Animals ; SARS-CoV-2 ; Antibodies, Neutralizing ; Macaca mulatta ; COVID-19/prevention & control* ; Antibodies, Viral ; Vaccines

Objective:To investigate the application value of Overlap guiding tube (OGT) in Overlap esophagojejunostomy of laparoscopic total gastrectomy.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 5 patients with gastric cancer who were admitted to Nanfang Hospital of Southern Medical University from June to July in 2021 were collected. There were 3 males and 2 females, aged from 48 to 61 years, with a median age of 54 years. Patients underwent laparoscopic total gastrectomy combined with OGT-assisted Overlap esophagojejunostomy. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted by outpatient examination and telephone interview to detect postoperative anastomotic stenosis and esophageal reflux up to September 2021. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(IQR) or M(range). Count data were represented as absolute numbers. Results:(1) Surgical situations: 5 patients underwent laparoscopic total gastrectomy combined with OGT-assisted Overlap esophagojejunostomy and D 2 lymph node dissection success-fully, achieving R 0 resection. There was no combined organ resection, intraoperative conversion to laparotomy or combined thoracotomy. There was no intraoperative conversion to other esophagoje-junostomy method either. The tumor diameter, length of surgical incision, the number of lymph nodes dissected, time of esophagojejunal anastomosis, time of digestive reconstruction, operation time, volume of intraoperative blood loss of 5 patients were 3.0(2.8)cm, 5.0(2.0)cm, 47.0(21.0), 21.0(5.0)minutes, 62.0(23.0)minutes, 295.0(75.0)minutes, and 50.0(60.0)mL, respectively. The anvil fork of linear stapler was successfully inserted into esophageal lumen by once operation in 4 cases of 5 patients and by twice operation in 1 case to complete the esophagojejunostomy. (2) Post-operative situations: the time to first out-of-bed activities, time to postoperative first anal flatus, time to postoperative initial liquid diet intake, time to postoperative initial semi-liquid diet intake, time to abdominal drainage tube removal, duration of postoperative hospital stay of 5 patients were 2.0(1.0)days, 3.0(2.0)days, 4.0(3.0)days, 6.0(3.0)days, 7.0(4.0)days, and 9.0(6.0)days, respectively. Results of postoperative pathological examination of 5 patients showed gastric adenocar-cinoma in all the 5 patients, with the TNM staging as stage pT2-4aN0M0. The esophageal surgical margin was negative in all cases, and the length of proximal margin from esophagus was 5.0(4.0)cm. None of the 5 patients developed anastomotic leakage, anastomotic bleeding or anastomotic stenosis. Two cases with mild pneumonia (Clavien-Dindo grade Ⅱ) were cured by conservative treatment such as anti-infection and expectoration promotion. There was no unplanned secondary surgery or perioperative death occurred to the 5 patients. (3) Follow-up: 5 patients were followed up for 3 months. None of the 5 patients developed anastomotic stenosis or esophageal reflux during the follow-up. Conclusion:OGT-assisted Overlap esophagojejunostomy of laparoscopic total gas-trectomy is safe and feasible, with good short-term effects.

Allografts ; COVID-19 ; China/epidemiology* ; Disease Outbreaks ; Humans ; Kidney Transplantation/adverse effects* ; SARS-CoV-2

Objective:To study the risk factors of necrotizing enterocolitis (NEC) after surgery for intestinal atresia.Method:From August 2013 to June 2020, children with intestinal atresia receiving surgery in our hospital were retrospectively reviewed. The patients were assigned into NEC group and non-NEC group according to the occurrence of postoperative NEC. Demographic data and clinical characteristics were summarized and the risk factors for postoperative NEC were analyzed using Logistic regression analysis method.Result:A total of 96 infants were enrolled and NEC occurred in 13 patients (13.5%) after surgery for intestinal atresia. Compared with the non-NEC group, the NEC group were diagnosed of intestinal atresia [4.0(1.5,6.0)d vs. 1.4(0,2.0)d, P<0.001] and received surgery [4.8(2.0,7.0)d vs. 3.1(1.0,4.0)d, P=0.034] at later ages. The incidences of complex intestinal atresia [76.9%(10/13) vs. 44.6%(37/83), P=0.030] and blood transfusion [46.2%(6/13) vs. 13.3%(11/83), P=0.007] in the NEC group were higher than the non-NEC group. Logistic regression analysis showed that the age of initial diagnosis of intestinal atresia ( OR=3.346, 95% CI 1.493~7.500, P=0.003), complex intestinal atresia ( OR=9.052, 95% CI 1.119~73.209, P=0.039) and blood transfusion ( OR=6.835, 95% CI 1.399~33.380, P=0.018) were independent risk factors for postoperative NEC. Conclusion:Patients with delayed diagnosis of intestinal atresia, complex intestinal atresia and blood transfusion within 48 hours after surgery should be monitored for the occurrence of postoperative NEC.

