Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.

Osteoporotic thoracolumbar fracture in the elderly will seriously reduce their quality of life and life expectancy. For osteoporotic thoracolumbar fracture in the elderly, spinal reconstruction is necessary, which should comprehensively consider factors such as the physical condition, fracture type, clinical characteristics and osteoporosis degree. While there lacks relevant clinical norms or guidelines on selection of spinal reconstruction strategies. In order to standardize the concept of spinal reconstruction for osteoporotic thoracolumbar fracture in the elderly, based on the principles of scientificity, practicality and progressiveness, the authors formulated the Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients ( version 2022), in which suggestions based on evidence of evidence-based medicine were put forward upon 10 important issues related to the fracture classification, non-operative treatment strategies and surgical treatment strategies in spinal reconstruction after osteoporosis thoracolumbar fracture in the elderly, hoping to provide a reference for clinical treatment.

Objective To evaluate the feasibility and accuracy of cardiac CT (CCT) in quantitation of extracellular volume (ECV) fraction in patients with heart failure, with 3 T Cardiac MR (CMR) as the reference. Methods Twenty?eight patients with variety reasons of heart failure were enrolled in this study. ECVs was calculated, the correlation between CCT and CMR ECV value and other cardiac function parameters (left ventricular end systolic volume LVESV, left ventricular end diastolic volume LVEDV, cardiac output CO and ejection fraction LVEF, and clinical bio?marker BNP) was determined. Interclass correlation coefficient (ICC) was used to evaluate the agreement of measurement by two radiologists. Results The average of ECV on CCT and CMR was 33% ± 8% and 31% ± 6%, respectively. A good correlation was revealed between myocardial ECV at CCT and that at CMR (r=0.854, P<0.001). Bland?Altman analysis between CCT and CMR showed a small bias (4.6%), with 95% limits of agreement of-18.2% to 27.4%. ICC for ECV at CCT was excellent (ICC=0.910). For both CCT and CMR, ECV was inversely related to LVEF. The radiation dose for CCT?ECV was (1.60±0.04) mSv. Conclusions ECV at CCT and that at CMR showed good correlation, suggesting the potential for myocardial tissue characterization using CCT. However, CCT?ECV would possibly overestimate the extent of ECV.

Objective To study the effects of different color light stimulus, duration of stimulus and day/night training on the incentive conditioned reflex of rats,and to provide a data basis for the methodology of incentive conditional reflection experiments. Methods Three experiments were included in this study. During the experiment 1, a total of 30 male 8-week-old Wistar rats were divided into three groups:red light stimulation group,yellow light stimulation group and blue light stimulation group. During the experiment 2, a total of 32 male 8-week-old Wistar rats were divided into three groups:the group I(with a light stimulation duration of 10 s), the group II(with a light stimulation duration of 30 s), and the group III(with a light stimulation duration of 60 s). During the experiment 3,a total of 16 male 8-week-old Wistar rats were randomly divided into two groups,of which the first group was trained at 9:00 a.m. every day, and the second group was trained at 21:00 every day. All the laboratory animals were given reward conditioned reflex training, and indicators such as the number of correct nose pokes,the number of incorrect nose pokes,the ratio of correct nose pokes and so on were counted and calculated. Results During the experiment 1,there was no significant difference in the numbers of correct nose pokes and incorrect nose pokes,movement distances and average speeds of the rats among the three groups. During the experiment 2,compared with the group with a light duration of 10 s,the rats in the groups with a light duration of 30 s or 60 s had a higher number of correct nose pokes(P< 0.05). Moreover,on the 13th and 14th days,the ratio of correct nose pokes of the group with a light duration of 30 s was significantly higher than that of the group with a light duration of 10 s(P< 0.001). During the experiment 3,there were no significant differences in the number of correct nose pokes and the nose poke accuracy of the rats between the two groups. Conclusions In the reward conditioned reflex test, red,yellow and blue light stimuli have similar reward prediction effect. When stimulated with the same light, the time of stimulation has an impact on the learning ability of the rats,and an appropriate extension of stimulation is beneficial to the formation of conditioned reflex in them. The day/night training has no effect on the learning and memory ability of the rats.

