Objective:To evaluate the effectiveness of low-dose of prophylactic indomethacin in reducing the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in elderly patients.Methods:From July 2021 to October 2022, patients undergoing ERCP in Zhongshan Hospital, Fudan University and Shanghai Xuhui District Central Hospital were enrolled prospectively and assigned to either the low-dose (50 mg) indomethacin group or the conventional-dose (100 mg) group using the DAS electronic central randomization system. Data from elderly patients aged≥60 were collected and compared for the incidence of PEP and other adverse reactions.Results:A total of 418 elderly patients (Zhongshan Hospital, Fudan University, n=122; Shanghai Xuhui Distric Central Hospital, n=296) were ultimately included in the study, with 201 in the low-dose group and 217 in the conventional-dose group. There was no significant difference in the incidence of PEP between the low-dose group and the conventional-dose group [5.97% (12/201) VS 7.37% (16/217), χ2=0.33, P=0.566]. There was also no significant difference in drug-related adverse events between the two groups [4.98% (10/201) VS 4.15% (9/217), χ2=0.16, P=0.685]. Further subgroup analysis revealed that among elderly patients aged 60-<70, there were 13 patients diagnosed as having PEP. The incidence of PEP between the low-dose group and the conventional-dose group was not statistically significant [6.19% (6/97) VS 6.60% (7/106), χ2=0.01, P=0.903], and the occurrence of drug-related adverse events between the two groups was not statistically significant [6.19% (6/97) VS 2.83% (3/106), P=0.315]. Among elderly patients aged≥70, there were 15 patients diagnosed as having PEP. The incidence of PEP between the low-dose group and the conventional-dose group was not statistically significant [5.77% (6/104) VS 8.11% (9/111), χ2=0.45, P=0.501], and the occurrence of drug-related adverse events between the two groups was not statistically significant [3.85% (4/104) VS 5.41% (6/111), P=0.749]. Conclusion:The prophylactic use of 50 mg indomethacin showed similar efficacy in reducing the incidence of PEP in elderly patients compared with 100 mg indomethacin. Therefore, elderly patients can use 50 mg indomethacin prophylactically to reduce the incidence of PEP.

OBJECTIVE To investigate the causal association between ticagrelor and risk of infection METHODS Two-sample Mendelian randomization was adopted. Genetic instrumental variables were selected based on the results of the largest genome-wide association analysis to in vivo exposure of ticagrelor and its major active metabolite AR-C124910XX. The causal associations of ticagrelor and its major active metabolite AR-C124910XX with drug indications （coronary artery disease， unstable angina pectoris， myocardial infarction， stroke and ischemic stroke）were analyzed by inverse variance weighted Mendelian randomization model as a positive control for genetic instrumental variables. The causal relationship between ticagrelor and bacterial infection， acute lower respiratory infection， bacterial pneumoniae， pneumoniae，acute upper respiratory infection and sepsis were furtheranalyzed by using this method， and the robustness of the results was assessed by using heterogeneity tests and horizontal 202002030415） pleiotropy tests. RESULTS The increase of area under the curve at steady state （AUCss） of the genetic surrogated ticagrelor significantly reduced the risk of coronary artery disease， myocardial infarction and unstable angina pectoris （P＜0.001）. AUCss genetic instrument variables of its main active metabolite AR-C124910XX failed to pass positive control. Further analysis showed that the increase of the genetic surrogated ticagrelor exposure suggestively reduced the risk of bacterial infection [OR（95%CI）＝0.80（0.65，0.99），P＝0.040] and sepsis [OR （95%CI）＝0.84（0.73， 0.98）， P＝0.023]. The results of the heterogeneity tests showed that there was no heterogeneity in the causal association of the genetic surrogated ticagrelor AUCss with bacterial infection and sepsis （P＞0.05）. The results of horizontal pleiotropy tests showed that the causal association of genetic surrogated ticagrelor AUCss with bacterial infection and sepsis had no effects on horizontal pleiotropy （P＞0.05）. CONCLUSIONS Ticagrelor has a potential role in reducing the risk of sepsis and bacterial infections.

