Objective To investigate the difference of surgical effect of exclusion,simple continuous suture and circular suture suspension in TAPP for the treatment of false hernia sac in patients with direct inguinal hernia.Method From May 2020 to May 2022,120 patients diagnosed with direct inguinal hernia and treated with TAPP in our hospital were retrospectively.The false hernia sacs were divided into three groups according to different methods of treatment patients treated with false hernia sac exclusion were included in group A,those treated with simple continuous suture were included in group B,and those treated with circular suture suspension were included in group C.There were 40 patients in each group.The perioperative indicators(operation time,intraoperative blood loss,postoperative hospital stay,hospitalization cost)and postoperative effects(chronic pain,seroma,incision or mesh infection,foreign body traction feeling)were compared among the three groups.Results All 120 patients successfully completed TAPP surgery.There was no significant difference in general condition,intraoperative blood loss,postoperative hospital stay,wound or mesh infection and chronic pain among the three groups(P＞0.05).The operation time of group B and C was longer than that of group A,and the incidence of seroma was significantly lower than that of group A,the difference was statistically significant(P＜0.05).The incidence of foreign body traction in group A and group C was lower than that in group B,and the difference was statistically significant(P＜0.05).The hospitalization cost of group B and group C was lower than that of group A,with statistically significant difference(P＜0.05).Conclusion In clinical practice,direct hernia and false hernia sac often need to be treated.In direct hernia TAPP operation,simple continuous suture method and circular suture suspension method have the effect of improving the condition of the false hernia sac,but in terms of economy and postoperative effect,the circular suture suspension method can benefit patients more.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

OBJECTIVE To provide reference for safe use of risperidone in clinic. METHODS Data mining and analysis of risperidone-related adverse drug event （ADE） reports from the first quarter of 2017 to the third quarter of 2021 in the United States FAERS database were carried out using reported odds ratio and composite criteria methods from Medicines and Healthcare Products Regulatory Agency. RESULTS There were 101 181 ADE reports with risperidone as the primary suspect drug，involving a total of 33 179 patients. Among those reports，the male-to-female ratio was about 6.21 to 1； most of them were ＜18 years old （15.01%）； ADE was mainly reported by consumers （69.74%） and mainly reported by the United States （79.72%）； oral dosage form was the most used，accounting for 83.71%. A total of 409 ADE signals were obtained，including male breast development， pseudogynecomastia，abnormal increase in body mass，hyperprolactinemia and Wellens syndrome，etc. Twenty-six systems and organs were involved，mainly including reproductive system and breast diseases，various injuries，poisoning and operational complications， mental diseases，metabolic and nutritional diseases，and various nervous system diseases，etc. CONCLUSIONS The common ADE signals of risperidone and the system involved are consistent with the instructions，but we should also be alert to the ADE not recorded in the instruction，such as Wellens syndrome，fibroproliferative endocarditis，cavernous degeneration of portal vein，rabbit syndrome，etc.

