Abstract Background: immunonutrition has been introduced and proposed to have positive modulating effects on inflammatory and immune responses in surgical patients. This meta-analysis aimed to assess whether perioperative enteral immunonutrition (EIN) can reduce postoperative complications or reduce inflammatory responses in esophageal cancer (EC) patients undergoing esophagectomy. Methods: PubMed, Embase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of EIN before and/or after surgery in EC patients undergoing esophagectomy were identified. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. Results: ten RCTs involving 1,052 patients were included in the meta-analysis, including 573 patients in the EIN group and 479 patients in the enteral nutrition (EN) group. Overall, no significant difference was observed between the two groups in the incidence of postoperative pneumonia, surgical site infection, intra-abdominal abscess, septicemia, and urinary tract infection. No significant incidence of postoperative anastomotic leakage, acute respiratory distress syndrome (ARDS), and in-hospital mortality was found. Conclusions: perioperative enteral immunonutrition did not reduce the incidence of infectious complications and anastomotic leakage in EC patients undergoing esophagectomy, nor did it reduce postoperative CRP and IL-6, but did not increase in-hospital mortality.

Resumen Antecedentes: se ha introducido y propuesto la inmunonutrición para regular activamente la inflamación y la respuesta inmune en pacientes quirúrgicos. El presente metaanálisis fue diseñado para evaluar si la inmunonutrición enteral perioperatoria (EIN, por sus siglas en inglés) puede reducir las complicaciones postoperatorias o la inflamación en pacientes con cáncer de esófago (CE) sometidos a esofagectomía. Métodos: se realizó una búsqueda sistemática en las bases de datos de PubMed, Embase, Web of Science, EBSCO y Cochrane Library. Se evaluó el efecto de la EIN preoperatoria y/o postoperatoria en un ensayo aleatorizado controlado (RCT) en pacientes con cáncer de esófago sometidos a esofagectomía. Dos investigadores buscaron independientemente artículos, extrajeron datos y evaluaron la calidad de los artículos incluidos. Resultados: el metanálisis incluyó diez ensayos controlados aleatorios en los que participaron 1.052 pacientes, de los cuales 573 fueron incluidos en el grupo EIN y 479, en el grupo de nutrición enteral (NE). En general, no hubo diferencia significativa en la incidencia de neumonía postoperatoria, infección del sitio quirúrgico, absceso intraperitoneal, sepsis e infección del tracto urinario entre los dos grupos. No hubo diferencia significativa en la incidencia de fístula anastomótica postoperatoria, síndrome de distrés respiratorio agudo (SDRA) y mortalidad hospitalaria. Conclusión: la inmunonutrición enteral perioperatoria no puede reducir la incidencia de complicaciones infecciosas postoperatorias y fístulas anastomóticas, ni la PCR postoperatoria ni la IL-6. Pero no aumentó la mortalidad hospitalaria.

Abstract Objectives: The incidence of cerebellar Glioblastoma Multiforme (cGBM) is rare. Database like TCGA have not distinguish cGBM from GBM, our knowledge on cGBM gene expression characteristics is limited. The expression status of Oligodendrocyte Lineage Transcription factor 2 (OLIG2) and its clinical significance in cGBM is still unclear. Methods: The clinical data and tissue specimens of 73 cGBM patients were retrospectively studied. The association between OLIG2 expression level and the demographic characteristics of cGBM patients was identified by the Chi-Square test. The survival curves were drawn by Kaplan-Meier analysis. The independent prognostic factors was calculated according to Cox regression analysis. Results: The OLIG2 high expression was observed in about 57.5% (42/73) of the cGBM patients. Patients with high OLIG2 expression levels had a higher alive ratio at the end of follow-up (alive ratio: 70.6% vs. 29.4%, p = 0.04). The median survival time was 21 months and 13 months for high and low expression of OLIG2 (p < 0 .05). Univariate analysis and Multivariate analysis indicated that EOR (HR = 3.89, 95% CI 1.23−12.26, p = 0.02), low OLIG2 expression (HR = 5.26, 95% CI 1.13−24.59, p = 0.04), and without adjuvant therapy (HR = 4.95, 95% CI 1.22−20.00, p = 0.03) were independent risk factors for the OS of cGBM patients. Conclusion: High expression level of OLIG2 could be used as an independent favorable prognosis indicator in cGBM patients and be recognized as a characteristic biomarker of cGBM.

