Objective:To evaluate the risk factors for the formation of parastomal Hernias(PSH)using meta-analysis,and to provide a theoretical basis for the prevention and treatment of PSH.Methods:Case control or Cohort study of PSH risk factors were collected by searching PubMed,CNKI,Wanfang data and other databases.Extract relevant data and perform meta-analysis using RevMan 5.3.Results:The results included a total of 16 studies,with a total sample size of 2411 cases,including 670 in the PSH group and 1741 in the non PSH group.The results showed that advanced age,female gender,BMI≥25,hypertension,COPD/chronic cough,diabetes,and postoperative Hypoproteinemia could increase the risk of PSH(P＜0.05);Smoking,previous ab-dominal surgery history,preoperative radiotherapy/chemotherapy etc.,were not significantly asso-ciated with the occurrence of PSH(P＞0.05).Conclusion:The current evidence shows that ad-vanced age,female gender,BMI≥25,hypertension,COPD/chronic cough,diabetes,postoperative Hypoproteinemia are risk factors for PSH,and extraperitoneal stoma can reduce the occurrence of PSH.

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.

Objective: The docking and superantigen activity sites of staphylococcal enterotoxin-like W (SElW) and T cell receptor (TCR) were predicted, and its SElW was cloned, expressed and purified. Methods: AlphaFold was used to predict the 3D structure of SElW protein monomers, and the protein models were evaluated with the help of the SAVES online server from ERRAT, Ramachandran plot, and Verify_3D. The ZDOCK server simulates the docking conformation of SElW and TCR, and the amino acid sequences of SElW and other serotype enterotoxins were aligned. The primers were designed to amplify selw, and the fragment was recombined into the pMD18-T vector and sequenced. Then recombinant plasmid pMD18-T was digested with BamHⅠand Hind Ⅲ. The target fragment was recombined into the expression plasmid pET-28a(+). After identification of the recombinant plasmid, the protein expression was induced by isopropyl-beta-D- thiogalactopyranoside. The SElW expressed in the supernatant was purified by affinity chromatography and quantified by the BCA method. Results: The predicted three-dimensional structure showed that the SElW protein was composed of two domains, the amino-terminal and the carboxy-terminal. The amino-terminal domain was composed of 3 α-helices and 6 β-sheets, and the carboxy-terminal domain included 2 α-helices and 7 antiparallel β-sheets composition. The overall quality factor score of the SElW protein model was 98.08, with 93.24% of the amino acids having a Verify_3D score ≥0.2 and no amino acids located in disallowed regions. The docking conformation with the highest score (1 521.328) was selected as the analysis object, and the 19 hydrogen bonds between the corresponding amino acid residues of SElW and TCR were analyzed by PyMOL. Combined with sequence alignment and the published data, this study predicted and found five important superantigen active sites, namely Y18, N19, W55, C88, and C98. The highly purified soluble recombinant protein SElW was obtained with cloning, expression, and protein purification. Conclusions: The study found five superantigen active sites in SElW protein that need special attention and successfully constructed and expressed the SElW protein, which laid the foundation for further exploration of the immune recognition mechanism of SElW.
Humans ; Enterotoxins/genetics* ; Superantigens/genetics* ; Catalytic Domain ; Selenoprotein W/metabolism* ; Receptors, Antigen, T-Cell

