included in the study. Among them, 44 were male and 34 were female. The average age was 53.17±10.12 years. There were 42 patients with central retinal vein occlusion(CRVO group) and 36 patients with branch retinal vein occlusion (BRVO group). Forty-two eyes of 33 gender and age matched healthy volunteers were selected as the control group. Among them, 17 were male (22 eyes) and 16 were female (20 eyes), with the mean age of 53.48±10.84 years. OCT angiography was performed on all eyes in CRVO group, BRVO group and control group. The scanning region in the macular area was 6 mm× 6 mm. Macular vascular density and FAZ area in the superficial and deep retinal capillary plexi were measured.Results:The mean overall vascular density measured in the entire scan was lower in the CRVO group( t=-4.26, -4.93) and BRVO group ( t=-4.79, -4.74) compared with the control group in both the superficial and deep capillary plexus ( P<0.05). The reduce degree of vascular density in the deep capillary plexus (CRVO group:5.51%, BRVO group:4.58%) was higher than that in the superficial plexus (CRVO group:4.13%, BRVO group:3.50%). In the CRVO group, the FAZ area decreased compared with the control group ( t=-3.43, P<0.05). There was no statistically significant difference in the area of FAZ between the BRVO group and the control group ( t=-0.10, P>0.05). Conclusions:The macular vascular density in the follow eyes of monocular RVO patients is lower than that of normal healthy eyes. The reduce degree of vascular density in the deep capillary plexus is higher than that in the superficial plexus. Compared with normal healthy eyes, the FAZ area in the follow eyes of monocular CRVO patients decreased, while it did not change significantly in the follow eyes of monocular BRVO patients.

Objective:To investigate the discriminant function of optical coherence tomography angiography (OCTA) in the diagnosis of primary open angle glaucoma (POAG) and to evaluate the correlation between vessel density, as measured by OCTA, and visual field mean defect (MD) in patients with POAG.Methods:A case control study was designed.Ninety-five eyes of 54 patients with POAG and ninety-six eyes of 48 healthy subjects in Changsha Aier Eye Hospital were included in this study.The vessel density in the radial peripapillary capillary (RPC) network, the macular vessel density, the ganglion cell complex (GCC) layer thickness, the macular thickness, and the retinal nerve fiber layer thickness were tested for correlation with MD.The aera under the receiver operating characteristic (ROC) curves (AUC), as well as sensitivities at fixed vessel density specificities in the RPC network, and macular regions were analyzed.ROC regression was used to evaluate the effect of covariates on the diagnostic abilities.The study protocol was approved by the Ethics Committee of Changsha Aier Eye Hospital.Written informed consent was obtained from all subjects prior to entering the study cohort.Results:Compared with the normal control group, the macular area and vessel density in the RPC network were significantly decreased in the POAG group ( P<0.001). Also in the POAG group, except for the capillary density inside the disc, all other measurements including the density of superficial capillaries in the macula, the density of deep capillaries in the macula, the density of RPC layers around the optic disc, the average capillary density of the optic disc RPC layer, the capillary density of the optic disc RPC layer (above, below, nasal, and temporal), the thickness of the retinal nerve fiber layer, the thickness of the whole macular layer, and the thickness of the GCC layer of the macula area were positively correlated with the MD value ( r=0.586, 0.352, 0.610, 0.592, 0.598, 0.589, 0.445, 0.587, 0.578, 0.530, 0.609; all at P<0.01). The AUCs of vessel densities ranged from 0.623 to 0.927.The highest diagnostic efficiency was the RPC vessel density (whole image), the AUC value was 0.927. Conclusions:The OCTA parameters have a high diagnostic ability for POAG, except for the capillary density of inside the disc, all other vascular parameters are positively correlated with the MD value.

Neurotransmitters play an important role in nervous system. Temporal and spatial changes of neurotransmitter distribution are crucial to information processing in neural networks. Biosensors that can visually monitor neurotransmitters are one of the vital tools to explore a variety of physiological and pathological activities. This article reviews recent advances in monitoring neurotransmitters with high temporal and spatial resolution, and introduces the latest fluorescent imaging methods for typical neurotransmitters, including glutamate, dopamine, γ-aminobutyric acid and acetylcholine. The article also summarizes the basic principles, advantages and disadvantages of various visually detection methods, and provides systematic suggestions for designing neurotransmitter sensors with high temporal and spatial resolution.
Animals ; Biosensing Techniques ; instrumentation ; trends ; Fluorescence ; Humans ; Neurotransmitter Agents ; metabolism

Objective: To establish and hevaluate a detection method for influenza virus using reverse transcriptase-recombinase polymerase amplification (RT-RPA). Methods: RT-RPA was developed for detection of influenza viruses (type A and B) and subtyping of H1 and H3 using the primers targeted matrix and hemagglutinin (HA) genes of influenza A virus, and non-structural (NS) protein gene of influenza B virus. The specificity and sensitivity of RT-RPA were determined. Results: The RT-RPA for the detection of influenza viruses showed specific amplification products of corresponding target gene, but no amplification products for other respiratory viruses, indicating that the method had good specificity. The detection limits of RT-RPA were 100 copies/μl. RT-RPA combined with SYBR Green I was used for the detection of influenza B virus with the detection limit of 100 copies/μl. Conclusions The feasibility of detecting influenza virus by RT-RPA was preliminarily confirmed.