Resumo Introdução A manobra de Epley é útil para o retorno da otocônia do braço longo do canal semicircular posterior para o utrículo. Diferentes manobras são necessárias para mover a otocônia para fora do braço curto do canal semicircular posterior e para dentro do utrículo. Objetivo Diagnosticar a VPPB do tipo braço curto do canal semicircular posterior e tratá-la com a manobra de incline and balance. Método Foram diagnosticados 171 casos como VPPB de canal semicircular posterior com base na manobra de Dix-Hallpike positiva. Primeiro tentamos tratar os pacientes com a manobra de incline and balance e, em seguida, executamos a manobra de Dix-Hallpike novamente. Se a repetição da manobra de Dix-Hallpike desse resultados negativos, diagnosticávamos o paciente como VPPB do canal semicircular posterior do tipo braço curto e considerávamos que ele ou ela havia sido curado pela manobra de incline and balance; caso contrário, provavelmente o paciente apresentava VPPB do canal semicircular posterior do tipo braço longo e tratávamos o paciente com a manobra de Epley. Resultados Aproximadamente 40% dos casos foram curados pela manobra de incline and balance, com resultados negativos nas manobras de Dix-Hallpike repetidas, e foram diagnosticados com litíase de braço curto. Conclusão A VPPB de canal semicircular posterior do tipo braço curto pode ser diagnosticada e tratada de maneira conveniente e confortável.

Abstract Introduction The Epley maneuver is useful for the otoconia to return from the long arm of the posterior semicircular canal into the utricle. To move otoconia out of the posterior semicircular canal short arm and into the utricle, we need different maneuvers. Objective To diagnose the short-arm type BPPV of the posterior semicircular canal and treat them with bow-and-yaw maneuver. Methods 171 cases were diagnosed as BPPV of the posterior semicircular canal based on a positive Dix-Hallpike maneuver. We first attempted to treat patients with the bow-and-yaw maneuver and then performed the Dix-Hallpike maneuver again. If the repeated Dix-Hallpike maneuver gave negative results, we diagnosed the patient with the short-arm type of BPPV of the posterior semicircular canal and considered the patient to have been cured by the bow-and-yaw maneuver; otherwise, probably the long-arm type BPPV of the posterior semicircular canal existed and we treated the patient with the Epley maneuver. Results Approximately 40% of the cases were cured by the bow-and-yaw maneuver, giving negative results on repeated Dix-Hallpike maneuvers, and were diagnosed with short-arm lithiasis. Conclusion The short-arm type posterior semicircular canal BPPV can be diagnosed and treated in a convenient and comfortable manner.

RESUMO Objetivos Avaliar o potencial da aplicação da tecnologia de impressão 3D na medição da área de defeito ósseo acetabular em pacientes adultos diagnosticados com displasia do desenvolvimento do quadril (DDH). Métodos 23 casos de DDH que requereram cirurgia de substituição total do quadril foram incluídos neste estudo. O exame pré-operatório confirmou os filmes pélvicos padrão Crowe, incluindo 3 casos de Crowe I, 7 Crowe II, e 13 Crowe III. A tecnologia de impressão 3D foi utilizada para imprimir o modelo de quadril antes da operação. Com base no modelo pré-impresso, o planejamento pré-operatório e os procedimentos cirúrgicos foram estabelecidos. A área dos defeitos ósseos acetabulares foi medida, a prótese de tamanho selecionado foi registrada, e a cirurgia foi realizada (grupo A). A área do defeito ósseo acetabular real e o tamanho da prótese também foram registrados (grupo B). Resultados Os resultados comparativos indicaram que a área real do defeito acetabular medida intraoperativamente e a área medida usando a tecnologia de impressão 3D não diferiu significativamente para todos os participantes (todos P>0,05). Conclusão O modelo pré-operatório pode medir com precisão a área de defeito ósseo acetabular para DDH. É relevante desenvolver implantes individualizados para pacientes com DDH tratados com a técnica de impressão 3D. Nível de Evidência IV: Série de casos.

