Objective To systematically evaluate the efficacy and safety of three-dimensional visualization technology in assisting ablation therapy for hepatocellular carcinoma.Methods This study was conducted according to PRISMA guidelines,with a PROSPERO registration number of CRD42023488398.PubMed,Embase,Web of Science,the Cochrane Library,CNKI,Wanfang Data,VIP,and CBM were searched for Chinese and English articles on three-dimensional visualization technology in assisting ablation therapy for hepatocellular carcinoma published up to March 2023.After quality assessment and data extraction of the studies included,RevMan 5.4 software was used to perform the meta-analysis.Results A total of 11 studies were included,with 972 patients in total,among whom 447 underwent ablation assisted by three-dimensional visualization technology(3D group)and 525 underwent ablation assisted by traditional two-dimensional imaging technology(2D group).The meta-analysis showed that compared with the 2D group,the 3D group had significantly higher success rate of first-time ablation treatment(odds ratio[OR]=5.43,95%confidence interval[CI]:2.64—11.18,P<0.001),technical efficiency(OR=6.15,95%CI:3.23—11.70,P<0.001),and complete ablation rate(OR=2.50,95%CI:1.08—5.78,P=0.03),as well as significantly lower incidence rate of major complications(OR=0.45,95%CI:0.24—0.87,P=0.02),local recurrence rate(OR=0.35,95%CI:0.17—0.72,P=0.004),and local tumor progression rate(OR=0.29,95%CI:0.16—0.50,P<0.001),while there was no significant difference in the incidence rate of mild complications between the two groups(P>0.05).Conclusion Three-dimensional visualization technology is safe and feasible in assisting ablation therapy for hepatocellular carcinoma and can improve ablation rate and reduce the incidence rate of serious complications,local recurrence rate,and local tumor progression rate,thereby showing an important application value in clinical practice.

Objective:To evaluate the predictive value of mechanical power (MP) on the risk of in-hospital mortality in critical ill patients in emergency department.Methods:A total of 105 critical ill patients with invasive mechanical ventilation in the Department of Emergency of Second Affiliated Hospital of Guangzhou Medical University between December 1, 2017 and October 31, 2020 were retrospectively analyzed. Based on the clinical prognosis, the patients were divided into the in-hospital survival group (80 patients) and the in-hospital death group (25 patients). The clinical data and ventilator parameters were recorded, and the MP of the two groups was calculated in order to assess the predictive efficacy of MP on in-hospital death.Results:Compared to the in-hospital death group, the oxygenation index PaO 2/FiO 2 was significantly higher (271 mmHg vs. 217 mmHg, P=0.020) and blood lactate (1.59 mmol/L vs. 2.56 mmol/L, P<0.001) and procalcitonin (0.31 ng/mL vs. 3.55 ng/mL, P=0.028), minute ventilation (7.03 L/min vs.8.32 mmol/L, P=0.013), MP (14.37 J/min vs. 16.12 J/min, P=0.041), SOFA score (5 vs. 8, P=0.001) and APACHE II score (16 vs. 22, P=0.041) were significantly lower in the in-hospital survival group. Multivariate Logistic regression analysis showed that PaO 2/FiO 2( OR=1.015, P=0.044), MP ( OR=1.813, P=0.039) and SOFA score( OR=2.651, P=0.010) were independent risk factors for predicting hospital mortality in patients with mechanical ventilation. The areas under the ROC curves (AUC) were 0.62, 0.63 and 0.75, respectively. Moreover, the MP combined with SOFA score for predicting in-hospital death was significantly higher than that of MP alone (0.77 vs. 0.63, P<0.05). Conclusions:MP is associated with in-hospital death in patients with invasive mechanical ventilation in emergency department. MP combined with SOFA score can enhance its predictive efficacy

