ObjectiveTo systematically review the expression of E-cadherin protein and the risk of pancreatic cancer. MethodsWe searched PubMed, EMbase, The Cochrane Library, CNKI, VIP, CBM and WanFang Data from inception to October 2016 to collect case-control studies about the correlation between E-cadherin protein expression and the risk of pancreatic cancer. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.2 software and Stata 12.0 software. ResultsSeventeen studies (986 cases in pancreatic cancer group and 433 cases in normal pancreatic tissue group) were finally included. The results of meta-analysis showed that: the expression of E-cadherin protein in the pancreatic cancer group was lower than normal tissue group (OR=0.04, 95%CI 0.01 to 0.23, P=0.000 2), poor differentiation group was lower than high or middle differentiation group (OR=0.44, 95%CI 0.26 to 0.76, P=0.003), lymph node metastasis group was lower than without lymph node metastasis group (OR=0.50, 95% CI 0.31 to 0.81, P=0.005), and the difference was statistically significant. However, there was no significant difference between the clinical stageⅠ-Ⅱ group and Ⅲ-Ⅳ group (OR=0.63, 95%CI 0.25 to 1.59, P=0.33), pancreatic head cancer group and pancreatic body and tail cancer group (OR=1.22, 95%CI 0.72 to 2.07, P=0.46), pancreatic cancer with nerve invasion group and without nerve invasion group (OR=1.45, 95%CI 0.81 to 2.62, P=0.21), pancreatic cancer with vascular invasion group and without vascular invasion group (OR=0.55, 95%CI 0.13 to 2.22, P=0.40). ConclusionLower expression of E-cadherin protein is significantly associated with the risk of pancreatic cancer. Due to the limited quality and quanity of includied studies, the above conclusion should be approved by more studies.
Objective To explore the prognostic value of red cell volume distribution width (RDW) for hematological malignancies. Methods PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang, Chongqing VIP, and SinoMed were searched for related literatures on myelodysplastic syndrome, leukemia and other hematological malignancies and pretreatment RDW from the establishment of databases to April 5, 2022. The main statistical indicators were Hazard ratio (HR) and its 95% confidence interval (CI). Stata 12.0 SE software was used for analysis, and Q test was used to evaluate literature heterogeneity. Subgroup pooled analysis was used to evaluate the prognostic value of RDW. Results A total of 7 articles were included, with a total of 804 patients. A fixed-effect model was selected for meta-analysis, and the results showed that patients with elevated pretreatment RDW had worse overall survival [HR=2.91, 95%CI (2.01, 4.22), I2=0%, P=0.714]. The results of subgroup analysis for different types of diseases showed that in myelodysplastic syndrome group [HR=2.61, 95%CI (1.28, 5.31), I2=22.0%, P=0.258)], chronic myeloid leukemia group [HR= 3.24, 95%CI (1.91, 5.51), I2=0%, P=0.546], and adult T-cell leukemia/lymphoma group [HR=2.64, 95%CI (1.22, 5.70)], the overall survival rate of patients with elevated pretreatment RDW were worse. Sensitivity analysis showed that the study was stable and there was no heterogeneity in the overall study result.Conclusion Elevated pretreatment RDW is associated with overall survival and can be used as an indicator for evaluating the prognosis of hematological malignancies, but large sample studies are still needed to determine the best predictive cutoff for various diseases.
The mechanical properties of artificial intervertebral disc (AID) are related to long-term reliability of prosthesis. There are three testing methods involved in the mechanical performance evaluation of AID based on different tools: the testing method using mechanical simulator, in vitro specimen testing method and finite element analysis method. In this study, the testing standard, testing equipment and materials of AID were firstly introduced. Then, the present status of AID static mechanical properties test (static axial compression, static axial compression-shear), dynamic mechanical properties test (dynamic axial compression, dynamic axial compression-shear), creep and stress relaxation test, device pushout test, core pushout test, subsidence test, etc. were focused on. The experimental techniques using in vitro specimen testing method and testing results of available artificial discs were summarized. The experimental methods and research status of finite element analysis were also summarized. Finally, the research trends of AID mechanical performance evaluation were forecasted. The simulator, load, dynamic cycle, motion mode, specimen and test standard would be important research fields in the future.