Objective To investigate the ocular hemodynamic characteristics before and after treatment of diabetic retinopathy(DR).Methods This study was a case-control study using a non-random sampling method.A total of 86 DR patients(86 eyes)and 43 healthy subjects who were diagnosed and treated in the Affiliated Hospital of Hebei University from December 2021 to April 2022 were selected as the research objects.Among them,86 DR patients were set up as the observation group,and 43 healthy subjects were set up as the control group.The central retinal artery(CRA),peak systolic velocity(PSV),end-diastolic velocity(EDV),and resistance in-dex(RI)were compared between the two groups.And according to the results of fluorescein fundus angiography(FFA)and macular opti-cal coherence tomography(OCT),the observation group was divided into PRP group[treated with panretinal photocoagulation(PRP)]and VEGF group[treated with intravitreal injection of anti-vascular endothlial growth factor(VEGF)],43 cases in each group.The curative effect was observed,the changes of PSV,EDV and RI before and after surgery were compared,and the area under the curve(AUC),sensitivity and specificity of PSV,EDV and RI for predicting curative effect were analyzed by receiver operating characteristic(ROC)curve model.Results PSV and EDV in the observation group were lower than those in the control group,but RI was higher than that in the control group(P＜0.05).All patients in PRP group successfully completed PRP treatment,with a total effective rate of 88.37％;PSV and EDV at 1day and 1 week after operation were higher than those before operation,while RI was lower than before opera-tion(P＜0.05);There was no significant difference in PSV and EDV at 1week after operation compared with 1day after operation(P＞0.05),while RI was lower than that at 1day before operation(P＜0.05).All patients in VEGF group successfully completed intravitreal injection of anti-VEGF therapy,with a total effective rate of 86.04％;PSV and EDV at 1 day and 1 week after operation were higher than those before operation,while RI was lower than before operation(P＜0.05);PSV and EDV at 1 week were lower than those at 1day after operation,while the RI was higher than that at 1day before operation(P＜0.05).ROC curve analysis showed that the AUC values of PSV,EDV and RI for predicting the efficacy of PRP in the treatment of stage Ⅰ-Ⅲ DR were 0.879,0.831,0.894(P＜0.05),re-spectively;the AUC values of PSV,EDV and RI for predicting the efficacy of intravitreal injection of anti-VEGF in the treatment of stageⅣ DR were 0.860,0.881,0.831(P＜0.05).Conclusion Both PRP and intravitreal injection of anti-VEGF have good curative effects in the treatment of stage Ⅰ-Ⅳ DR,which can effectively increase the PSV and EDV of the CRA and reduce the RI.And color Doppler ultrasound was used to observe the changes of ocular hemodynamics in patients with DR before and after operation,which is bene-ficial to provide reference for clinical diagnosis and treatment.

Aristolochic acids (AAs) have long been considered as a potent carcinogen due to its nephrotoxicity. Aristolochic acid I (AAI) reacts with DNA to form covalent aristolactam (AL)-DNA adducts, leading to subsequent A to T transversion mutation, commonly referred as AA mutational signature. Previous research inferred that AAs were widely implicated in liver cancer throughout Asia. In this study, we explored whether AAs exposure was the main cause of liver cancer in the context of HBV infection in mainland China. Totally 1256 liver cancer samples were randomly retrieved from 3 medical centers and a refined bioanalytical method was used to detect AAI-DNA adducts. 5.10% of these samples could be identified as AAI positive exposure. Whole genome sequencing suggested 8.41% of 107 liver cancer patients exhibited the dominant AA mutational signature, indicating a relatively low overall AAI exposure rate. In animal models, long-term administration of AAI barely increased liver tumorigenesis in adult mice, opposite from its tumor-inducing role when subjected to infant mice. Furthermore, AAI induced dose-dependent accumulation of AA-DNA adduct in target organs in adult mice, with the most detected in kidney instead of liver. Taken together, our data indicate that AA exposure was not the major threat of liver cancer in adulthood.

Objective:To analyze the molecular epidemiological characteristics of the Corona virus disease 2019 (COVID-19) cases in Shijiazhuang, which can reveal the origin of the outbreak and provide a scientific basis for COVID-19 prevention and control.Methods:From January 2 to January 8, 2021, a total of 404 samples from 170 COVID-19 cases were collected from the Shijiazhuang Fifth Hospital. The consensus sequence of 2019 novel Coronavirus(2019-nCoV) was obtained through multiplex polymerase chain reaction-based sequencing. The sequences of 170 COVID-19 cases were analyzed by the PANGOLIN, and the data were statistically analyzed by T-test.Results:Among the 404 COVID-19 samples, a total of 356 samples obtained high quality genome sequences (>95%,100×sequencing depth). The whole genome sequences of 170 COVID-19 cases were obtained by eliminating repeated samples. All 170 sequences were recognized as lineage B1.1 using PANGOLIN. The number of single nucleotide polymorphism arrange from 18-22 and most of the single nucleotide polymorphism were synonymous variants. All of 170 genomes could be classified into 48 sub-groups and most of the genomes were classified into 2 sub-groups (66 and 31, respectively).Conclusions:All cases in this study are likely originated from one imported case. The viruses have spread in the community for a long time and have mutated during the community transmission.