Objective:To observe the effect of a modified version of high-intensity interval training (HIIT) on the rehabilitation of persons with coronary artery disease (CAD), and to evaluate its safety and patient compliance.Methods:Sixty CAD patients were randomly divided into an exercise group and a control group, each of 30. Both groups were given conventional cardiac rehabilitation (including controlled nutrition, psychological counseling and low-intensity aerobic exercise). The exercise group additionally completed a session of HIIT twice a week for 6 weeks. Each session involved 30s of cycling at 85-90% of the patient′s maximum heart rate followed by 30s rest, repeated 15 times. The cardiorespiratory fitness, blood pressure, vascular function and body composition of both groups were documented before and after the 6 weeks. Compliance was recorded and the safety of the modified HIIT program was evaluated.Results:A significant improvement was observed in the maximum oxygen uptake and workload in a graded exercise test among the exercise group. The average blood pressure and body composition improved significantly, as did the average positive mood score and enjoyment of training. There was a significant decrease in negative mood and anxiety scores among the exercise group. No significant differences were observed in the control group. Compliance with the HIIT training program of the exercise group (97.4%) was significantly better than the control group′s compliance (88.7%) with its less strenuous regimen. There were no serious adverse reactions or cardiovascular events during the experiment.Conclusion:Modified HIIT is an effective form of cardiac rehabilitation training for CAD. It is safe, and compliance is good.

Objective:To investigate the clinical effect of static staple in the treatment of metatarsal neck fracture.Methods:The clinical data of 34 patients with the 2 nd to 5 th metatarsal neck fracture admitted to the Department of Orthopaedic Surgery, Tianjin Fifth Central Hospital from January 2017 to December 2018 were retrospectively analyzed.Seventeen patients were treated with static staple and 17 with retrograde Kirschner wire.In solustaple group, there were 11 males, 6 females, aged 34.6 years (range: 21 to 50 years), 10 cases on the right side, 7 cases on the left side.In retrograde Kirschner wire group, there were 12 males and 5 females, aged 36.2 years (range: 23 to 53 years), 9 on the right and 8 on the left.The fracture healing time was recorded and the postoperative complications were counted.The American Orthopedic Foot and Ankle Society Score (AOFAS) forefoot score, visual analogue scale (VAS), and the active flexion and extension range of metatarsophalangeal joints were measured to compare the clinical efficacy of the two groups.The data were compaired by t test, non-parametric or χ 2 test. Results:All patients were followed up for 14.2 months (range: 12 to 17 months).All the fractures were healed and there was no statistically significant difference between solustaple group and retrograde Kirschner wire group in fracture healing time ((11.2±2.1) week vs.(11.5±3.1) week, t=0.030, P=0.743).There was no statistically significant difference between VAS (1.00 (1.00) vs.1.00 (1.50) M( QR), Z=-0.443, P=0.658) and AOFAS scores(90.9±5.3 vs. 88.6±6.1, t=1.174, P=0.249) at the last follow-up. The difference in active dorsiflexion((35.1±4.3)° vs.(31.2±6.4)°, t=2.055, P=0.048) and flexion range of motion ((34.7±4.5)° vs. (30.2±5.3)°, t=2.681, P=0.011) between the two groups was statistically significant. One case of open fracture in the Solustaple group had local skin necrosis, and three patients had metatarsal pain after weight-bearing walking. Four patients in the retrograde Kirschner wire group developed metatarsalgia after weight-bearing walking, and two patients developed mild dorsal extension contracture and joint pain. Conclusions:The treatment of the 2 nd to 5 th metatarsal neck fracture by static staple is minimally invasive and firmly fixed. It can effectively reduce the complications of tendon and joint adhesion, and is beneficial to the fracture healing and joint function recovery.