ObjectivesTo systematically review the association between the SIX6 gene rs10483727 mutation and primary open angle glaucoma (POAG).MethodsPubMed, Web of Science, The Cochrane Library, CNKI, WanFang Data and VIP databases were searched to collect case-control studies on the SIX6 gene rs10483727 polymorphism and primary open angle glaucoma from inception to December 28th, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed by Stata 12.0 software.ResultsSeventeen case-control studies in 16 papers were included, involving 9 886 patients and 19 663 controls. The results of meta-analysis showed that rs10483727 polymorphism in SIX6 gene was associated with the risk of POAG in the Asians and Caucasians. However, no association was found in the Africans.ConclusionsThe current evidence shows that rs10483727 polymorphism in SIX6 gene is associated with the risk of POAG in the Asians and Caucasians.
ObjectiveTo establish and validate a nomogram model for predicting the risk of new-onset postoperative atrial fibrillation (POAF) after isolated aortic valve replacement (AVR). MethodsThe clinical data of patients without atrial fibrillation (AF) who underwent isolated AVR in the General Hospital of the Northern Theater of Command from June 2020 to June 2022 were retrospectively collected. Patients with AVR were divided into a POAF group and a non-POAF group according to whether POAF occurred within 7 days after surgery. The preoperative baseline data, blood indexes, color Doppler echocardiography and the heart rate variability (HRV) in 7 days before surgery were analyzed. Logistic regression was used to analyze the preoperative risk factors for POAF and R language was used to construct a nomogram to predict POAF. The results were compared with the established AF model (POAF-AF score). ResultsA total of 191 patients were enrolled in this study, and 66 (35%) of them developed POAF within 7 days after the surgery. The age of the patients in the POAF group was (60.97±8.41) years and 16 (24%) were female, while the age of the patients in the non-POAF group was (54.65±11.85) years and 59 (47%) were female. Univariate and multivariate logistic regression analysis showed that age, sex, drinking history, chronic obstructive pulmonary disease, plateletocrit and high frequency power were independently associated with POAF after the AVR. The nomogram of POAF was constructed by combining the above independent risk factors. We predicted the area under receiver operating characteristic curve (AUC=0.812) in the nomogram of POAF after simple aortic valve replacement. The model was internally verified by a 10-fold cross-validation resampling (AUC=0.757, Kappa=0.438). Compared with the POAF-AF score, the nomogram had a superior discrimination performance. ConclusionAge, sex, drinking history, chronic obstructive pulmonary disease, plateletocrit, and high frequency power are independent predictors for POAF after isolated AVR. The nomogram can be used as a practical tool to help clinicians predict the probability of individual POAF occurrence and take necessary preventive measures.
Objective To assess the effectiveness and safety of hepatitis B immunoglobulin (HBIG) in interrupting the intrauterine transmission of HBV.Methods The Cochrane Library (Issue 3, 2007), MEDLINE (1996 to April 2007), CBM (1978 to April 2007), and EMBASE (1980 to April 2007) were searched. The quality of included studies was evaluated and meta-analysis was performed. Results Four studies involving 359 participants with HBVDNA (+) were included. All the included studies were judged to be inadequate in regard to the reporting of randomization, concealment of allocation and blinding. Meta-analysis based on the included studies showed that HBIG significantly decreased the intrauterine transmission rate of HBV compared to the control group [OR 0.17, 95%CI (0.09 to 0.31), Plt;0.000 01]. No HBIG-related severe adverse reactions were reported. Conclusions HBIG is effective and safe for the interruption of intrauterine transmission of HBV. However, because of the high risk of selection and detection bias in the included studies, this evidence is not b enough. Large-scale randomised trials on the use of HIBG for the interruption of intrauterine transmission of HBV are needed
ObjectiveTo discuss the effect of Piezo1 mechanically sensitive protein in migration process of mouse MC3T3-E1 osteoblast cells.MethodsThe 5th-10th generation mouse MC3T3-E1 osteoblasts were divided into Piezo1-small interfering RNA (siRNA) transfection group (group A), negative control group (group B), and blank control group (group C). Piezo1-siRNA or negative control siRNA was transfected into mouse MC3T3-E1 osteoblasts by siRNA transfection reagent, respectively; group C was only added with siRNA transfection reagent; and the cell morphology was observed under inverted phase contrast microscope and fluorescence microscope, and the transfection efficiency was calculated. The expression of Piezo1 protein was detected by immunofluorescence staining and Western blot. Transwell cell migration assay and cell scratch assay were used to detect the migration of MC3T3-E1 osteoblasts after Piezo1-siRNA transfection.ResultsAfter 48 hours of transfection, group A showed a slight increase in cell volume and mutant growth, but cell colonies decreased, suspension cells increased and cell fragments increased when compared with untransfected cells. Under fluorescence microscope, green fluorescence was observed in MC3T3-E1 osteoblasts of group B, and the transfection efficiency was 68.56%±4.12%. Immunofluorescence staining and Western blot results showed that the expression level of Piezo1 protein in group A was significantly lower than that in groups B and C (P<0.05); there was no significant difference between group B and group C (P>0.05). Transwell cell migration assay and cell scratch assay showed that the number of cells per hole and the scratch healing rate of cells cultured for 1-4 days in group A were significantly lower than those in groups B and C (P<0.05); there was no significant difference between group B and group C (P>0.05).ConclusionPiezo1 knocked down by siRNA can inhibit the migration ability of MC3T3-E1 osteoblast cells.