OBJECTIVE: To explore a surgical method for the reconstruction of volar soft tissue defect and sensory and vascular repair in middle and far phalangeal digits. METHODS: From January 2016 to January 2020, a total of 14 patients , 9 males and 5 females, ages ranging from 22 to 69 years old, and with volar soft tissue defects in the middle and distal digits 2 to 4, underwent surgical reconstruction using the V-Y shaped flap with digital artery and nerve at the metacarpophalangeal joint. The defect area was (2.0~2.5) cm×(1.5 ~2.0) cm. The procedure involved the harvest of a V-Y shaped flap with the digital artery and nerve from the metacarpophalangeal joint. Flap design, dissection of blood vessels and nerves, and anastomosis with the digital artery and nerve were performed according to a standardized protocol., Functional exercise of affected finger was initiated 3 weeks postoperatively. Subsequent assessments were conducted to evaluate finger pulp sensation, shape and other relevant parameters. According to the upper extremity functional evaluation standard set up by Hand Surgery Branch of Chinese Medical Association, the surgical outcomes were evaluated. RESULTS: All 14 cases demonstrated successful tissue transplantation, , with immediate recovery of sensation observed in 10 cases with distal finger pulp defects. Four patients with middle phalangeal defects experienced gradual sensory recovery within 2 to 3 months postoperatively. Thirteen patients were followed up for a mean duration of (8.8 ± 4.49) months, during which satisfactory outcomes were observed. The average two-point resolution of the finger pulp was 4-6mm, and sensory function evaluation yielded a score of S3 or above. Patients exhibited realistic finger shape, normal skin color and temperature, good wear resistance, and cold resistance. Furthermore, finger joint function was essentially normal. CONCLUSION The V-Y shaped flap with digital artery and nerve at the metacarpophalangeal joint offers a suitable solution for repairing the defect of the middle or distal phalangeal finger. This technique is characterized by its simplicity, low risk, and favorable outcomes, including restored finger shape, blood supply and sensation. Moreover, high patient satisfaction was achieved.
Male ; Female ; Humans ; Young Adult ; Adult ; Middle Aged ; Aged ; Plastic Surgery Procedures ; Skin Transplantation ; Finger Injuries/surgery* ; Treatment Outcome ; Soft Tissue Injuries/surgery* ; Fingers/surgery* ; Ulnar Artery/surgery* ; Metacarpophalangeal Joint/surgery*

Diabetes mellitus complicated with cerebral infarction is the commonest and most serious vascular complication of diabetes mellitus. With a high disability and mortality rate, it seriously threatens human health. Because the pathogenesis is still unclear, more and more scholars have focused on the research of diabetic cerebral infarction at home and abroad. Traditional Chinese medicine(TCM) compounds have a remarkable curative effect in the treatment of diabetic cerebral infarction. Its mechanisms of action mainly include anti-hypertension, reduction of blood sugar and lipid, promotion of vascular regeneration and vascular endothelial function, anticoagulation, anti-thrombosis, improvement of nerve function defect, reduction of infarct volume, improvement of hemorheological, inhibition of inflammation and platelet aggregation, and promotion of collateral circulation. Through literature search, this paper summarizes the research progress of the mechanisms of TCM compounds in treating diabetic cerebral infarction in recent five years at home and abroad, in order to provide reference for clinical treatment.

BACKGROUND AND OBJECTIVES: To find more accurate way to determine the location of parotid tumors that cross anatomical criteria for the facial nerve (FN). SUBJECTS AND METHOD: Two hundred patients were included in the study and retrospectively studied. Five anatomical criteria were used to predict the location of parotid tumors on computed tomography (CT). Deep portion of tumors was measured and then, cut-off value was obtained after receiver operator curve analysis. The location of tumor was predicted by using the cut-off value and by the conventional way, in which the side where most of the tumor is located is determined as the tumor site. RESULTS: The parotid tumors were located in superficial lobes in 148 cases, and in deep lobes in 52 cases by operative record. The tumors that cross the anatomical criteria were defined as ‘crossing tumor.’ The cut-off values for prediction of ‘crossing tumor’ location on CT were 6.7 mm for anatomical line, 6.4 mm for FN line, 11.2 mm for retromandibular vein, 4.9 mm for Utrecht line and 3.8 mm for Conn's arc. The accuracy of 5 anatomical criteria for ‘crossing tumor’ was between 55.9% and 81.6% when the cut-off value was used, whereas the accuracy was between 25.7% and 68.9% when conventional way was used. CONCLUSION: In cases of ‘crossing tumor,’ the cut-off value obtained by measurement of deep portion of tumor can be applied to improve the diagnostic performance for the prediction of tumor location.
Facial Nerve ; Humans ; Methods ; Parotid Gland ; Parotid Neoplasms ; Retrospective Studies ; Veins