ABSTRACT Objectives Evaluate the application value of 3D printing technology in measuring acetabular bone defect area in adult patients diagnosed with developmental dysplasia of the hip (DDH). Methods 23 cases of DDH requiring total hip replacement surgery were enrolled in this study. Preoperative examination confirmed the standard pelvic plain films Crowe, including 3 cases of Crowe I, 7 Crowe II, and 13 Crowe III. The 3D printing technology was used to print the hip model before the operation. Based on the pre-printed model, pre-operative planning and surgical procedures were established. The area of the acetabular bone defects was measured, the selected size prosthesis was recorded, and the surgery was performed (group A). The actual acetabular bone defect area and the prosthesis size were also recorded (group B). Results The comparative results indicated that the actual acetabular defect area measured intraoperatively and the area measured using the 3D printing technology did not significantly differ for all participants (all P>0.05). Conclusion Preoperative model can accurately measure the acetabular bone defect area for DDH. It is significant to develop individualized implants for DDH patients treated with the 3D printing technique. Level of Evidence IV: Case series.

Abstract The purpose of this study is to investigate the influence and analysis of Chaihu plus Longgu oyster decoction combined with five-elements music therapy on inflammatory factors and depression in patients with postoperative reflux cholangitis of cholangiocarcinoma. 90 patients with reflux cholangitis and mild to moderate depression after cholangiocarcinoma surgery were selected and were randomly divided into control and treatment groups. Control group was treated with antibiotics and antidepressant drugs, and treatment group was given Chaihu plus Longgu oyster decoction plus five-elements music therapy based on antibiotics. After treatment, the improvement of the main clinical symptoms, the serum IL-6, IL-10, TNF-α, CRP levels, and Hamilton Depression Scale evaluation of depression were analyzed. Follow up for 12 months, analyze the recurrence of the two groups of patients. The levels of IL-6, IL-10, TNF-αand CRP in the treatment group were significantly lower than in the control group. The scores of the main clinical symptoms and the efficacy of relieving depression in the treatment group were better. Therefore, Chaihu plus Longgu oyster decoction combined with five-elements music therapy can reduce the release of serum IL-6, IL-10, TNF-α and CRP inflammatory factors, improve fever, jaundice, abdominal pain and other symptoms, and reduce the degree of depression and the recurrence after treatment.

Resumo Introdução A ultrassonografia é um método rápido para determinar de qual nódulo se deve coletar uma amostra para biópsia por aspiração com agulha fina. Por outro lado, o exame de tomografia computadorizada não é restringido pela atenuação do eco e distingue entre nódulos benignos e malignos. Objetivo Comparar exames tomográficos versus biópsia por ultrassonografia/aspiração por agulha fina no diagnóstico diferencial de nódulos tireoidianos. Método Dados sobre exames tomográficos, achados ultrassonográficos após biópsia por aspiração com agulha fina e histologia tumoral de 953 nódulos de 698 pacientes submetidos à tireoidectomia foram coletados e analisados. O escore de benefício para detecção do tumor maligno para cada modalidade adotada foi avaliado. Resultados As imagens de ultrassom não mostraram uma lesão sólida bem circunscrita em 89 nódulos; e na análise final não foram detectados nódulos nas biópsias por aspiração com agulha fina (nódulos não malignos falsos positivos). As imagens ultrassonográficas mostraram doença parenquimatosa (nódulos malignos falsos positivos) em vários nódulos. Os exames de tomografia computadorizada apresentaram grandes dificuldades na detecção de nódulos malignos de 1,0-2,0 cm de tamanho em comparação com o exame de ultrassonografia após biópsias por aspiração com agulha fina; comparados aos dados histológicos do tumor, os exames de tomografia computadorizada apresentaram sensibilidade de 0,879. Conclusão Os exames de tomografia computadorizada são um método mais confiável para o diagnóstico diferencial de nódulos tireoidianos do que os exames de ultrassonografia, seguidos por biópsia por aspiração com agulha fina.

