Background::Transplant renal artery stenosis (TRAS) is a vascular complication after kidney transplantation associated with poor outcomes. This study aimed to analyze the efficacy and safety of low-dose aspirin for preventing TRAS.Methods::After kidney transplantation, patients were enrolled from January 2018 to December 2020 in Henan Provincial People’s Hospital. A total of 351 enrolled recipients were randomized to an aspirin group with low-dose intake of aspirin in addition to standard treatment ( n = 178), or a control group with only standard treatment ( n = 173). The patients was initially diagnosed as TRAS (id-TRAS) by Doppler ultrasound, and confirmed cases were diagnosed by DSA (c-TRAS). Results::In the aspirin and control groups, 15.7% (28/178) and 22.0% (38/173) of the recipients developed id-TRAS, respectively, with no statistical difference. However, for c-TRAS, the difference of incidence and cumulative incidence was statistically significant. The incidence of c-TRAS was lower in the aspirin group compared with the control group (2.8% [5/178] vs. 11.6% [20/173], P = 0.001). Kaplan–Meier estimates and Cox regression model identified the cumulative incidence and hazard ratio (HR) of TRAS over time in two groups, showing that recipients treated with aspirin had a significantly lower risk of c-TRAS than those who were not treated (log-rank P = 0.001, HR = 0.23, 95% confidence interval [CI]: 0.09–0.62). The levels of platelet aggregation rate ( P < 0.001), cholesterol ( P = 0.028), and low-density lipoprotein cholesterol ( P = 0.003) in the aspirin group were decreased compared with the control group in the third-month post-transplantation. For the incidence of adverse events, there was no statistical difference. Conclusion::Clinical application of low-dose aspirin after renal transplant could prevent the development of TRAS with no significant increase in adverse effects.Trial Registration::Clinicaltrials.gov, NCT04260828.

Objective:To investigate the epidemic status and molecular characteristics of Borrelia burgdorferi in ticks in Xinjiang Uygur Autonomous Region (referred to as Xinjiang). Methods:From April to June 2020, 312 samples of Ixodes were collected in 6 areas of Yili, Alashankou, Hutubi, Qinghe, Fuhai and Wujiaqu, Xinjiang. Nested PCR and fluorescence quantitative PCR were used to detect Borrelia burgdorferi in ticks. The positive samples by both methods were genotyped and identified by nested PCR products. Results:The positive rates of nested PCR and fluorescence quantitative PCR were 8.97% (28/312) and 11.86% (37/312), respectively. Among them, the fluorescence quantitative PCR positive rate of Qinghe was the highest of 35.29% (12/34), and the positive rate of Fuhai was the lowest of 2.00% (1/50). The positive samples by both methods was 26. Genotyping results showed that 12 samples were highly homologous to Borrelia garinii, 10 copies to Borrelia burgdorferi sensu stricto, and 4 copies to Borrelia afzelii. Conclusions:The positive rate of Borrelia burgdorferi in ticks in Xinjiang is higher, which has confirmed that there are 3 pathogenic Borrelia burgdorferi genotypes in Xinjiang. The dominant genotype is Borrelia garinii, followed by Borrelia burgdorgferi sensu stricto genotype and Borrelia afzelii genotype.

Objective To explore the association of single nucleotide polymorphism ( SNP ) in TP53 Arg72Pro (rs1042522) locus with thyroid cancer risk in human. Methods Articles involved in the association between SNP in TP53 Arg72Pro ( rs1042522) locus and thyroid cancer risk were retrieved from PubMed, Embase, and Web of Science databases, and studies which met the inclusion criteria were included. The meta-analysis, sensitivity analysis, subgroup analysis, and the assessment of publication-bias were performed by Stata 14. 0 software. The odds ratio ( OR) and their corresponding 95％ Confidence Intervals ( CI) were used to determine the strength of association between SNP in TP53 Arg72Pro locus and thyroid cancer risk. Results Thirteen case-control studies were eligible for this meta-analysis, including 2112 thyroid cancer cases and 4000 control subjects. Overall, mutated homozygous genotype ( Pro/Pro) in TP53 Arg72Pro ( rs1042522) locus was associated with significantly increased thyroid cancer risk(Recessive model, OR=1.78, 95％CI 1.24-2.56, P=0.002), showing a significantly higher Pro mutation frequency among thyroid cancer patients ( Allelic model, OR=1. 35, 95％ CI 1. 12-1. 63, P=0.002). In the stratified analysis, mutated homozygous genotype (Pro/Pro) in TP53 Arg72Pro (rs1042522) locus was only asscociated with significantly increased thyroid cancer risk among Asians, but not among Europeans and South Americans;mutated homozygous genotype ( Pro/Pro) in TP53 Arg72Pro ( rs1042522) locus was asscociated with significantly increased risk of papillary thyroid carcinomas ( PTC) among total population, but not medullary thyroid carcinomas. Conclusion There is a significant association between TP53 Arg72Pro polymorphism in TP53 and thyroid cancer risk, and the mutated homozygous genotype ( Pro/Pro) in this locus of TP53 maybe a risk factor for thyroid carcinoma among Asians.