BACKGROUND AND OBJECTIVES: To find more accurate way to determine the location of parotid tumors that cross anatomical criteria for the facial nerve (FN).SUBJECTS AND METHOD: Two hundred patients were included in the study and retrospectively studied. Five anatomical criteria were used to predict the location of parotid tumors on computed tomography (CT). Deep portion of tumors was measured and then, cut-off value was obtained after receiver operator curve analysis. The location of tumor was predicted by using the cut-off value and by the conventional way, in which the side where most of the tumor is located is determined as the tumor site. RESULTS: The parotid tumors were located in superficial lobes in 148 cases, and in deep lobes in 52 cases by operative record. The tumors that cross the anatomical criteria were defined as ‘crossing tumor.’ The cut-off values for prediction of ‘crossing tumor’ location on CT were 6.7 mm for anatomical line, 6.4 mm for FN line, 11.2 mm for retromandibular vein, 4.9 mm for Utrecht line and 3.8 mm for Conn's arc. The accuracy of 5 anatomical criteria for ‘crossing tumor’ was between 55.9% and 81.6% when the cut-off value was used, whereas the accuracy was between 25.7% and 68.9% when conventional way was used. CONCLUSION In cases of ‘crossing tumor,’ the cut-off value obtained by measurement of deep portion of tumor can be applied to improve the diagnostic performance for the prediction of tumor location.

Objective To study the effects of traditional Chinese medicine (TCM) five-tone therapy on nursing care of patients with irritable bowel syndrome (IBS).Methods By convenience sampling,a study was conducted among 100 patients with IBS.The patients were randomly divided into the control group and the intervention group,each group consisted of 50 patients.Patients in two groups were both treated with conventional drug and routine nursing care,but patients in the intervention group were intervened by TCM five-tone therapy for 3 months.Clinical efficiency of patients in two groups were assessed by Symptoms Check List-90 (SCL-90),Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD)before treatment and after 12-week treatment.Results The clinical efficiency in the control group and intervention group were 60％ (30/50) and 84％ (42/50) after intervention (P＜0.05).The scores of HAMA and HAMD after TCM five-tone therapy intervened were (5.24±1.15)points and (5.21±1.63) points,which were lower than the control group (8.32±1.42)points and (7.64±1.96) points (P＜0.05).The intervention group was scored lower than the control group in SCL-90 (P＜0.05).Conclusions TCM five-tone therapy may be more effective in decreasing the depression and anxiety of patients with IBS and alleviating their abdominal symptoms.

Objective To explore the effects of traditional Chinese medicine (TCM) five-tone therapy in combination with constitutional types of Chinese medicine based dietary intervention on patients with irritable bowel syndrome (IBS). Methods By convenience sampling, a study was conducted among 68 patients with IBS. The patients were divided into the control group and the intervention group by random digital table method, and each group consisted of 34 patients. Patients in two groups were both treated with conventional drug and routine nursing care, but patients in the intervention group were provided TCM five-tone therapy in combination with constitutional types of Chinese medicine based dietary intervention for 3 months. Patients in two groups were assessed by Chinese Medicine Constitution Questionnaire (CMCQ), Symptom Check List-90 (SCL-90), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) before treatment and after 12-week treatment. Results After TCM five-tone therapy in combination with constitutional types of Chinese medicine based dietary intervention, the number of IBS patients with pathological constitution types decreased in two groups, the number of patients with gentleness constitution increased to 8 and 25 separately in the control group and intervention group (P<0.05). After intervention, the scores of SAS and SDS in the intervention group were (40.73±8.27)points and (41.16±8.75)points respectively, which were lower than(48.36±7.53)points and(50.03±9.23)points of the control group, and the difference was statistically significant (P< 0.05). The intervention group scored lower than the control group in SCL-90, and the scores had significant differences between two groups (P<0.05). Conclusions TCM five-tone therapy in combination with constitutional types of Chinese medicine based dietary intervention may be more effective in adjusting pathological constitution to gentleness constitution of patients with IBS, alleviating their depression and anxiety and improving their physiological symptoms.

Objective To explore the effects of “Trinity” medical nursing practice teaching system on core competence of nursing students. Methods We utilized sampling method to select 280 undergraduate students of 2010 grade which was divided into experimental group (“Trinity” medical nursing practice teaching system) and control group ( traditional practice teaching method ) . After the course, we compared the examination scores of ‘Medical Nursing’, self-assessment of nursing students, and feedback of doctors and teachers from interning departments. Results In the experimental group, the theory and skill scores of‘Medical Nursing’were(82.5±6.5)and(83.6±7.2)thatallwerehigherthanthoseofthecontrolgroup(t=8.26, 7. 67;P<0. 01);the nursing students of experimental group was better than that of the control group at aspects of self-assessment and feedback of doctors and teachers from interning departments (P<0. 05). Conclusions The“Trinity” medical nursing practice teaching system can optimize instructional resources and promote the core competence of nursing students.