Does chronic kidney disease affect the complications and prognosis of patients after primary colorectal cancer surgery?

BACKGROUNDThe effect of chronic kidney disease (CKD) on the outcomes of colorectal cancer (CRC) patients after primary CRC surgery is controversial.AIMTo analyze whether CKD had specific effect on the outcomes after CRC surgery.METHODSWe searched the PubMed, Embase, Cochrane Library databases and CNKI, from inception to March 14, 2022. Newcastle-Ottawa Scale was used for the quality assessment in this meta-analysis, and we used RevMan 5.3 was used for data analysis.RESULTSA total of nine studies including 47771 patients were eligible for this meta-analysis. No significant difference was found in terms of overall postoperative complications [odds ratio (OR) = 1.78, 95%CI: 0.64-4.94, P = 0.27]. We analyzed the specific complications and found that the CKD group had higher rates of pulmonary infection (OR = 2.70, 95%CI: 1.82-4.00, P < 0.01), cardiovascular complications (OR = 3.39, 95%CI: 2.34-4.91, P < 0.01) and short-term death (OR = 3.01, 95%CI: 2.20-4.11, P < 0.01). After pooling the hazard ratio (HR), the CKD group had worse overall survival (OS) (HR = 1.51, 95%CI: 1.04-2.20, P = 0.03). We performed subgroup analyses of the dialysis and non-dialysis groups, and no significant difference was found in the non-dialysis group (HR = 1.20, 95%CI: 0.98-1.47, P = 0.08). The dialysis group had worse OS (HR = 3.36, 95%CI: 1.92-5.50, P < 0.01) than the non-dialysis group. The CKD group had worse disease-free survival (DFS) (HR = 1.41, 95%CI: 1.12-1.78, P < 0.01), and in the subgroup analysis of the dialysis and non-dialysis groups, no significant difference was found in the non-dialysis group (HR = 1.27, 95%CI: 0.97-1.66, P = 0.08). The dialysis group had worse OS (HR = 1.95, 95%CI: 1.23-3.10, P < 0.01) than the non-dialysis group.CONCLUSIONPreexisting CKD was associated with higher rates of pulmonary infection, higher rates of short-term death, and worse OS and poorer DFS following CRC surgery.     

盐酸氨溴索对老年肺炎祛痰作用疗效分析

目的评价盐酸氨溴索注射液对老年肺炎患者祛痰作用的临床疗效及安全性。方法将124例老年肺炎住院患者随机分成治疗组64例和对照组60例，治疗组使用左氧氟沙星注射液0．2g＋10％葡萄糖液（糖尿病患者用生理盐水）100mL，静脉滴注，2次／d；加用盐酸氨溴索注射液45mg，静脉注射，2次／d。对照组用左氧氟沙星注射液（用法同治疗组），加用必嗽平片16mg，口服，3次／d。疗程7～14d，2组均不同时使用其他抗生素，有基础疾病者按相应疾病常规治疗。结果治疗组对咳嗽的临床控制率＋显效率（31％＋38％）明显高于对照组（15％＋20％），有极显著性差异（P〈0．01）；对痰性状的改变及肺部哆音的改变2组间无显著性差异（P〉0．05）。治疗组盐酸氨溴索注射液的主要不良反应为胃部灼热，治疗过程中有6例出现，发生率为9％，患者能耐受，未作特殊处理。对照组必嗽平片治疗过程中有7例出现胃部不适，表现为上腹胀痛，恶心、欲呕，发生率为12％，经服用西咪替丁片后好转，未中断治疗。结论盐酸氨溴索注射液对老年肺炎患者祛痰效果显著，是一种安全、经济、有效的祛痰药物。     

Patulin Detoxification by Recombinant Manganese Peroxidase from Moniliophthora roreri Expressed by Pichia pastoris

The fungal secondary metabolite patulin is a mycotoxin widespread in foods and beverages which poses a serious threat to human health. However, no enzyme was known to be able to degrade this mycotoxin. For the first time, we discovered that a manganese peroxidase (MrMnP) from Moniliophthora roreri can efficiently degrade patulin. The MrMnP gene was cloned into pPICZα(A) and then the recombinant plasmid was transformed into Pichia pastoris X-33. The recombinant strain produced extracellular manganese peroxidase with an activity of up to 3659.5 U/L. The manganese peroxidase MrMnP was able to rapidly degrade patulin, with hydroascladiol appearing as a main degradation product. Five mg/L of pure patulin were completely degraded within 5 h. Moreover, up to 95% of the toxin was eliminated in a simulated patulin-contaminated apple juice after 24 h. Using Escherichia coli as a model, it was demonstrated that the deconstruction of patulin led to detoxification. Collectively, these traits make MrMnP an intriguing candidate useful in enzymatic detoxification of patulin in foods and beverages.     

特步他林并布地奈德治疗对急性支气管哮喘患者IL-5、IL-10及TNF-α的影响

目的研究急性支气管哮喘(BA)经特步他林并布地奈德治疗后白介素-5(IL-5)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)的变化。方法选取2016年1月至2020年12月商丘市中医院收治的122例急性BA患者的临床资料进行分析,根据不同治疗方法分为研究组(n=62,特步他林+布地奈德)和对照组(n=60,特步他林),比较两组临床疗效、肺功能[用力肺活量(FVC)、1秒用力呼气容器(FEV1)、1秒用力呼气容积占用力肺活量的百分比(FEV1/FVC%)、治疗前后IL-5、IL-10、TNF-α变化及不良反应情况。结果研究组总疗效(93.55%)高于对照组(81.67%),差异有统计学意义(P<0.05)。治疗后两组FVC、FEV1、FEV1/FVC%均较治疗前升高,且研究组高于对照组,差异具有统计学意义(P<0.05)。治疗后两组IL-5、TNF-α水平均降低,且研究组低于对照组,两组IL-10水平均上升,且研究组高于对照组,差异有统计学意义(P<0.05)。两组不良反应率比较差异无统计学意义(P>0.05)。结论特步他林与布地奈德联合治疗急性BA...     