The ideological and political education in standardized residency training plays an important role in cultivating medical talents with noble medical ethics and exquisite medical skills. Teaching evaluation is an important method to promote teaching improvement and optimization. However, there are still some problems and challenges in the evaluation of ideological and political education for standardized residency training. This article proposes the ideological and political education of standardized residency training can be comprehensively evaluated by the context-input-process-product evaluation model from four aspects: background, input, process, and result evaluation. The aim is to provide solid support and guidance for the ideological and political education route in standardized residency training.
Objective To evaluate the clinical effectiveness and safety of different mesh fixation techniques in laparoscopic trans-abdominal preperitoneal hernia repair (TAPP) by using network meta-analysis. Methods CNKI, WanFang Data, VIP, CBM, the Cochrane Library, PubMed, Embase, and Web of Science databases were retrieved to collect randomized controlled trials (RCTs) studies comparing different fixation methods of patches in laparoscopic TAPP. The retrieval time limit was from the establishment of the database to March 1, 2022. After two researchers independently screened the literatures, extracted the data, and evaluated the bias risk, Bayesian network meta-analysis was conducted by using R4.1.2 software. Results Twenty-nine RCTs were included, including 4 095 patients. The results of network meta-analysis showed that the risk of chronic postoperative inguinal pain was higher in staples fixation than that of no fixation [OR=0.06, 95%CI (0.01, 0.26), P＜0.001], glue fixation [OR=0.21, 95%CI (0.04, 0.53), P=0.001] and self-gripping mesh [OR=0.09, 95%CI (0.01, 0.52), P=0.009], the incidence of chronic postoperative inguinal pain with suture fixation was higher than that with no fixation [OR=0.10, 95%CI (0.01, 0.70), P= 0.020]. Postoperative visual analogue scale of staples fixation was higher than those of no fixation [MD=–0.90, 95%CI (–1.49, –0.33), P=0.002] and glue fixation [MD=–0.92, 95%CI (–1.35, –0.49), P＜0.001], the postoperative visual analogue scale with suture fixation was higher than those of no fixation [MD=–0.83, 95%CI (–1.61, –0.08), P=0.030] and glue fixation [MD=–0.85, 95%CI (–1.56, –0.13), P=0.020]. There was no significant difference in the incidence of seroma and hematoma, hospital stay and hernia recurrence among different fixation methods. Conclusions The network meta-analysis shows that medical glue and self-gripping mesh have certain advantages in reducing chronic pain after surgery, which may be the better patch fixation method in TAPP. The non fixation mesh will not increase the risk of postoperative recurrence, and can be used in clinical practice. This conclusion needs to be further verified by large sample, long-term follow-up and high-quality RCTs.
【Abstract】ObjectiveTo improve curative effects in the treatment of hilar bile duct stricture. MethodsIntrahepatic cholelithiasis was associated with the development of hilar bile duct stricture.Plastics of hilar bile duct stricture (PHBDS) using pedicled cholecystic graft and Roux-en-Y cholangiojejunostomy (RYCJ) were performed. The patients with hepatolithiasis treated with PHBDS or RYCJ between Jan. 1994 and Jan. 2004 were retrospectively analyzed.ResultsFollow-up was carried out from 16 months to 87 months with an average of 47 months. The postoperative morbidity of cholangitis was 5.66% and 21.88% (P=0.010) and recurring rate of hepatolithiasis was 3.77% and 16.67%(P=0.021).ConclusionPHBDS can preserve the physiological compatible, convenient and effective in treatment of hilar bile duct stricture. The late result after operation of PHBDS is better than that of RYCJ.