Objective:To investigate the clinical effect of static staple in the treatment of metatarsal neck fracture.Methods:The clinical data of 34 patients with the 2 nd to 5 th metatarsal neck fracture admitted to the Department of Orthopaedic Surgery, Tianjin Fifth Central Hospital from January 2017 to December 2018 were retrospectively analyzed.Seventeen patients were treated with static staple and 17 with retrograde Kirschner wire.In solustaple group, there were 11 males, 6 females, aged 34.6 years (range: 21 to 50 years), 10 cases on the right side, 7 cases on the left side.In retrograde Kirschner wire group, there were 12 males and 5 females, aged 36.2 years (range: 23 to 53 years), 9 on the right and 8 on the left.The fracture healing time was recorded and the postoperative complications were counted.The American Orthopedic Foot and Ankle Society Score (AOFAS) forefoot score, visual analogue scale (VAS), and the active flexion and extension range of metatarsophalangeal joints were measured to compare the clinical efficacy of the two groups.The data were compaired by t test, non-parametric or χ 2 test. Results:All patients were followed up for 14.2 months (range: 12 to 17 months).All the fractures were healed and there was no statistically significant difference between solustaple group and retrograde Kirschner wire group in fracture healing time ((11.2±2.1) week vs.(11.5±3.1) week, t=0.030, P=0.743).There was no statistically significant difference between VAS (1.00 (1.00) vs.1.00 (1.50) M( QR), Z=-0.443, P=0.658) and AOFAS scores(90.9±5.3 vs. 88.6±6.1, t=1.174, P=0.249) at the last follow-up. The difference in active dorsiflexion((35.1±4.3)° vs.(31.2±6.4)°, t=2.055, P=0.048) and flexion range of motion ((34.7±4.5)° vs. (30.2±5.3)°, t=2.681, P=0.011) between the two groups was statistically significant. One case of open fracture in the Solustaple group had local skin necrosis, and three patients had metatarsal pain after weight-bearing walking. Four patients in the retrograde Kirschner wire group developed metatarsalgia after weight-bearing walking, and two patients developed mild dorsal extension contracture and joint pain. Conclusions:The treatment of the 2 nd to 5 th metatarsal neck fracture by static staple is minimally invasive and firmly fixed. It can effectively reduce the complications of tendon and joint adhesion, and is beneficial to the fracture healing and joint function recovery.

Objective To explore the association between white matter hyperintensities volume and cognitive function in patients with hypertension.Methods Eighty-two patients with hypertension enrolled from the Department of Neurology of Nanjing Drum Tower Hospital from January 2017 to December 2017 were recruited in this study sequentially,who aged between 50 and 80 years.All subjects used automatic white matter quantitative technique to get their personal whole white matter hyperintensities volume,periventricular white matter hyperintensities volume and deep white matter hyperintensities volume.Neuropsychological scales were used to evaluate their global cognitive function,memory function,fluency,executive function and processing speed.The association between white matter hyperintensities volume and cognitive function via linear regression analysis was assessed.To explore whether the association between white matter hyperintensities volume and cognitive function be affected by the duration of hypertension,stratification analyses were conducted using the median of the duration of hypertension as separation.Results After adjusting for age,sex,education,lacunar infarctions and global cortical atrophy grade,the Trail Marking Test (2-1) score which reflects executive function was found to be related to whole white matter hyperintensities volume (standardized beta-value=0.268,P=0.019),periventricular white matter hyperintensities volume (standardized beta-value=0.243,P=0.037) and deep white matter hyperintensities volume (standardized beta-value=0.243,P=0.021).Victorial Snoop Test-2 score which reflects processing speed was found to be related to periventricular white matter hyperintensities volume (standardized beta-value=0.270,P=0.023).After additional adjusting for the duration of hypertension,the Trail Marking Test (2-1) score was still found to be related to whole white matter hyperintensities volume (standardized beta-value=0.277,P=0.016),periventricular white matter hyperintensities volume (standardized beta-value=0.251,P=0.032) and deep white matter hyperintensities volume (standardized beta-value=0.248,P=0.019).The Victorial Stroop Test-2 score was found to be related to whole white matter hyperintensities volume (standardized beta-value=0.237,P=0.041) and periventricular white matter hyperintensities volume (standardized beta-value=0.290,P=0.013).Conclusion Whole white matter hyperintensities volume,periventricular white matter hyperintensities volume and deep white matter hyperintensities volume are related to executive function,periventricular white matter hyperintensities volume is also related to processing speed in patients with hypertension,and the association between white matter hyperintensities volume and cognitive domain is not influenced by the duration of hypertension.