Objective To Study the depression-like behavior and impairment of learning and memory induced by chronic injection of corticosterone in mice. Methods Forty male C57BL/6J mice were divided into four groups, the control group, and the corticosterone groups(20,40,80 mg/kg). The mice received subcutaneous injection of corticosterone once a day for 21 days. The depression-like behaviors were detected by open field test(OFT), tail suspension test(TST)and forced swimming test(FST). To select the most effective dose of corticosterone, TST, FST, object location recognition test, and Morris water maze(MWM)test were used to study the corticosterone-induced depression-like behaviors and impairment of learning and memory in the mice. Results Compared with the control group, the movement distance and duration were significantly decreased in the corticosterone injection groups(40,80 mg/kg)(P< 0.01 or P< 0.05). In the TST group,the immobilization time was significantly increased in the corticosterone injection group(40,80 mg/kg)(P< 0.05). The TST and FST showed that the immobilization time of the corticosterone injection group(40 mg/kg)was significantly increased(P < 0.05). The object recognition test showed that the discrimination indexes of the object location recognition were decreased in the corticosterone injection group(40 mg/kg). The MWM test showed that the escape latency was increased(P< 0.05),and the number of crossing in target quadrant and the velocity in target quadrant were decreased(P< 0.05)in the corticosterone injection group(40 mg/kg). Conclusions Chronic injection of corticosterone can induce depression accompanied with learning and memory impairment in mice.

Objective In view of the controversy over radiotherapy target volume for patients with limited-stage small cell lung cancer ( SCLC), a prospective randomized controlled trial was conducted to compare the impact of different radiotherapy target volumes on prognosis. Methods After 2 cycles of EP chemotherapy,patients without progressive disease were randomly assigned to receive thoracic radiotherapy (TRT) to either the post-or pre-chemotherapy primary tumour extent as study arm or control. Involved field radiotherapy (IFRT) to the entire metastatic lymph node regions was applied for both arms. TRT consisted of 45 Gy/30Fx/19 d administered concurrently with cycle 3 chemotherapy. Prophylactic cranial irradiation was administered to patients achieved complete or partial remission. Kaplan-Meier method was used for survival analysis. Results Between June 2002 and December 2017,159 and 150 patients were randomly assigned to study arm and control respectively. The 1-,2-,and 5-year local/regional control rates were 79. 4%,61. 5% and 60. 1% respectively in the study arm versus 79. 8%,66. 5%,and 57. 3% in the control arm (P=0. 73). The median OS time was 22. 1 months in the study arm (95%CI,18. 2-26. 0 months) and 26. 9 months (95%CI,23. 5-30. 3 months) in the control arm,the 1-,3-,5-,and 7-year OS rates were 81. 1%,31. 6%, 23. 9% and 22. 2% respectively in the study arm versus 85. 3%,36. 6%,26. 1% and 20. 0% in the control arm (P=0. 51).Grade 2-3 acute esophagitis was developed in 32. 9% and 43. 2% of patients respectively in study arm and control arm (P=0. 01),while grade 2-3 pulmonary fibrosis was observed in 2. 0% and 10. 9% of patients ( P= 0. 01 ) respectively. Conclusions For patients with limited-stage SCLC who received induction chemotherapy,thoracic radiotherapy can be limited to post-chemotherapy tumour extent and IFRT can be routinely applied.

Objective To investigate the results of arthroscopic anterior cruciate ligament anatomic reconstruction using three-tunnel double-bundle methods with Femoral-Intrafix system.Methods From October 2010 to October 2013,data of 30 cases of arthroscopic anterior cruciate ligament (ACL) reconstruction who were randomly used with Femoral-Intrafix system were retrospectively analyzed.Hamstring tendons autograft were used for all patients.The Femoral-Intrafix system fixation was used for the femoral tunnel and the Milagro interference screw was used for tibial tunnels.KT-1000 arthrometer measurements,Lachman and Pivot-shift tests,and knee function with the Intemational Knee Documentation Committee (IKDC),Lysholm scores were used for clinical evaluation.Results All the patients were followed up for an average time of 24.71 ± 1.60 months (range,18-36 months).No patients had ligament re-rupture,deep vein thrombosis,exfliation of interference screw,joint pain and limited mobility during follow-up period.At the latest follow-up,the Lachman sign was Ⅰ degrees positive in 1 patient,and all patients had normal range of motion.The Lysholm scores increased from preoperative 67.51 ±4.92 to 96.41 ±6.31 at the latest follow up.The IKDC scores increased from preoperative 62.31 ±5.45 to 95.61±6.32 at the latest follow up.There was 93.3％ excellent and good rate,including excellent in 23 cases,good in 5 cases,and fair in 2 cases according to the IKDC.All knee function scores were improved.The results of KT-1000 were improved significantly (7.62± 1.25 mm vs.1.53± 1.02 mm at 30° of flexion,5.43± 1.21 mm vs 1.07± 1.02 mm at 90° of flexion) at the tensile fore of 134 N.Conclusion Arthroscopic ACL reconstruction using three-tunnel double-bundle methods with the Femoral-Intrafix system fixation is a reliable technique,which is easy to operate and has satisfactory short clinical outcome for knee function recovery.