Vena cava filter is a filter device designed to prevent pulmonary embolism caused by thrombus detached from lower limbs and pelvis. A new retrievable vena cava filter was designed in this study. To evaluate hemodynamic performance and thrombus capture efficiency after transplanting vena cava filter, numerical simulation of computational fluid dynamics was used to simulate hemodynamics and compare it with the commercialized Denali and Aegisy filters, and in vitro experimental test was performed to compare the thrombus capture effect. In this paper, the two-phase flow model of computational fluid dynamics software was used to analyze the outlet blood flow velocity, inlet-outlet pressure difference, wall shear stress on the wall of the filter, the area ratio of the high and low wall shear stress area and thrombus capture efficiency when the thrombus diameter was 5 mm, 10 mm, 15 mm and thrombus content was 10%, 20%, 30%, respectively. Meanwhile, the thrombus capture effects of the above three filters were also compared and evaluated by in vitro experimental data. The results showed that the Denali filter has minimal interference to blood flow after implantation, but has the worst capture effect on 5 mm small diameter thrombus; the Aegisy filter has the best effect on the trapping of thrombus with different diameters and concentrations, but the low wall shear stress area ratio is the largest; the new filter designed in this study has a good filtering and capture efficiency on small-diameter thrombus, and the area ratio of low wall shear stress which is prone to thrombosis is small. The low wall shear stress area of the Denali and Aegisy filters is relatively large, and the risk of thrombosis is high. Based on the above results, it is expected that the new vena cava filter designed in this paper can provide a reference for the design and clinical selection of new filters.
Blood Flow Velocity ; Hemodynamics ; Humans ; Software ; Thrombosis ; therapy ; Vena Cava Filters ; Vena Cava, Inferior

The incidence of sternoclavicular joint dislocation is rare due to its specially physiological anatomy. At present, the main therapy of sternoclavicular joint dislocation is operation, including the sternoclavicular joint reconstruction, internal clavicle resection and internal fixation with thoracoclavicular joint. Overall,surgical treatment is difficult to operate and has high risk. The article summarized the relevant literature and reviewed the treatment of sternoclavicular joint dislocation as follows.

Objective To study the surgical treatment of hepatic hemangiomas and the timing of surgery.Methods A retrospective study was conducted on 908 patients with giant hemangiomas who underwent surgery between December 1997 and December 2017.The clinical data,surgical indications,surgical outcomes,lesion size,and the effect of TAE were compared.Results The diameter (mean + /-S.D.)of the resected hepatic cavernous hemangiomas was (11.1 ± 6.2) cm (the longest diameter was 60 cm).585 patients (64.4％) underwent enucleation of hepatic hemangiomas and 323 patients (35.6％) underwent anatomical hepatectomy.Six patients died perioperatively (mortality rate 0.7％).The incidence of severe complication (Clavien-Dindo grade 3 ～ 5) was 3.8％.The incidence of severe postoperative complication for enucleation (2.7％) was significantly less than anatomic liver resection (5.6％,P ＜0.05).When the lesion was more than 20 cm,the complication and mortality rates were significantly higher than those less than 20 cm (P ＜ 0.05).The complication and mortality rates in patients who underwent TAE before surgery were significantly higher than those without TAE (P ＜ 0.05).Conclusions Surgical enucleation of hemangiomas was superior to anatomical hepatectomy.With increase in tumor size,the risk of surgery increased.Surgical treatment was safe and effective for giant hepatic hemangiomas.For giant hepatic hemangiomas with significant increase in size,prompt surgical treatment is recommended.

Objective To explore the effect of Jintiange capsule on treatment of postmenopausal osteoporosis (PMOP) and its mechanism.Method 133 patients diagnosed as PMOP and meeting the standard were collected from Oct.2011 to Aug.2015 in our hospital.They were randomly divided into two groups:treatment group and the control group.The control group received calcium and alendronate,while the treatment group received 3 Jintiange capsules 3 times daily on the basis of the control group.The lumbar bone densit (BMD),greater trochanter BMD,femoral neck BMD,Ward triangle BMD,visual analogue score (VAS) of knee and back,the serum levels of bone glaprotein (BGP),alkaline phosphatase (ALP),β-C-terminal telopeptide of type Ⅰ collagen (β-CTX),N-terminal propeptide of type Ⅰ procollagen (PINP) and adverse reactions were recorded before and after treatment.Results The lumbar BMD,greater trochanter BMD,femoral neck BMD,ward triangle BMD of treatment group after treatment were higher than those before treatment and those of the control group (P＜0.05).VAS score of knee and back of treatment group were lower than those of the control group (P＜0.05).The serum levels of BGP,ALP,β-CTX,PINP of treatment group were lower than those of the control group (P＜0.05).The adverse reactions rate of two groups had no significant difference (P＞0.05).Conclusion Jintiange capsule can significantly reduce bone metabolism level,increasing BMD,reducing bone loss,relieving knee and back pain of PMOP,without increasing complication rates,which is worthy to be promoted due to high safety and efficacy.