Humans ; Phosphorylation ; Serine/metabolism* ; Protein Serine-Threonine Kinases/metabolism* ; Signal Transduction ; Neovascularization, Pathologic

Objective To explore the regularity of traditional Chinese medicine (TCM) in the treatment of postembolization syndrome (PES) after transcatheter arterial chemoembolization (TACE). Methods CNKI, WANFANG and VIP were used as data sources to search the journals and literatures related to TCM treatment from January 2000 to December 2021. Then, relevant TCM formula or Chinese patent medicines preparations were screened out. The Chinese medicinal materials contained were entered into Excel 2019 table database, and the data were analyzed by SPSS Statistics 21.0 and SPSS Modeler 18.0 statistical software. Results 86 qualified prescriptions were included, containing 181 Chinese medicinal materials, with a total frequency of 942 times. Of the 181 Chinese herbs included, there were 28 herbs with frequency ≥10%, with a total frequency of 587. The top 5 Chinese medicinal materials of frequency were licorice, Poria, Atractylodes, Bupleurum and Astragalus. Among the efficacy classifications, tonifying deficiency drugs, heat-clearing drugs and diuretics were most used. In four properties and five tastes, the top three of four properties were warm, flat and cold, and the top three of five tastes were sweet, bitter and pungent. In the classification of meridians, the first three meridians were spleen meridian, lung meridian and liver meridian. 30 association rules were obtained in association rules analysis, 11 common factors were obtained by factor analysis, 6 clustering combinations were obtained by cluster analysis, and 4 commonly used drug combinations were obtained. Conclusion The prescription drugs for the treatment of PES after TACE were mainly tonic drugs, heat-clearing drugs and diuresis and dampness-draining drugs. The treatment methods were mainly invigorating spleen and replenishing qi, clearing heat and dampness and detoxification.

Objective To investigate the level of finger systolic blood pressure (FSBP) in healthy young adults. Methods A total of 28 healthy young adults were selected as the study subjects by convenient sampling method. The FSBP of the study subjects was detected at 30 and 10 ℃, and the FSBP index (F_i) was calculated. Results The FSBP of the study subjects at 30 and 10 ℃ were (102.0±16.5) and (104.4±15.2) mmHg, respectively. The FSBP in male group at 30 and 10 ℃ was (99.6±18.6) and (107.2±17.0) mmHg, respectively. The FSBP in female group at 30 and 10 ℃ was (104.4±13.9) and (101.5±2.8) mmHg, respectively. The results of factorial analysis showed that the interaction between gender and temperature on FSBP was statistically significant (P<0.05). FSBP in male group was higher at 10 than 30 ℃ (P<0.05) and higher than female group at 10 ℃ (P<0.05). There was no statistical significance for the main effect of gender, temperature, finger, or the interaction effect of gender and finger, temperature and finger for FSBP (all P>0.05). The average F_i of the study subjects was (98.0±16.6)%, with males and females having the average F_i of (100.7±20.7) % and (95.2±10.6) % respectively. The results of factorial analysis of variance showed that there was no significant difference on F_i in the main effect gender and fingers or the interaction effect between them(all P>0.05). Conclusion The FSBP test could be used as a detection method for assessing peripheral microcirculation function in Chinese population. However, further research is needed to establish reference ranges and influencing factors.

Objective:To investigate the safety and efficacy of submucosal tunnel docking endoscopic resection (SDER) for the treatment of giant submucosal tumors in the cardia.Methods:A retrospective analysis was performed on data of patients with giant submucosal tumors in the cardia who were treated with SDER at the endoscopy center of Zhongshan Hospital, Fudan University and Xuhui District Central Hospital from January 2021 to January 2022. The surgical records, postoperative pathology, complications, hospitalization, and follow-up were analyzed.Results:A total of 6 patients were included. The mean long diameter of the lesions was 4.0 cm, all of which were located in the cardia. All patients successfully underwent SDER treatment with a surgical time of 23-42 min. Postoperative pathology revealed that 4 cases were leiomyomas and 2 cases were gastrointestinal stromal tumors. All lesions were completely resected. The postoperative hospital stay was 3-5 d, and no serious complications occurred after surgery. All patients recovered on follow-up gastroscopy at 3 and 6 months postoperatively.Conclusion:The preliminary conclusion is that SDER for the treatment of giant submucosal tumors in the cardia is safe, effective.