Objectives: To explore the expression regulation of type 1 and type 2 (Th1 and Th2) cytokines from serum of coal miners and the evaluation in surveillance of coal workers' pneumoconiosis, 630 coal miners were studied. Methods: A total of 90 male patients diagnosed as coal workers' pneumoconiosis (CWP) in a institute for occupational health and 19 male workers newly diagnosed as CWP patients was chosen as CWP group with simple random sampling method from a coal mine group from January 2013 to December in 2015. 180 male coal miners with abnormal but not diagnosed as CWP were selected as CWP suspected group with simple random sampling methods, meanwhile 180 male coal miners with normal chest X-ray photograph was as dust-exposed group by 1∶1 matched as age. And 161 healthy males accepted pre-employed examination were selected as control group, CWP suspected group, dust-exposed group and control group called as non-CWP group. According to screening test and diagnosis test, the basic information and occupational history of all subjects were collected, and cytokines including IL-1β, IL-8, IFN-γ, IL-6 and IL-10 of serum were detected. Receiver operator characteristic (ROC) curve was used to determine the optimal cutoff value of each cytokine. Area under curve (AUC), the validity and reliability were calculated and judged. Results: The average age of control group, dust-exposed group, CWP suspected group and CWP group were (27.4±5.0) , (43.4±10.7) , (48.2±6.2) , (64.7±7.0) years old, respectively. The median level of IL-1β, IL-8, IFN-γ and IL-6 in cases group (1 638.30, 2 099.49, 815.18,140.32 pg/ml) were higher than that of non-cases group (1 445.57, 1 402.26, 736.38, 95.73 pg/ml) (P<0.05) . The level of IL-8 (1 503.99 pg/ml) in CWP suspected group was higher than that of control group (1 295.67 pg/ml) and dust-exposed group (1 376.94 pg/ml) , but the level of IL-10 (654.08 pg/ml) was lower than that of control group (596.64 pg/ml) . The ratio of IFN-γ/IL-6 ranged from 5 to 8, and the ratio in CWP group (5.87) was lower than that of non-CWP group (7.61) . The IL-6 and IL-8 among the subjects of dust-exposed group in terms of the age distribution of among had reached statistical significance. According to ROC, the cutoff value of IL-1β, IL-6, IL-8, IL-10 and INF-γ reached 1 582.65, 116.53, 1 791.54, 581.08 and 792.69 pg/ml, respectively. The AUC was 0.668, 0.895, 0.859, 0.716 and 0.637, respectively. It was found that IL-6 and IL-8 could be used as biomarkers in detecting CWP, the sensitivity and specificity was 82.6% and 84.6%, 78.0% and 84.8%, respectively; Youden's index was 0.674 and 0.628 and the consistency rate was 84.3% and 83.7%, while Kappa value was 0.55 and 0.52. Conclusion There was Type 1 and type 2 cytokine dysregulation in CWP patients. IL-6 and IL-8 can be used as effective biomarkers to forecast lung injury before X-ray changes.