Abstract Introduction Ultrasound sonography provides a quick method for determining which nodule to sample for fine needle aspiration biopsy in thyroid nodules. On the other hand, the computed tomography examination is not restricted by echo attenuation and distinguishes between benign and malignant nodules. Objective To compare computed tomography examinations against ultrasound/fine needle aspiration biopsy in the differential diagnosis of thyroid nodules. Methods Data regarding computed tomography examinations, sonographic finding following fine needle aspiration biopsy, and tumor histology of 953 nodules from 698 patients who underwent thyroidectomy were collected and analyzed. The beneficial score for detection of the malignant tumor for each adopted modality was evaluated. Results Ultrasound images did not show a well-circumscribed solid mass in 89 nodules, and ultimately did not detect nodules in fine needle aspiration biopsies (false positive non-malignant nodules). Ultrasound images showed parenchymatous disease (false positive malignant nodules) in several nodules. Computed tomography examinations demonstrated higher difficulty in detection of malignant nodules of 1.0-2.0 cm size than ultrasound examination following fine needle aspiration biopsies; compared to tumor histological data, computed tomography examinations had a sensitivity of 0.879. Conclusion Computed tomography examinations are a more reliable method for differential diagnosis of thyroid nodules than ultrasound examinations followed by fine needle aspiration biopsy. Level of Evidence III.

ABSTRACT Background: The diagnostic value and suitability of prostate cancer antigen 3 (PCA3) for the detection of prostate cancer (PCa) have been inconsistent in previous studies. Thus, the aim of the present meta-analysis was performed to systematically evaluate the diagnostic value of PCA3 for PCa. Materials and Methods: A meta-analysis was performed to search relevant studies using online databases EMBASE, PubMed and Web of Science published until February 1st, 2019. Ultimately, 65 studies met the inclusion criteria for this meta-analysis with 8.139 cases and 14.116 controls. The sensitivity, specificity, positive likelihood ratios (LR+), negative likelihood ratios (LR−), and other measures of PCA3 were pooled and determined to evaluate the diagnostic rate of PCa by the random-effect model. Results: With PCA3, the pooled overall diagnostic sensitivity, specificity, LR+, LR−, and 95% confidence intervals (CIs) for predicting significant PCa were 0.68 (0.64-0.72), 0.72 (0.68-0.75), 2.41 (2.16-2.69), 0.44 (0.40-0.49), respectively. Besides, the summary diagnostic odds ratio (DOR) and 95% CIs for PCA3 was 5.44 (4.53-6.53). In addition, the area under summary receiver operating characteristic (sROC) curves and 95% CIs was 0.76 (0.72-0.79). The major design deficiencies of included studies were differential verification bias, and a lack of clear inclusion and exclusion criteria. Conclusions: The results of this meta-analysis suggested that PCA3 was a non-invasive method with the acceptable sensitivity and specificity in the diagnosis of PCa, to distinguish between patients and healthy individuals. To validate the potential applicability of PCA3 in the diagnosis of PCa, more rigorous studies were needed to confirm these conclusions.

ABSTRACT The soaking and germination process of rice seeds is the starting point in rice cultivation in cold regions and has a significant effect on grain yield. Efficient techniques for controlling the water temperature in the seed tank are required to enhance germination quality. This paper introduces a fuzzy theory for designing a fuzzy logic-based sliding mode controller (SMC) system for a rice seed soaking and germination device. The proposed system was theoretically and experimentally investigated to determine the efficiency of the soaking temperature-control system. A modified fuzzy SMC based on exponent approaching law is also presented for optimizing the proposed controller. A proportional integral derivative (PID) controller was designed to identify and compare the advantages of the proposed controllers. A comparative study of the computer simulation demonstrates that the performance of fuzzy SMC and modified fuzzy SMC are acceptable, and that both SMCs are superior to the PID controller. Furthermore, compared with the fuzzy SMC system, a reduction in electric energy consumption was observed for the modified fuzzy SMC. Moreover, both SMCs yielded similar soaking qualities.

