Portal vein embolization （PVE） can induce atrophy of the embolized lobe and compensatory regeneration of the non-embolized lobe. However， due to inadequate regeneration of future liver remnant （FLR） after PVE， some patients remain unsuitable for hepatectomy after PVE. In recent years， liver venous deprivation （LVD）， which combines PVE with hepatic vein embolization （HVE）， has induced enhanced FLR regeneration. Compared with associating liver partition and portal vein ligation for staged hepatectomy （ALPPS）， LVD triggers faster and more robust FLR regeneration， with lower incidence rate of postoperative complications and mortality rate. By reviewing related articles on LVD， this article introduces the effectiveness of LVD and analyzes the differences and safety of various technical paths， and it is believed that LVD is a safe and effective preoperative pretreatment method.

Objective To study the safety and effectiveness of arc edge needle therapy for moderate to severe tenosynovitis of the flexor digitorum tendon in the thumb.Methods A total of 62 patients with moderate to severe stenosing tenosynovitis of the flexor digitorum thumb who met the inclusion criteria were collected.The patients were randomly assigned 1:1 to the arc edge needle group and the needle knife group using a random number table method.Among them,31 patients in the arc edge needle group were treated with arc edge needles,while 31 patients in the needle knife group were treated with traditional needle knife release surgery.Both groups were treated once.Record the number rating scale(NRS),range of motion(ROM),Quinell grade,and disease efficacy score(WDES)of patients before and after treatment at various stages(1 week,2 weeks,4 weeks),and at follow-up after 24 weeks to evaluate the treatment effect.Results During the 24 weeks follow-up of 62 patients after treatment,the Quinell grading comparison between the two groups showed that the arc edge needle group was better than the needle knife group(P<0.05);The total effective rate of disease efficacy score(WDES)was 96.77%in the arc edge needle group and 83.87%in the needle knife group.The clinical total effective rate of the arc edge needle group was better than that of the needle knife group(P<0.05);After treatment,both groups showed significant improvement in pain numerical score(NRS)and joint range of motion(ROM),and the degree of improvement increased over time(P<0.05);And the inter group comparison at 1 week,2 weeks,4 weeks and 24 weeks time points after treatment showed that the curved blade needle was superior to the needle knife group in improving pain and joint mobility(P<0.05).Conclusion Both the 45° tenosynovitis incision and release surgery with arc edge needle and traditional needle knife release surgery are effective in treating moderate to severe tenosynovitis of the thumb flexor digitorum tendon.However,the 45° tenosynovitis incision and release surgery with arc edge needle has significant advantages in improving pain,interphalangeal joint mobility,and safety.

With the advent of an aging society,Alzheimer's disease(AD)has gradually become a major ailment affecting the elderly.AD is a neurodegenerative disorder associated with cognitive impairments.In AD patients,brain network connections are disrupted,and their topological properties are also affected,leading to the disintegration of anatomical and functional connections.Anatomical connections can be tracked and evaluated using structural magnetic imaging(MRI)and diffusion tensor imaging(DTI),while functional connections are detected through functional MRI to assess their connectivity status.This review incorporates the findings of previous scholars and summarizes the current research of AD.It mainly discusses the imaging characteristics of large-scale brain network changes in AD patients,so as to provide researchers with scientific and objective imaging markers for AD prediction and early diagnosis,as well as future research.

A two-photon near infrared(NIR)fluorescence turn-on sensor with high selectivity and sensitivity for Zn2+detection has been developed.This sensor exhibits a large Stokes'shift(-300 nm)and can be excited from 900 to 1000 nm,with an emission wavelength of-785 nm,making it ideal for imaging in biological tissues.The sensor's high selectivity for Zn2+over other structurally similar cations,such as Cd2+,makes it a promising tool for monitoring zinc ion levels in biological systems.Given the high concentration of zinc in thrombi,this sensor could provide a useful tool for in vivo thrombus imaging.

Objective:This study targets students enrolled in the Sino-foreign joint clinical medicine program collaboratively run by Chongqing Medical University, China and the University of Leicester, UK, aiming to propose suggestions and improvement measures on optimizing students' learning experiences and promoting the high-quality development of Sino-foreign cooperative education through questionnaire survey analysis.Methods:This study utilized convenience sampling and a self-designed questionnaire to collect feedback on the curriculum system and teaching methods, the adaptability of the educational system to the Chinese clinical practitioner examination, and the approaches and benefits of studying abroad. The data were presented as percentages.Results:Among the 75 respondents, 32 (42.67%) students expressed overall satisfaction or high satisfaction with the curriculum system and teaching methods. Specifically, 22 (29.33%) students were satisfied or very satisfied with the teaching methods of the Sino-foreign joint medical courses. Regarding the educational system's adaptability to the Chinese clinical practitioner examination, 74 (98.67%) students felt that the medical education provided by the joint program needed further adjustments or improvements, of whom 53 (70.67%) students believed that the content of the joint program was somewhat or not well aligned with the requirements of the Chinese practitioner examination, and 55 (73.33%) students thought that the joint program's discipline structure was not sufficiently comprehensive for training medical professionals. In terms of studying abroad, 57 (76.00%) students felt that overseas study had a positive impact on enhancing their overall quality.Conclusions:The joint clinical medicine program at our university draws on British educational principles to improve overall student quality. In response to students' needs regarding the curriculum system, teaching methods, and practitioner examination, the university plans to refine its teaching content and methods by implementing innovative training concepts, focusing on interdisciplinary integration, streamlining the curriculum, increasing tutoring, and promoting case-based group discussions to improve classroom teaching quality.