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor among gastrointestinal tumors, with an inherent potential for malignancy. The primary approach to addressing GIST remains surgical intervention. Laparoscopic and endoscopic cooperative surgery (LECS) has emerged as an innovative treatment approach for GIST. LECS includes various techniques, such as classic LECS, inverted LECS, and laparoscopic-assisted endoscopic full-thickness resection, all of which aim to combine the advantages of laparoscopy and endoscopy. This treatment offers benefits such as accurate localization, complete lesion removal, and a good prognosis. Generally, LECS can be used for GIST with a tumor diameter less than 50 mm, which cannot be completely removed through traditional endoscopic surgery. The clinical application of LECS deserves further exploration and expansion in the future, ultimately benefiting patients.

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor among gastrointestinal tumors, with an inherent potential for malignancy. The primary approach to addressing GIST remains surgical intervention. Laparoscopic and endoscopic cooperative surgery (LECS) has emerged as an innovative treatment approach for GIST. LECS includes various techniques, such as classic LECS, inverted LECS, and laparoscopic-assisted endoscopic full-thickness resection, all of which aim to combine the advantages of laparoscopy and endoscopy. This treatment offers benefits such as accurate localization, complete lesion removal, and a good prognosis. Generally, LECS can be used for GIST with a tumor diameter less than 50 mm, which cannot be completely removed through traditional endoscopic surgery. The clinical application of LECS deserves further exploration and expansion in the future, ultimately benefiting patients.

ObjectiveTo observe the effect of twelve-week aerobic exercise on inhibitory control abilities and the change of brain activation in overweight children. MethodsFrom October to December, 2021, 20 overweight children from a primary school in Changping District were selected for a twelve-week aerobic exercise intervention. Their inhibitory control abilities were measured by Flanker task before and after intervention, while their brain activation levels during the task were detected by functional near infrared spectroscopy (fNIRS). ResultsThe interactions between task type and time of accuracy and reaction time in inconsistent tasks Flanker task were significant (F > 9.277, P < 0.05), with higher accuracy and lower reaction time of after intervention (P < 0.05). After intervention, ch1, ch2, ch3, ch6, and ch8 channels were activated by inconsistent tasks (P < 0.05). ConclusionA twelve-week aerobic exercise intervention could improve the inhibitory control ability, and increase the prefrontal cortex activation during inconsistent tasks in overweight children.

Objective To explore the affect of physical activity on neurocognitive function of overweight children.Methods The literatures about the effect of physical activity on neurocognitive function of overweight children were retrieved with subjected retrieval method in CNKI, VIP, Wanfang database, PubMed, Web of Science, EBSCO databases from January, 2000 to January, 2022. The authors, countries, published years, ages of subjects, research methods, intervention time, measurement tools and measurement indicators were extracted.Results Twelve articles were selected finally. These articles came from United States, Italy, Belgium and China, were mainly published in journals of psychology, clinical medicine, neuroscience, physical education. The study design included randomized controlled trials and pre-post-trial. The mean PEDro score was 6.67. The types of physical activity included fitness, skills and sports activities. The overweight children participating in physical activities could benefit from cognition and brain plasticity. On the cognition, physical activity could improve attention, memory, inhibitory control, working memory and cognitive flexibility. In terms of brain plasticity, physical activity could improve the integrity of brain white matter, increase hippocampal volume, enhance brain activation and brain network connectivity.Conclusion Physical activity is a simple and effective form of exercise. It can improve not only attention, memory, executive function and other cognitive functions, but also brain structure and brain function in overweight children. The mechanism of cognition, the interaction between physical activity and other factors, and the dose-relationship between physical activity and cognitive benefits still need to be explored in the future.