ABSTRACT We present the case of a 28 year old patient with an incomplete tear of the tunica albuginea occurred after having sexual intercourse in the female superior position. The diagnostic assessment was performed first clinically, then with CT, owing to its high resolution, allowed to exactly detect the tear location leading to precise preoperative planning. After adequate diagnosis through imaging and proper planning, the patient was performed a selective minimally invasive surgical approach to repair the lesion. The patient had good erection with no angular deformity or plaque formation after a 3-month follow-up.

Abstract Wide compatibility and erect panicles are important traits for heterosis and ideal plant type breeding in rice and accordingly are targets for rice yield improvement. In this study, a multiplex PCR system based on functional markers was developed to simultaneously identify genotypes of the wide compatibility allele S5-n and the erect panicle allele dep1. Forty-nine rice varieties in the Huang-Huai-Hai region of China were identified using this system. Thirty-three varieties contained the erect panicle allele dep1 and two varieties contained the wide compatibility allele S5-n. The frequency of dep1 was obviously higher than that of S5-n. The multiplex PCR method was also tested using an F2 segregating population and was found to be simple, efficient, and reliable. It will be useful in marker-assisted selection based on the wide compatibility allele S5-n and erect panicle allele dep1 to breed super rice varieties using indica and japonica heterosis.

Iron nitride films were deposited by radio frequency (RF) reactive magnetron sputtering at different bias voltages. It was found that the composition, structure and magnetic properties of the iron nitride films were strongly dependent on the depositing bias voltage. With a bias voltage of –50 V, the iron nitride film is fully dense and has a homogenous microstructure consisting of α-Fe and Fe16N2, leading to a unique combination of high Ms of 1645 emu/cc, Hc of 5 Oe and μi of 1573.

The biological functions of the BC047440 gene highly expressed by hepatocellular carcinoma (HCC) are unknown. The objective of this study was to reconstruct antisense eukaryotic expression vectors of the gene for inhibiting HepG2 cell proliferation and suppressing their xenograft tumorigenicity. The full-length BC047440 cDNA was cloned from human primary HCC by RT-PCR. BC047440 gene fragments were ligated with pMD18-T simple vectors and subsequent pcDNA3.1(+) plasmids to construct the recombinant antisense eukaryotic vector pcDNA3.1(+)BC047440AS. The endogenous BC047440 mRNA abundance in target gene-transfected, vector-transfected and naive HepG2 cells was semiquantitatively analyzed by RT-PCR and cell proliferation was measured by the MTT assay. Cell cycle distribution and apoptosis were profiled by flow cytometry. The in vivo xenograft experiment was performed on nude mice to examine the effects of antisense vector on tumorigenicity. BC047440 cDNA fragments were reversely inserted into pcDNA3.1(+) plasmids. The antisense vector significantly reduced the endogenous BC047440 mRNA abundance by 41% in HepG2 cells and inhibited their proliferation in vitro (P < 0.01). More cells were arrested by the antisense vector at the G1 phase in an apoptosis-independent manner (P = 0.014). Additionally, transfection with pcDNA3.1(+)BC047440AS significantly reduced the xenograft tumorigenicity in nude mice. As a novel cell cycle regulator associated with HCC, the BC047440 gene was involved in cell proliferation in vitro and xenograft tumorigenicity in vivo through apoptosis-independent mechanisms.

Most frequently reported Chinese renal biopsy data have originated from southeastern China. The present study analyzed the renal biopsy data from northeastern China. The records of 1550 consecutive native patients who were diagnosed with primary glomerular diseases (PGD) after renal biopsy at our hospital during 2005-2009 were used. These patients were divided into four age groups for stratified analysis: <15, 15-44, 45-59, and ≥60 years old. Among PGD, minimal change disease (MCD) was the most common histologically diagnosed disease (30.7%), followed by IgA nephropathy (IgAN), mesangial proliferative glomerulonephritis (MsPGN), membranous nephropathy (MN), membranoproliferative glomerulonephritis (MPGN), focal segmental glomerulosclerosis (FSGS), and endocapillary proliferative glomerulonephritis (EnPGN). MCD was the disease most frequently observed (43.7%) in the <15-year-old group. MsPGN was the most common disease in the elderly group (38.1%). MsPGN was more prevalent in females (27.8%), whereas MCD was more prevalent in males (35.3%). Primary glomerular diseases constituted the most commonly encountered group of diseases with a high prevalence of MCD, which predominantly affected males and young adults. The prevalence of MCD was high in northeastern China. Further study is necessary to expand the epidemiologic data available for renal disease in China.

