Comment on “Outcomes of curative liver resection for hepatocellular carcinoma in patients with cirrhosis”

The present letter to the editor is in response to the research “Outcomes of curative liver resection for hepatocellular carcinoma in patients with cirrhosis” by Elshaarawy et al in World J Gastroenterol 2021; 13(5): 424–439. The preoperative assessment of the liver reserve function in hepatocellular carcinoma (HCC) patients with cirrhosis is crucial, and there is no universal consensus on how to assess it. Based on a retrospective study, Elshaarawy et al investigated the impact of various classical clinical indicators on liver failure and the prognosis after hepatectomy in HCC patients with cirrhosis. We recommend that we should strive to explore new appraisal indicators, such as the indocyanine green retention rate at 15 min.     

Safety and efficacy of oral nemonoxacin versus levofloxacin in treatment of community-acquired pneumonia: A phase 3, multicenter,randomized, double-blind,double-dummy,active-controlled,non-inferiority trial

Background/Purpose

Nemonoxacin is a novel nonfluorinated quinolone with excellent in vitro activity against most pathogens in community-acquired pneumonia (CAP), especially Gram-positive isolates. The purpose of this study was to assess the efficacy and safety of nemonoxacin compared with levofloxacin in patients with CAP.

Penetration moxibustion for postpartum subinvolution of uterus: Two case reports and mechanism analysis: 透灸法成功治疗产后子宫复旧不良:两则病例报告及机制分析

This article introduced the application of penetration moxibustion in successfully treating two cases of postpartum subinvolution of uterus. The main complaint of one case was increasing volume of abnormal vaginal bleeding for five days after delivery. The bleeding stopped after the patient received 7 times treatment of warming needle and penetration moxibustion on Zhōngjí (中极CV3), Guānyuán (关元CV4) and Qìhăi (气海CV6). The other case complained about persistent abdominal pain for 15 days, which was worsening for the recent 2 days. The symptom of abdominal pain was relieved after the penetration moxibustion was applied on CV4, CV6 and Zǐgōng (子宫 EX-CA1) for 5 times for the case. Penetration moxibustion can relieve abdominal pain during the postpartum period, accelerate lochia discharge, and recovery of menstrual and uterine cavity. Àiyè (艾叶 Artemisiae Argyi Folium) was proved to have antibacterial, hemostatic, and analgesic effects. The warming function and radiation features of moxibustion can help to alleviate spasm of the smooth muscle in the uterus and enhance the metabolism of the uterine tissue by expanding microvessels and improving the circulations of both blood and lymph. It can also activate cells in the uterine tissue by increased temperature in order to enhance the decomposition and elimination of pathological wastes, such as inflammation and hematoma. In addition, it can also relieve pelvic pain by inhibiting neuronal excitability.     

维生素E在骨质疏松症中的影响机制及研究进展

随着人口老龄化发展趋势的逐步加剧,骨质疏松症作为一种慢性代谢性骨疾病,在病程进展及预后转归上严重影响着人们的健康生活状态。现阶段对于骨质疏松症的有效防治仍是世界公共卫生领域需要解决的焦点问题。骨质疏松症在宏观上表现为骨密度的持续减少,在微观上则揭示了骨重建的内在失衡。营养素中含有多种人体所必须的物质原料,可直接影响机体的生理功能。维生素E作为一种必须营养素,与骨代谢联系密切,能够对骨形成及骨吸收产生调控作用。本文旨在通过对二者之间联系的具体阐述,为骨质疏松症的防治策略提供更多的科学理念。     

基于辨证论治结合网络药理学探析六味地黄丸治疗绝经后骨质疏松症作用机制

目的 基于临床试验结合网络药理学探析六味地黄丸治疗绝经后骨质疏松症的作用机制。方法 ①将60例肾阴虚证绝经后骨质疏松症患者随机分为治疗组和对照组,两组患者在口服维生素D和钙剂的同时,治疗组口服六味地黄丸、对照组口服雷洛昔芬,治疗6个月后测定并比较两组患者腰椎（L1～4）、右侧股骨颈骨密度值、血清骨钙素(OCN)及血清抗酒石酸酸性磷酸酶-5b（TRAP-5b）水平。②依据TCMSP数据库筛选出六味地黄丸活性成分及其对应的靶点,通过GeneCards、OMIM、Drugbank 3个数据库获取绝经后骨质疏松症相关靶点,将活性成分靶点与绝经后骨质疏松症相关靶点取交集所得靶点即为六味地黄丸治疗绝经后骨质疏松症靶点。采用Cytoscape3.7.2软件构建活性成分、靶点以及蛋白间的相互作用网络,使用STRING数据库进行PPI网络分析,运用Metascape数据分析平台进行GO生物过程富集以及KEGG通路富集分析。结果 与治疗前比较两组均可提升骨密度,反映骨形成指标的OCN值明显升高,骨吸收指标的TRAP-5b值则明显降低,且治疗组优于对照组（P＜0.05）。而通过网络药理学预测显示六味地黄丸作用于绝经后骨质疏松症的活性成分有36个,位居前三位的活性成分为槲皮素、山奈酚、儿茶素,主要靶点为干扰素调节因子-1（IRF1）、抑瘤素M（OSM）、白介素6（IL-6）。GO富集分析显示,生物过程主要涉及到细胞因子介导的信号通路、细胞凋亡信号通路等;细胞组成主要包括蛋白激酶复合物、质膜蛋白复合物等;分子功能主要包括转录因子结合、核受体活性等。KEGG富集分析获取相关信号通路为JAk-STAT、Wnt及NF-κB信号通路。结论 六味地黄丸可显著增加骨密度、促进骨形成、抑制骨吸收,而其作用机制在于应用槲皮素、山奈酚、儿茶素等活性成分,以IRF1、OSM及IL-6为主要靶点,通过JAk-STAT、Wnt及NF-κB等信号通路发挥改善绝经后骨质疏松症的作用。     