Objective:To investigate the feasibility and efficacy of three mini-incision double eyelid blepharoplasty with concurrent reposition of orbital fat pad to correct sunken upper eyelids.Methods:The data of patients who underwent orbital fat reposition to correct upper eyelid depression during the period from January 2018 to April 2021 in the Medical Plastic and Cosmetic Center of Beijing Tongren Hospital affiliated to Capital Medical University were retrospectively analyzed. During the operation, the central mass of orbital fat and its lateral extension were fully dissociated, and then transferred and fixed inward through three mini-incisions. Postoperative follow-up was performed to observe the improvement of the double eyelid shape and upper eyelid depression, and the patient satisfaction was recorded.Results:A total of 72 patients (140 eyes) were included in this study, including 1 male and 71 females, with an average age of 28 years (19-40 years old), 122 eyes with mild upper eyelid depression and 18 eyes with moderate upper eyelid depression before operation. Postoperative follow-up was 6-24 months, with an average of 11 months. The curvature of the double eyelid after operation was smooth and basically symmetrical. Among the 122 eyes with mild upper eyelid depression before operation, 118 eyes were completely corrected after operation, and 4 eyes were not improved. Of the 18 eyes, 3 eyes were completely corrected after operation, and 15 eyes still had mild upper lid depression. The overall satisfaction rate was 93.1% (67/72), the rate of double eyelid failure was 3.6% (5/140), and no other serious complications were found.Conclusions:Three mini-incision double eyelid blepharoplasty simultaneously with orbital fat reposition can effectively correct mild and moderate sunken upper eyelid deformity. The postoperative double eyelid shape is stable with high satisfaction rate.

The importance of structural variants(SVs)for human phenotypes and diseases is now recognized.Although a variety of SV detection platforms and strategies that vary in sensitivity and specificity have been developed,few benchmarking procedures are available to confidently assess their performances in biological and clinical research.To facilitate the validation and application of these SV detection approaches,we established an Asian reference material by characterizing the genome of an Epstein-Barr virus(EBV)-immortalized B lymphocyte line along with identified benchmark regions and high-confidence SV calls.We established a high-confidence SV callset with 8938 SVs by integrating four alignment-based SV callers,including 109x Pacific Biosciences(PacBio)continuous long reads(CLRs),22 x PacBio circular consensus sequencing(CCS)reads,104x Oxford Nanopore Technologies(ONT)long reads,and 114×Bionano optical mapping plat-form,and one de novo assembly-based SV caller using CCS reads.A total of 544 randomly selected SVs were validated by PCR amplification and Sanger sequencing,demonstrating the robustness of our SV calls.Combining trio-binning-based haplotype assemblies,we established an SV benchmark for identifying false negatives and false positives by constructing the continuous high-confidence regions(CHCRs),which covered 1.46 gigabase pairs(Gb)and 6882 SVs supported by at least one diploid haplotype assembly.Establishing high-confidence SV calls for a benchmark sample that has been characterized by multiple technologies provides a valuable resource for investigating SVs in human biology,disease,and clinical research.