Objective To investigate the safety and curative effect of CT-guided percutaneous cryoablation in treating recurrent tumors in pelvic cavity and retroperitoneal space.Methods A total of 100 patients with recurrent tumors in pelvic cavity or retroperitoneal space were included in this study.CT-guided percutaneous cryoablation treatment was carried out in all patients.Results ① Of the 100 patients,complete cryoablation treatment was performed in 9 and palliative cryoablation treatment was adopted in 91.The following-up time ranged from 3 years to 11 years.The one-,3-and 5-year survival rates were 87.0％ (87/100),17％ (17/100) and 9％ (9/100) respectively.The pain relief rate after cryoablation treatment was 84.0％ (70/83).② Contrast-enhanced CT scan performed one month after cryoablation treatment showed that complete cryoablation was seen in 9 patients,presenting as no enhancement in the tumor frozen area on CT image;palliative cryoablation was seen in 91 patients,the ablation extent ≥90％ was obtained in 48 patients,the ablation extent of 80-90％ in 25 patients,the ablation extent of 70-80％ in 12 patients,the ablation extent of 60-70％ in 4 patients,and the ablation extent ＜60％ in 3 patients.③ Postoperative complications included local infection (n=3),which was cured after anti-infective therapy;intestinal fistula at upper rectum (n=1),which was gradually healed after enterostomy;transient dysuresia (n=5),which was recovered through retention catheterization for 3-5 days;fever lasting 3-5 days;and skin frostbite (n=3),which was cured after symptomatic treatment.Conclusion For the treatment of recurrent tumors in pelvic cavity and retroperitoneal space,CT-guided percutaneous cryoablation is quite safe.Complete cryoablation is very helpful for improving local tumor control and prolonging survival time.

Objective To explore the short- term efficacy of argon- helium knife cryotherapy followed by chemotherapy in treating advanced non- small cell lung cancer (NSCLC) and to investigate its effect on the long- term survival. Methods During the period from March 2005 to March 2008, a total of 61 patients withⅢb or Ⅳ stage NSCLC received argon- helium knife cryotherapy followed by chemotherapy (study group), and other 52 patients with Ⅲb or Ⅳ stage NSCLC were treated with chemotherapy only (control group). The clinical data were retrospectively analyzed. The pain was evaluated by numeric rating scale (NRS) and the quality of life (QOL) was assessed by functional assessment of cancer therapy- general (FACT- G) scale. The clinical effect was evaluated according to RECIST criteria for solid tumor, and the patient’s survival time was recorded. Results (1) Twenty- six patients had local pain before the treatment, and the pain was relieved in different degrees after cryotherapy. The QOL, including all respects of FACT - G, was significantly improved after cryotherapy in all 61 patients. (2) The remission rate of the study group and the control group was 34.4% and 15.4% respectively, the difference between the two groups was statistically significant (P <0.05). (3) The median survival time of the study group and the control group was 12.9 months and 9.5 months respectively, and the one- year survival rate of the study group and the control group was 53.6% and 35.4% respectively. The differences between the two groups were statistically significant (P < 0.01). Conclusion Argon- helium knife cryotherapy is a safe and effective local treatment for advanced NSCLC, which can quickly reduce the tumor load, relieve the pain and improve patient’s quality of life. Cryotherapy with subsequent chemotherapy is superior to simple chemotherapy in improving the patient’s survival rate.

Objective To explore the surgical techniques and clinical indication of laparoscopic splenectomy combined with cholecystectomy.Methods The clinical data from two patients underwent laparoscopic splenectomy combined with cholecystectomy were retrospectively analyzed.Results Two patients have been performed splenectomy with cholecystectomy successfully under laparoscopy.The operation time of laparoscopic splenectomy was 90 min and 100min.Blood loss was 700ml and 800ml.Two patients were discharged 5 days postoperatively without any complications of bleeding,infection,pancreatic leakage.Conclusion The key surgical technique in the laparoscopic splenectomy combined with cholecystectomy was to control the splenic artery and vein according 1o different spleen anatomy.Non-acute inflammatory gallstone with surgical splenic diseases was considerel the clinical indications and the aseptic techniques and the sequence should be taken seriously during LS + LC.