Objective:To explore the relationship between work stress, sense of coherence (SOC) and compassion fatigue (CF) among oncological nurses, and to study the mediating role of SOC between work stress and CF in oncological nurses.Methods:Totally 370 oncological nurses from 7 ClassⅢ Grade A hospitals in Anhui Province between November 2019 and January 2020 were conveniently selected and investigated with the Chinese Nurse Work Stressor Scale, Sense of Coherence Scale-13, Professional Quality of Life and the general information questionnaire. AMOS 21.0 and SPSS 23.0 were used for statistical analysis of the data. A total of 370 questionnaires were distributed and 345 valid questionnaires were returned.Results:The work stress of oncological nurses was negatively correlated with their SOC ( r=-0.547, P<0.01) , and positively correlated with job burnout and secondary trauma ( r=0.607, 0.418; P<0.01) ; SOC was negatively correlated with job burnout and secondary trauma ( r=-0.581, -0.405; P<0.01) . SOC played a mediating role between the work stress, job burnout and secondary trauma of oncological nurses, and the mediating effect accounted for 45.81% and 33.82% of the total effect, respectively. Conclusions:SOC is a mediating variable between the work stress and CF of oncological nurses. Actively assessing the level of nurses' SOC and providing interventions are helpful to reduce CF caused by work stress.

With the rapid development of organ transplantation in China,the donation after cardiac death (DCD) donor organs are widely used.However,the quality of these organs is relatively poor,so the way to preserve and maintain organ still remains a severe problem.Among them,ischemic reperfusion injury (IRI) impairs the organs severely.Acetaldehyde dehydrogenase 2 (ALDH2) protects organs from stress conditions,including ischemia-reperfusion injury,and the activation and autophagy inhibition also protects the organs from stress conditions as well.Recent studies showed that ALDH2 can regulate autophagy to inhibit the organ injury during ischemia-reperfusion.Our study aims to discuss the new findings in this mechanism.

Objective To observe the effect of intrathecal injection of TRESK overexpression adenoviruson phosphorylation of JNK and apoptosis of neurons in neuropathic pain rats.Methods Seventy-two male SD rats were randomly divided into six groups:groups C,S,NP,T,V,and NS,12 for each group.SNI was administrated to rats in groups NP,T,V and NS.TRESK adenovirus and negative virus were intrathecally injected after use of SNI in groups T and V,while equal volume of NS was injected to rats in group NS.MWT and TWL were measured at 1 day before operation(baseline,BL)and at 1,3,7 and 14 days after operation (days 1,3,7,and 14).Six rats in each group were sacrificed at D7 to determinate the expression of TRESK protein of DRG.The other rats were sacrificed at D14 to determinate neural apoptosis and the expressions of caspase3 and p-JNK of DRG.Results As compared with groups C,S and T,the expression of TRESK protein was significantly decreased at D7 in groups NP,NS and V (P＜0.05).Compared with groups C and S,MWT was significantly decreased at days 1,3,7 and 14 (P＜0.05),phosphorylation of JNK in DRG was significantly increased at D14 (P＜0.05),neuronal apoptosis rate and expressions of Caspase3 of DRG were significantly increased at D14 (P＜0.05) in groups NP,T,NS and V.Compared with groups NP,V and NS,MWT was significantly increased at time points of days 1,3,7 and 14 in group T (P＜0.05),phosphorylation of JNK of in DRG was significantly decreased at D14 in group T (P＜0.05),neuronal apoptosis rate and expression of Caspase3 of DRG were significantly decreased at D14 in group T (P＜0.05).Intrathecal injection ofpAd/CMV/VS-DEST-TRESK obviously reduced mechanical hyperalgesia,upregulated TRESK expression,and lowered JNK phosphorylation and NP in SNI rat.Conclusions Intrathecal injection of TRESK over expression adenovirus relieves NP via inhibiting JNK activation and neuronal apoptosis.