Objective:To study the spatiotemporal heterogeneity of the incidence rate of pulmonary tuberculosis and its macro influencing factors in China, so as to provide a reference for the relevant departments to formulate prevention and control policies.Methods:In virtue of the complexity of influencing factors, a new method combining principal component analysis (PCA) with geographically and temporally weighted regression (GTWR) was proposed to analyze the spatiotemporal heterogeneity of influencing factors for pulmonary tuberculosis. Using the data of incidence rate of pulmonary tuberculosis and gross regional product (secondary indicators) of 31 provinces (excluding Hong Kong, Macao, and Taiwan) in China from 2010 to 2019, a macro influencing factor indicator system was established by the PCA scores of 21 secondary indicators quantified to determine four primary indicators: comprehensive economy, medical security, cultural and educational transportation, and resources and environment. Based on the indicator system, PCA-ordinary least squares (PCA-OLS) model, PCA-geographically weighted regression (PCA-GWR) model, and PCA-GTWR model were constructed.Results:Three models passed F-test with F-values of 58.74, 196.62, and 1 202.90 respectively (all P < 0.05), indicating that the impact of the primary indicators on the incidence of tuberculosis is statistically significant. The mean squared error (0.01), the mean absolute error (0.08), the mean absolute percentage error (0.02), and the corrected Akaike information criterion (-358.76) of PCA-GTWR were lower than those of PCA-OLS (0.13, 0.28, 0.07, 258.38) and PCA-GWR (0.06, 0.15, 0.03, 23.41). Meanwhile, the determination coefficient (0.95) of PCA-GTWR was higher than that of PCA-OLS (0.44) and PCA-GWR (0.77), indicating the goodness of fit of the model is the best. And the PCA-GTWR model showed that the comprehensive economy, medical security, cultural and educational transportation, and resources and environment had significant spatiotemporal heterogeneity on the incidence rate of pulmonary tuberculosis according to the distribution of regression coefficients. Conclusion:It is necessary to comprehensively consider various factors and formulate detailed and overall prevention and control measures for pulmonary tuberculosis according to local conditions.

Purpose: Previous report from the ASCEND-8 trial showed consistent efficacy with less gastrointestinal (GI) toxicity in patients with anaplastic lymphoma kinase-rearranged (ALK+) advanced/metastatic non–small cell lung cancer (NSCLC) treated with ceritinib 450-mg with food compared with 750-mg fasted. In this subgroup analysis, we report outcomes in Asian patients of the ASCEND-8 trial. Materials and Methods: Key efficacy endpoints were blinded independent review committee (BIRC)–assessed overall response rate (ORR) and duration of response (DOR) evaluated per Response Evaluation Criteria in Solid Tumors v1.1. Other efficacy endpoints were investigator-assessed ORR and DOR; BIRC- and investigator-assessed progression-free survival (PFS) and disease control rate; overall survival (OS). Safety was evaluated by frequency and severity of adverse events. Results: At final data cutoff (6 March 2020), 198 treatment-naïve patients were included in efficacy analysis, of which 74 (37%) comprised the Asian subset; 450-mg fed (n=29), 600-mg fed (n=19), and 750-mg fasted (n=26). Baseline characteristics were mostly comparable across study arms. At baseline, more patients in 450-mg fed arm (44.8%) had brain metastases than in 750-mg fasted arm (26.9%). Per BIRC, patients in the 450-mg fed arm had a numerically higher ORR, 24-month DOR rate and 24-month PFS rate than the 750-mg fasted arm. The 36-month OS rate was 93.1% in 450-mg fed arm and 70.9% in 750-mg fasted arm. Any-grade GI toxicity occurred in 82.8% and 96.2% of patients in the 450-mg fed and 750-mg fasted arms, respectively. Conclusion Asian patients with ALK+ advanced/metastatic NSCLC treated with ceritinib 450-mg fed showed numerically higher efficacy and lower GI toxicity than 750-mg fasted patients.