Objective To investigate the antidepressant effect of DS-1226, a hydrolysate of ginsenosides, on a mouse model of depression induced by chronic sleep interruption, and provide scientific evidence for the research and de?velopment of antidepressant drugs. Methods 72 male ICR mice were divided into control group, model group, positive control group (paroxetine hydrochloride, 10 mg/kg) and 3 treatment groups (20 mg/kg, 40 mg/kg, 80 mg/kg of DS?1226). Except the control group, the other mice were put into a rotary roller (parameter settings:1 min/rev;rest 2 min af?ter 1 rev) for 3 days of drum adaptation, 3 h/d. Then making model for 14 days in the roller( parameter settings:1 min/rev;rest 2 min after 1 rev) . The antidepressant effects of DS?1226 were evaluated by weight monitoring, open?field test, tail suspension test, and forced swimming test. Results After 14 d sleep disturbance, compared with the control group,the body weight, immobility time in tail suspension test and forced swimming test were significantly decreased in the model group. Compared with the model group, DS?1226(40 mg/kg)significantly reversed the weight loss caused by sleep disturb?ance. Paroxetine significantly reduced the immobility time of tail suspension test. DS?1226 (40 mg/kg, 80 mg/kg)signifi?cantly decreased the immobility time of tail suspension test, and DS?1226 (80 mg/kg) significantly decreased the immobil?ity time of forced swimming test. Conclusion The hydrolysate of ginsenosides DS?1226 shows antidepressant effect on mouse model of depression induced by chronic sleep interruption.

Objective To observe the protein degredation of empty puparium cases ofC. megacephala after weathering and to explore its practical significance on postmortem interval estimation in forensic science. MethodsThe standardized feeding was used inC. megacephala, and the empty puparium cases were collected and put into the forest. They were taken back 5 days, and 10 days later, respectively. The spectra were collected and preprocessed, and then the absorption peaks of amides were read, and curve fitting was performed in the average spectra of each group. The statistical analysis was performed by SPSS 19.0.Results Compared to control group, ifve days post weathering, the position of amideⅠabsorption peak showed blue shift, but the amideⅡabsorption peak showed no shift, moreover, none of the amide absorption peaks showed changes inpeak intensity. For the secondary structures, α-helix decreased and β-sheet increased slightly, however, β-turn did not change; Ten days post weathering, the positions of both amideⅠandⅡabsorption peaks showed blue shift, and an obviousshoulder peak appeared in amide I absorption peak. Meanwhile, both of amideⅠandⅡabsorption peaks showed decreased in peak intensity. Moreover, for the secondary structures, α-helix and β-sheet showed the same tendency as in the 5th day group, except for the β-turn increased dramaticlly.Conclusion The spectra of the empty puparium cases of C. megacephala showed that the absorption peaks of amideⅠandⅡpresented certain characteristic features within ten days post weathering, and estimate relative long-time postmortem interval.

Objective To detect the molecular characteristics of the serum samples of rats suffered from sudden unexpected death of acute myocardial ischemia (experimental group) and death caused by air embolism (control group) applied by ATR-FTIR, and to discuss the forensic signiifcance of identiifcation of causes of death by sudden unexpected death of acute myocardial ischemia by two-dimension infrared spectroscopy. Methods Adult male SD rats were randomly divided into SCD group and DCAE group. The serum samples were analyzed by ATR-FTIR. The similarity coefifcient of spectra between two groups was analyzed by OMNIC software. The spectra with higher signal-noise ratio were obtained and used to build two-dimension spectra model by Matlab 2010a software. Results The peak shapes, positions and intensities of the spectra were extremely similar between two groups, and the similarity coefifcient reached 99.78%. Meanwhile, the similarity coefifcient of second derivative spectra decreased to 98.62% between two groups. Moreover, on the two-dimension spectra model, the component differences were present at about 1 625cm-1, 1 550cm-1, 1 080cm-1 and 860cm-1, and the number of auto-peaks was different, which suggested that the evident differences were related to the molecular contents of protein, glycogen, nuclear acid, and so on. Conclusion It is hard to differentiate the molecular differences of serum samples of rats between SCD and DACE based on one-dimension spectra. However, two-dimension infrared spectra could intuitively and effectively relfect the molecular differences, and it would apply to determining the cause of death in forensic science.