Objective To explore the predictive effect of pelvic floor muscle function on stress urinary incontinence (SUI). Methods A total of 258 women in gynecological outpatients at Fuzhou General Hospital were evaluated the pelvic floor muscle function by intravaginal manometery,then all of outpatients were divided into urinary incontinence group and non-incontinence group, and compared pelvic floor muscle function and clinical characteristic to establish prediction model of SUI by classification tree and analyse the predictive role of pelvic floor muscle function for SUI. Results There were significant difference in body mass index [BMI;(22.8±2.9)vs(21.5±2.7)kg/m2, P<0.05], maximum newborn weight [ (3396 ± 424) vs (3284 ± 384) g, P<0.05] between urinary incontinence group (n=114) and non-incontinence group(n=144). However, there were no significant differences in age, parity and mode of delivery between two groups(all P>0.05). There were significant differences(all P<0.01)in maximum vaginal pressure [(21±7)vs(35±9)mmHg(1 mmHg=0.133 kPa)], average pressure [(13±7)vs(23±9) mmHg], fatigue [(-65±20)％ vs(-46±17)％] and collecting time [(1.0±0.6)vs(0.8±0.5)s] between two groups. Prediction model, which obtained by classification tree analysis with the affecting factors of SUI (including BMI, maximum vaginal pressure, fatigue and collecting time), suggested that the incidence of SUI was 88.6％(70 / 79), when maximum vaginal pressure ≤26.2 mmHg. While, when maximum vaginal pressure was greater than 28.2 mmHg, there was no occurrence of SUI(0/7). But it would increase, when BMI >22.6 kg/ m2. Conclusions The occurrence of SUI is related to the BMI and pelvic floor muscles function. It would increase the risk of SUI with vaginal maximum pressure(≤26.2 mmHg)and BMI(>22.6 kg/m2). While there is almost no SUI, while vaginal maximum pressure >28.2 mmHg. To select high-risk group of SUI and intervene early according to the prediction model, which may be make sense of reducing incidence of SUI.

Objective To evaluate transperineal sonography for lower urinary tract symptoms after pelvic floor reconstruction. Methods Eighty-three patients with severe pelvic organ prolapse received surgeries in Fuzhou General Hospital from September 2014 to September 2015, dividing into two groups:27 patients were selected to receive transvaginal mesh (TVM) pelvic floor reconstruction surgery with tension-free vaginal tape-Abbrevo (TVT-Abbrevo) incontinence surgery, named TVM+TVT-Abbrevo group;56 patients were selected to receive TVM pelvic floor reconstruction surgery only, named TVM group. The ultrasonic parameters at rest, on contraction and Valsalva condition respectively were observed and measured, including the bladder neck descent (BND), urethral rotation angle, retrovesical angle, levator urethra gap (LUG), the existence of bladder neck funneling, position of the tape, by using 2D and 3D transperineal ultrasound. Results The two groups were compared with the ultrasonic parameters before and after operation: two groups of patients with postoperative BND [(2.3 ± 0.5) versus (3.1 ± 0.7) cm, (1.6 ± 0.4) versus (3.6±0.4) cm] were significantly reduced, the difference was statistically significant (P=0.02, P<0.01). The two groups of LUG before and after operation [(3.62 ± 0.45) versus (3.26 ± 0.92) cm, (2.96 ± 0.47) versus (2.72 ± 0.38) cm] both had significant difference by maximum Valsalva (P<0.01, P=0.04). There was statistical significance difference of urethral rotation angle in TVM+TVT-Abbrevo group by maximum Valsalva (P=0.01). Observation of morphology:(1) 2 patients with difficulty in urination in TVM+TVT-Abbrevo group, ultrasound showed when the position of the bladder down the urethra discount;4 patients with stress urinary incontinence (SUI), ultrasound showed slings off or release. (2) One patient with difficulty in urination in TVM group, but ultrasound showed lower urinary tract anatomy were normal; 5 patients with SUI, ultrasound showed the position of the bladder neck were significantly lower in 3 patients, showing high mobility, and the other 2 patients had a larger urethral diameter, showing a tendency of natural deletion. Conclusions Anatomy of lower urinary tract could be clearly showed by transperineal sonography. This could provide imaging support for the diagnosis of lower urinary tract symptoms after pelvic floor reconstruction.

Primary hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide and has a relatively high mortality rate.Liver transplantation has become an effective treatment for HCCs,but tumor recurrences after liver transplantation and donor shortages are the major limitations.The Milan criterion was the first standard and has been widely applied to liver transplantation of HCCs.Then,there are new emerging standards,namely University of California,San Francisco criterion (UCSF),Hangzhou and Shanghai criteria.Meanwhile,the comparison among these criteria laid the foundation for early prediction and prevention of post-transplantation tumor recurrence.In this review,clinical effect prediction and tumor recurrence after liver transplantation are also heated issues.