Abstract: Objective To observe the curative effect of thread-hanging combined with cotton plug on stage Ⅲ paronychia. Methods Sixty-one patients with stage Ⅲ paronychia were selected and randomly divided into a treatment group and a control group. The treatment group (n=31) was treated with thread-hanging and tampon under local infiltration anesthesia, and changed dressing and tampon every day after operation. After the wound healed, the patient soaked his feet in warm water every day and changed the tampon himself until the symptoms subsided, and the knot did not receive special treatment, and the nail plate would naturally shed as it outgrew the paronychia. The control group (n=30) was treated with thread-hanging and nail groove reconstruction under nerve block anesthesia, and the dressing was changed every day after operation. After thread removal, the patients soaked their feet in warm water every day until the symptoms subsided, and the knot was not specially treated, and it naturally fell off with the growth of the deck beyond the nail groove. The postoperative Visual Analog Scale (VAS) pain score, pain duration, wound healing time, cure rate, effective rate and recurrence rate of paronychia, and patients' satisfaction with the operation were compared between the two groups. Results Compared with the control group, the treatment group had lower VAS pain scores on the first and third postoperative days (2.1±0.3) and (0.2±0.1) vs. (6.3±0.1) and (3.2±0.2), respectively, shorter duration of pain and wound healing time (3.3±0.3) days and (10.1±0.5) days vs. (5.2±0.3) days and (15.2±0.3) days, respectively, higher cure rate (87.1% vs. 66.7%), lower failure rate (12.9% vs. 33.3%), lower recurrence rate (7.4% vs. 20.0%), and higher patient satisfaction (97.0% vs.75.3%). The treatment group showed significant superiority over the control group in all outcomes. Conclusion For patients with stage Ⅲ paronychia, thread-hanging combined with cotton tampon without nail groove reconstruction is advantageous as it avoids additional skin trauma, and does not affect the nail appearance and normal periungual barrier after healing, , reduces patient discomfort, and shortens the time off work, resulting in a higher cure rate. This treatment approach is therefore worth promoting in clinical practice.

Antimicrobial resistance has become a major public health issue of global concern. Conjugation is an important way for fast spreading drug-resistant plasmids, during which the type Ⅳ pili plays an important role. Type Ⅳ pili can adhere on the surfaces of host cell and other medium, facilitating formation of bacterial biofilms, bacterial aggregations and microcolonies, and is also a critical factor in liquid conjugation. PilV is an adhesin-type protein found on the tip of type Ⅳ pili encoded by plasmid R64, and can recognize the lipopolysaccharid (LPS) molecules that locate on bacterial membrane. The shufflon is a clustered inversion region that diversifies the PilV protein, which consequently affects the recipient recognition and conjugation frequency in liquid mating. The shufflon was firstly discovered on an IncI1 plasmid R64 and has been identified subsequently in plasmids IncI2, IncK and IncZ, as well as the pathogenicity island of Salmonella typhi. The shufflon consists of four segments including A, B, C, and D, and a specific recombination site named sfx. The shufflon is regulated by its downstream-located recombinase-encoding gene rci, and different rearrangements of the shufflon region in different plasmids were observed. Mobile colistin resistance gene mcr-1, which has attracted substantial attentions recently, is mainly located in IncI2 plasmid. The shufflon may be one of the contributors to fast spread of mcr-1. Herein, we reviewed the discovery, structure, function and prevalence of plasmid mediated shufflon, aiming to provide a theoretical basis on transmission mechanism and control strategy of drug-resistant plasmids.
Plasmids/genetics* ; Proteins/genetics* ; Bacteria/genetics* ; Recombinases ; Genes, Bacterial ; Anti-Bacterial Agents

ObjectiveTo observe the effect of comprehensive intervention on the incidence of lactation galactostasis in communities from the perspective of preventive medicine， so as to prevent the occurrence of the mammary ducts obstruction disease. MethodsA total of 400 women in the early stage of pregnancy were selected from four communities. Those in two communities were set up as the intervention group. Comprehensive intervention for the prevention and treatment of mammary ducts obstruction disease during pregnancy and "Six-step recanalization manual therapy" practical guidance were conducted on the intervention group. The pregnant women from the other two communities were the control group， who received no intervention or guidance training. The two groups were followed up at 1 month， 3 months and 5 months postpartum， and the occurrence of mammary ducts obstruction disease was investigated and interventions were carried out. ResultsThe incidence of galactostasis in the intervention group was 26.0%， 10.6% and 5.1%， respectively at 1， 3 and 5 months after delivery， and the incidence of galactostasis in the control group was 38.0%， 22.2% and 8.3%， respectively. The incidence of galactostasis at 1 month and3 months after delivery was statistically different （P<0.05）， while the incidence of galactostasis 5 months after delivery was not statistically different （P>0.05）. The protection rates of comprehensive intervention on galactostasis were 31.58%， 52.25% and 38.55%， respectively. ConclusionPublicity and education work of prevention and control of the mammary ducts obstruction disease and "Six-step recanalization manual therapy" practical guidance can effectively reduce the occurrence of plugged mammary ducts， and therefore should be promoted.