Objective To contrast and compare two surgical treatments for mucous cysts of the distal interphalangeal joint.Methods Clinical data from April 2004 to January 2016 were retrospectively analyzed.Patients who underwent tumor excision,osteophyte excision,and local flap coverage were assigned into a flap group(n=16),while patients who received osteophyte excision,cyst pedicle resection,and cystic fluid drainage were assigned into a simple osteophyte resection group(n=17).Procedure time,pain,satisfaction score,and hand function were compared between the two groups.Results Patients in the flap group were followed up for 14 to 28 months(mean=19.5 months);the simple osteophyte resection group for 15 to 26 months(mean=20.5 months).There was no recurrence in either group.The rate of excellent efficacy was 81.25 ％ (13/16)for the skin flap group and 82.35 ％ (14/17) for the simple osteophyte resection group,and the difference was not statistically significant(x2=0.007,P ＞ 0.05).Pain relief was achieved in both groups after operation,and the postoperative satisfaction score was higher than the pre-operation score.There was no statistical difference in pre operation pain and satisfaction scores (t 0.14 and 0.35,both P ＞ 0.05),no statistical difference in postoperative pain scores(t =-0.09,P ＞ 0.05),but a statistically significant difference in postoperative satisfaction scores (t =-4.15,P ＜ 0.05) between the two groups.Conclusions Two surgical treatments of mucous cysts can achieve satisfactory aesthetic and clinical outcomes.The simple osteophyte resection method is characterized by a short procedure time and a high level of postoperative satisfaction,but it requires training in microsurgery.Local flap coverage is simple and suitable for lower level hospitals where staff surgeons may lack microsurgical skills,but it may result in certain minor injuries.

Objective To analyze the occurrence features of the active surveillance of adverse events following immu?nization (AEFI) in Tianjin, and evaluate the sensitivity of passive surveillance systems over the same period. Methods The layered eight vaccination clinics of four counties were selected as active surveillance points. The data of active surveillance AEFI were collected through telephone investigation in 2011-2013. The data of passive surveillance was collected through the national AEFI information management system. The descriptive methodology and chi square test were used. Results A total of 235 cases were collected through active surveillance in 2011-2013. The AEFI incidence rate was 718.70 per 100 000 doses,no difference in the incidence between three years(χ2=5.07). A total of 4164 cases were collected through passive sur?veillance. The incidence rate was 34.09 per 100 000 doses,the incidence increased year by year(χ2=572.02,P<0.05). In ac?tive surveillance cases, 95.32%was the common vaccine reaction, 3.83%was the rare vaccine reaction, no serious vaccinereaction. In passive surveillance cases, the common vaccine reaction, the rare vaccine reaction were 85.09%and 13.32%. The serious vaccine reaction was found in 44 cases. Conclusion The more slightly common vaccine reaction can be found by active surveillance. The sensitivity of Tianjin passive surveillance system is increasing year by year, which can meet the requirements for job. The classification and diagnostic criteria of the serious vaccine reaction need to be established.

OBJECTIVEHepatitis A immunization strategies were carried out in 2001 in Tianjin. We wanted to evaluate the effectiveness of the strategies related to hepatitis A control programs and to provide the basis for further modification of the strategies.

METHODSDescriptive epidemiology study was used to analyze the hepatitis A epidemic situation in 2000-2011 in Tianjin and to evaluate the disease reporting system. Hepatitis A vaccine coverage of target population and serum epidemiological study were carried out in 1999, 2005 and 2010 to check on the hepatitis A antibody levels so as to evaluate the immuno-barrier condition in the normal population. Cox-Stuart test was used to analyze the epidemic trend of hepatitis A and other intestinal infectious diseases in Tianjin.

RESULTSThe incidence rate of hepatitis A decreased from 2.89/100 000 in 2000 to 0.12/100 000 in 2011, and the percentage of hepatitis A in all types of viral hepatitis decreased from 8.02% in 2000 to 0.48% in 2011 in Tianjin. The positive rates of hepatitis A antibody also increased in the residents.

CONCLUSIONThe hepatitis A vaccination program was successful in the programs on prevention and control of hepatitis A in Tianjin, China.

China ; epidemiology ; Epidemics ; prevention & control ; Hepatitis A ; epidemiology ; prevention & control ; Hepatitis A Antibodies ; blood ; Hepatitis A Vaccines ; administration & dosage ; Humans