China has been carrying out large-scale schistosomiasis control since the mid-1950s, but in the early 1990s, schistosomiasis was still endemic in eight provinces. A World Bank Loan Project enabled further significant progress to be made during the period 1992-2001. The control strategy was focused on the large-scale use of chemotherapy - primarily to reinforce morbidity control - while at the same time acting on transmission with the ultimate goal of interrupting it. Chemotherapy was complemented by health education, chemical control of snails and environmental modification where appropriate. A final evaluation in 2002 showed that infection rates in humans and livestock had decreased by 55% and 50%, respectively. The number of acute infections and of individuals with advanced disease had also significantly decreased. Although snail infection rates continued to fluctuate at a low level, the densities of infected snails had decreased by more than 75% in all endemic areas. The original objectives of the China World Bank Loan Project for schistosomiasis control had all been met. One province, Zhejiang, had already fulfilled the criteria for elimination of schistosomiasis by 1995. The project was therefore a success and has provided China with a sound basis for further control.

China lleva tomando medidas en gran escala contra la esquistosomiasis desde mediados de los años cincuenta, pero a comienzos de los noventa esa enfermedad era todavía endémica en ocho provincias. Un Proyecto de préstamo del Banco Mundial permitió hacer grandes progresos durante el periodo 1992-2001. La estrategia de control se centró en la administración de antibioticoterapia en gran escala - principalmente para reforzar el control de la morbilidad - unida a intervenciones paralelas contra la transmisión, a fin de interrumpirla. Como complemento de la antibioticoterapia se adoptaron medidas de educación sanitaria, control químico de los caracoles y modificación ambiental cuando fue necesario. Una evaluación final realizada en 2002 mostró que las tasas de infección en seres humanos y en el ganado habían disminuido en un 55% y un 50%, respectivamente. El número de infecciones agudas y de individuos con signos de enfermedad avanzada también había disminuido significativamente. Aunque las tasas de infección de los caracoles siguieron fluctuando a niveles bajos, las densidades de caracoles infectados habían disminuido en más de un 75% en todas las zonas endémicas. Todos los objetivos originales del Proyecto de préstamo del Banco Mundial en China para el control de la esquistosomiasis fueron alcanzados. Una provincia, Zhejiang, consiguió cumplir ya en 1995 los criterios de eliminación de la enfermedad. El proyecto fue por tanto un éxito, y ha proporcionado a China una base sólida para aplicar nuevas medidas de control.

La Chine mène une lutte à grande échelle contre la schistosomiase depuis le milieu des années 50, mais au début des années 90, cette maladie était encore endémique dans huit provinces. Un projet de prêt de la Banque mondiale a permis la réalisation de progrès importants sur la période 1992-2001. La stratégie de lutte contre la maladie était axée sur l'utilisation à grande échelle de la chimiothérapie dans l'objectif principal de maîtriser davantage la morbidité, tout en agissant simultanément sur la transmission dans le but ultime de l'interrompre. La chimiothérapie était complétée par une éducation sanitaire, une lutte chimique contre les escargots et des modifications de l'environnement le cas échéant. Une évaluation finale réalisée en 2002 a montré que les taux d'infection chez l'homme et les animaux d'élevage avaient diminué respectivement de 55 et 50 %. Le nombre d'infections aiguës et d'individus à un stade avancé de la maladie avait aussi notablement diminué. Bien que les taux de contamination des escargots continuent de fluctuer à un faible niveau, les densités d'escargots infectés ont diminué de plus de 75 % dans l'ensemble des zones d'endémie. Les objectifs de départ du Projet de prêt de la Banque mondiale en faveur de la lutte contre la schistosomiase ont été remplis. Une province, le Zhejiang, était parvenu à satisfaire les critères d'élimination de la schistosomiase dès 1995. Le projet a donc été un succès et a fourni à la Chine une base solide pour poursuivre la lutte.