单孔腹腔镜与传统腹腔镜完全腹膜外疝修补术及术后质量评估

目的:对比单孔腹腔镜(SPL)与多孔腹腔镜(MPL)完全腹膜外疝修补术的临床疗效,探讨SPL治疗腹股沟疝的安全性、有效性及优越性。方法:前瞻性对比分析2017年5月至2019年5月收治的127例行全腹膜外疝修补术患者的临床资料,其中65例行SPL(SPL组),62例行MPL(MPL组)。术后进行12个月的随访。对比分析两组手术时间、术后恢复日常生活时间、术后疼痛缓解时间、住院时间、手术并发症及术后满意度等指标。结果:SPL组手术时间、术后切口疼痛缓解时间长于MPL组(P<0.05),术后1个月满意度优于MPL组(P<0.05)。结论:SPL与MPL两种术式各有优缺点,均具有推广应用价值。应针对患者需求选择合适的手术方式。     

从中医“虚”论治原发性骨质疏松症与OPG/RANK/RANKL信号通路的相关性

原发性骨质疏松症(primary osteoporosis,POP)是现代临床中常见的骨科疾病,其归属于中医学之"骨痿""骨痹""骨枯"等范畴。随着中医药事业的发展,中医学在POP的治疗中应用愈加广泛,且疗效显著,已受到学界的广泛认可。但遗憾的是,其缺乏现代研究理论依据的支撑。随着分子生物学的发展,OPG/RANK/RANKL信号通路的发现对中医学治疗此病具有重要意义。故笔者将从中医"虚"理论出发,并以中医学脏腑辨证理论为基础,借助现代分子生物学的研究成果OPG/RANK/RANKL信号通路,揭示中医治疗POP的OPG/RANK/RANKL信号通路表达机制,以期为中医学治疗POP提供科学理论依据。     

肥胖症与骨质疏松症的相关性研究

肥胖症和骨质疏松症都是常见慢性疾病,随着我国人口老龄化进程的加剧,二者的发病率也在逐年上升。骨质疏松症是一种全身性骨骼疾病,导致骨密度降低、骨强度降低和骨微结构恶化,从而增加脆性骨折的易感性。肥胖可以被定义为一种包括异常或过量的身体脂肪堆积的复杂疾病,近年来随着研究的不断深入,发现该病与骨质疏松症的发生密切相关。该文通过总结分析近些年这方面的相关研究报道,就肥胖症与骨质疏松症之间的相关性展开综述,以期有针对性地对这两种疾病进行早期干预,改善患者临床症状,提高患者的生活质量。     

Nursing resources and patient outcomes in intensive care units: A protocol for systematic review and meta-analysis

Background:As nursing resources is directly related to patient outcomes in the intensive care unit setting, identifying factors related to nursing resources at various levels could contribute to improving those outcomes. This study aims to determine the association of nursing resources with outcomes of intensive care unit patients.Method:This study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-analysis for Protocols. Chinese electronic Database (Chinese Biomedical Literature Database, Wanfang, and China National Knowledge Infrastructure) and international electronic databases (PubMed, Embase, Cochrane Library, and Web of Science) will be searched for all relevant published articles, with no restrictions on the year of publication or language. Study selection, data collection and assessment of study bias will be conducted independently by a pair of independent reviewers. The Newcastle–Ottawa Scale tool will be used for the risk of bias assessment. The Grading of Recommendations Assessment Development and Evaluation system will be used to assess the quality of evidence. The statistical analysis of this meta-analysis will be calculated by Review manager version 5.3.Results:The results of this study will be published in a peer-reviewed journal.Conclusion:The findings of this systematic review will provide a high-quality synthesis of latest evidence and provide a basis for assessing the association of nursing resources on patients’ outcomes in intensive care units.Trial registration number:10.17605/OSF.IO/9FNEX