Point-of-Care Tests for Rapid Detection of Porcine Epidemic Diarrhea Virus: A Systematic Review and Meta-Analysis

The timely and accurate diagnosis of porcine epidemic diarrhea virus (PEDV) infection is crucial to reduce the risk of viral transmission. Therefore, the objective of this review was to evaluate the overall diagnostic accuracy of rapid point-of-care tests (POCTs) for PEDV. Studies published before 7 January 2022 were identified by searching PubMed, EMBASE, Springer Link, and Web of Science databases, using subject headings or keywords related to point of care and rapid test diagnostic for PEDV and PED. Two investigators independently extracted data, rated risk of bias, and assessed the quality using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The bivariate model and the hierarchical summary receiver operating characteristic (HSROC) model were used for performing the meta-analysis. Threshold effect, subgroup analysis, and meta-regression were applied to explore heterogeneity. Of the 2908 records identified, 24 eligible studies involving 3264 specimens were enrolled in the meta-analysis, including 11 studies on evaluation of lateral flow immunochromatography assay (ICA)-based, and 13 on nucleic acid isothermal amplification (NAIA)-based POCTs. The overall pooled sensitivity, specificity and diagnostic odds ratio (DOR) were 0.95 (95% CI: 0.92–0.97), 0.96 (95% CI 0.88–0.99) and 480 (95% CI 111–2074), respectively; for ICA-based POCTs and the corresponding values for NAIA-based, POCTs were 0.97 (95% CI 0.94–0.99), 0.98 (95% CI 0.91–0.99) and 1517 (95% CI 290–7943), respectively. The two tests showed highly comparable and satisfactory diagnostic performance in clinical utility. These results support current recommendations for the use of rapid POC tests when PEDV is suspected.     

Corrosion Behavior of Alx(CrFeNi)1−x HEA under Simulated PWR Primary Water

High-entropy alloys (HEAs) have great potential as accident-tolerant fuel (ATF) cladding. Aluminum-forming duplex (BCC and FCC) stainless-steel (ADSS) is a candidate for ATF cladding, but the multiphase composition is detrimental to its corrosion resistance. In this paper, two single-phase HEAs were prepared by adjusting the content of each element in the ADSS alloy. The two HEAs were designed as Al_0.05(CrFeNi)_0.95(FCC) and Al_0.25(FeCrNi)_0.75(BCC). Their corrosion behavior under simulated pressurized water reactor (PWR) primary water was investigated. The corrosion products and corrosion mechanisms of these two HEAs were explored. The results show that the corrosion resistance of HEA alloys containing FCC is better than that of BCC and ADSS alloys. At the same time, the reason why the BCC structure composed of these four elements is not resistant to corrosion is revealed.     

会厌瓣在声门癌术后喉呼吸功能不良整复中的应用

目的 探讨会厌瓣在声门癌行喉部分切除术所致喉呼吸功能不良再手术中的应用。方法 对19例因声门癌行喉部分切除术所致术后喉呼吸功能不良的患者,采 用会厌瓣进行再手术,将临床资料进行回顾性分析。结果 18例（94.7%）采用会厌瓣重建后17～194d成功拔出气管套管,1例因瘢痕形成而失败。结论 在因声门癌行喉部分切除术所致喉呼吸功能不良的再手术中应用会厌瓣,具有方法便捷、效果可靠的优点。     

中耳胆固醇肉芽肿的诊断和手术治疗

目的探讨中耳胆固醇肉芽肿(CG)的发病机制、临床特点及治疗效果。方法回顾性分析43例CG患者的临床资料，其中42病例经手术及病理证实。主要临床表现包括听力下降43/43例，耳闷感29/43例，咖啡样耳漏12/43例，耳鸣26/43例。蓝鼓膜为典型体征36/43例。颞骨高分辨CT（HRCT）主要表现为中耳乳突软组织阴影，可伴有听骨链破坏（17/43），手术中发现（13/43）与术前符合率76.47%（13/17）。结果手术方法选择完璧式乳突切除+鼓室探查+鼓室置管术31例，完璧式乳突切除+鼓室探查+听骨链重建术11例，单纯鼓室置管术1例。术后随访0.5～3.0年,无复发。术后1～2个月鼓膜颜色恢复正常，听力均有不同程度提高，骨气导间距平均减少（25.0±3.5）dB。结论CG的主要临床表现为听力下降、耳闷感、耳鸣、咖啡样耳漏和蓝鼓膜。HRCT对中耳胆固醇肉芽肿诊断及手术有重要参考价值。诊断明确应采取手术治疗,清除病变,建立鼓室及乳突的通气、引流，并重建听力     

儿童急性淋巴细胞和非淋巴细胞白血病诊断治疗

高怡瑾教授很荣幸邀请到Smith教授访问复旦大学附属儿科医院,并借此机会在上海医学会儿科学分会血液学组的学术活动中做儿童急性髓系白血病学术报告,Smith教授是美国辛辛那提儿童医院儿科学系教授,血液肿瘤科临床主任,并在美国儿童肿瘤协作组织(COG)担任儿童急性非淋巴细胞白血病(AML)临床试验组主席.以下是在征得Smith教授同意的情况下,根据这次学术活动中与其对话的部分内容整理而成,以飨读者.