Objective:To investigate the feasibility and efficacy of three mini-incision double eyelid blepharoplasty with concurrent reposition of orbital fat pad to correct sunken upper eyelids.Methods:The data of patients who underwent orbital fat reposition to correct upper eyelid depression during the period from January 2018 to April 2021 in the Medical Plastic and Cosmetic Center of Beijing Tongren Hospital affiliated to Capital Medical University were retrospectively analyzed. During the operation, the central mass of orbital fat and its lateral extension were fully dissociated, and then transferred and fixed inward through three mini-incisions. Postoperative follow-up was performed to observe the improvement of the double eyelid shape and upper eyelid depression, and the patient satisfaction was recorded.Results:A total of 72 patients (140 eyes) were included in this study, including 1 male and 71 females, with an average age of 28 years (19-40 years old), 122 eyes with mild upper eyelid depression and 18 eyes with moderate upper eyelid depression before operation. Postoperative follow-up was 6-24 months, with an average of 11 months. The curvature of the double eyelid after operation was smooth and basically symmetrical. Among the 122 eyes with mild upper eyelid depression before operation, 118 eyes were completely corrected after operation, and 4 eyes were not improved. Of the 18 eyes, 3 eyes were completely corrected after operation, and 15 eyes still had mild upper lid depression. The overall satisfaction rate was 93.1% (67/72), the rate of double eyelid failure was 3.6% (5/140), and no other serious complications were found.Conclusions:Three mini-incision double eyelid blepharoplasty simultaneously with orbital fat reposition can effectively correct mild and moderate sunken upper eyelid deformity. The postoperative double eyelid shape is stable with high satisfaction rate.

Objective:To describe clinical characteristics, genetic mutation and therapeutic response of a family diagnosed as slow-channel congenital myasthenia syndrome (SCCMS) and analyze the factors of the efficacy of channel blockers therapy.Methods:Clinical data and therapeutic response in three patients from a family of SCCMS from Department of Neurology, Xuanwu Hospital, Capital Medical University in May 2017 were collected. The clinical data, mutations and response to therapy of all literature SCCMS cases in the English database of Pubmed and Chinese database of Wanfang until December 31, 2018 were analyzed statistically.Results:The proband was a 48-year-old female who referred to Xuanwu Hospital for limb weakness for 40 years. The proband′s elder daughter presented with onset of the birth and delayed motor milestones, scoliosis and difficulty in walking. The younger daughter was born healthy with normal motor milestones, while fatigue and weakness gradually appeared. The antibodies of myasthenia gravis were negative. No repetitive compound muscle action potentials (CMAP) were detected in three patients. Repetitive nerve stimulation showed decrements. Gene test revealed heterozygous mutation of CHRNE p.εV279F, a known pathogenic mutation of SCCMS. Seventeen SCCMS cases were reported in literature. A total of 20 patients with SCCMS were described in terms of clinical manifestation, mutation, drug therapy and efficacy in detail. According to the literature description, they were divided into significant benefit group and mild to modest benefit group to channel blocker therapy. The age of onset in 10 patients with significant benefit was 1.50 (0.75, 28.25) years from birth to 43 years, and that in 10 patients with mild to modest benefit was 2.50 (0, 6.25) years from birth to 11 years. There was no significant difference between the two groups. The age at the initial channel blocker therapy in the group with significant benefit was (23.40±13.29) years from 12 to 43 years, whereas that in the group with mild to modest benefit was (34.10±13.43) years from 20 to 62 years, and there was no significant difference between the two groups. The delay time of treatment (age at the beginning of treatment with channel blockers-age of onset) in patients with significant benefit was 13.0 (10.25, 15.00) years, which was 32.50 (19.25, 38.00) years in patients with mild to modest benefit ( Z=-3.374, P=0.000). According to the response of cholinesterase inhibitor, eight patients were in the effective group, 10 patients were in the ineffective group and two patients were without cholinesterase inhibitor. The age of onset in the effective group was 0 (0, 4.75) years, while that in the ineffective group was 6.50 (1.00, 28.25) years ( Z=-2.315, P=0.021).The age of treatment with channel blockers was (27.90±12.99) years in the effective group and (32.00±13.21) years in the ineffective group, and there was no significant difference between the two groups. The delay time of channel blocker treatment in effective group was (30.25±11.07) years, while that in ineffective group was (14.30±9.60) years ( t=-3.274, P=0.005). Conclusions:In SCCMS, the effect of channel blockers was related to the delay time of treatment. Channel blocker was more effective the sooner it was started after the onset of symptoms. The average age of onset of SCCMS patients with positive responses to cholinesterase inhibitor was younger, but the delay time of channel blocker therapy was longer, resulting in poor therapeutic effect.