Abstract:China is a country with a high incidence of gastrointestinal cancer, as well as a country with a high incidence of gastric cancer and a high infection rate of Helicobacter pylori (H.pylori). H.pylori is a definite carcinogen of gastric cancer, hence is the most important controllable risk factor of gastric cancer. The earlier to eradicate H.pylori, the better outcomes could be obtained. For patients with intestinal metaplasia, can also benefit from eradicating H.pylori. The management strategy for H.pylori infection has been changed from “test and treat”, “screening and treat” to “family-based prevention and control”. Screening and eradicating H.pylori is a feasible way to reduce the incidence of gastric cancer in China.

Abstract:Objective To analyze the morbidity and mortality of colorectal cancer in the world and China in 2020 based on the global cancer statistics 2020 released by the International Agency for Research on Cancer (IARC) combined with characteristics such as gender, age, human development index (HDI), etc., and to compare the epidemic status of colorectal cancer between China and the world. Methods The data of colorectal cancer of 185 countries or regions in the world were collected from GLOBOCAN 2020 database, and the HDI were collated according to the Human Development Report 2020 published by the United Nations Development Programme. Cancer data were stratified by age, gender and HDI to describe the epidemic status of colorectal cancer in the world and China. Pearson correlation analysis was used to evaluate the correlation between standardized incidence rate (SIR), standardized mortality rate (SMR), mortality to incidence ratio (M/I) and HDI. Results In 2020, the incident cases of colorectal cancer (1932000) worldwide ranked third among all cancer types and SIR (19.5/100000) ranked fourth. The deaths of colorectal cancer (935000) worldwide ranked second among all cancer types and SMR (9.0/100 000) ranked third. In 2020, the incident cases of colorectal cancer (555 000) in China ranked second in all cancer types, accounting for 28.8% of the global incident cases of colorectal cancer, and SIR (23.9/100000) ranked third among all cancer types in China. The deaths of colorectal cancer (286000) in China ranked fifth in all cancer types, accounting for 30.6% of the global deaths of colorectal cancer, and SMR (12.0/100000) ranked fifth among all cancer types in China. The incident cases, deaths, SIR and SMR of colorectal cancer were higher in males than females worldwide. SIR and SMR were positively correlated with HDI (r＝0.795 and 0.804, both P＜0.001), and M/I was negatively correlated with HDI (r＝－0.843, P＜0.001). The incident cases, deaths, SIR and SMR of colorectal cancer in the world and China increased with age, and increased rapidly after age group of 40 to 44. Conclusion The disease burden of colorectal cancer is serious globally and in China, and the epidemic status of colorectal cancer is different in different genders and ages and in countries or regions with different HDI levels. Analyzing and discussing the epidemic status and characteristics of colorectal cancer and understanding the influencing factors of colorectal cancer epidemic can provide theoretical basis and data support for further effective and precise prevention and control measures.

Abstract:Objective To evaluate the effects of 3 machine learning algorithms (support vector machine ［SVM］, random forest, and extreme gradient boosting ［XGBoost］) and logistic regression in predicting the 30-d mortality of severe ischemic stroke patients. Methods The data of 2 358 patients with severe ischemic stroke who qualified for the criteria in the Medical Information Mart for Intensive CareⅣ (MIMIC-Ⅳ) database from 2008 to 2019 were used. SVM, random forest, XGBoost and logistic regression combined with synthetic minority oversampling technique (SMOTE) were used respectively to build early mortality prediction models. The prediction performance of models was evaluated by the area under curve (AUC) of receiver operating characteristic curve, accuracy, F1-score, and Brier score. Results The AUC values of SVM, random forest, XGBoost and logistic regression models using original unbalance data were 0.78, 0.81, 0.84 and 0.83, respectively. After using SMOTE-based synthetic data, the AUC values of SVM, random forest, XGBoost and logistic regression models were 0.72, 0.84, 0.83 and 0.83, respectively. Except for SVM, random forest and XGBoost had similar predictive ability to logistic regression, but their accuracy and Brier score were better than logistic regression, and their overall classification performance was better. Conclusion Machine learning algorithms have better performance than traditional logistic regression in predicting early mortality of ischemic stroke patients.

Abstract:Objective To observe the clinical efficacy of modified VitalStim electroacupuncture in the treatment of dysphagia in stroke patients with cricopharyngeal dysfunction (CPD). Methods A total of 40 stroke survivors with CPD in Department of Rehabilitation Medicine of The Second Affiliated Hospital of Chongqing Medical University from Oct. 2018 to Oct. 2019 were randomly divided into experimental group and control group, with 20 patients in each group. The experimental group received modified VitalStim electroacupuncture＋routine rehabilitation, and the control group received routine electroacupuncture＋routine rehabilitation. The patients in the 2 groups were assessed by video fluoroscopic swallowing study (VFSS) and laryngeal ultrasonography before and after treatment. The swallowing time, cricopharyngeal muscle expansion and hyoid bone displacement were analyzed respectively. The changes of above indexes were compared between the 2 groups before and after treatment. Adverse events and complications were observed during the treatment. Results Compared with before treatment, shortened swallowing time and increased cricopharyngeal muscle expansion and hyoid bone displacement were observed in both groups after treatment (all P＜0.01). After treatment, the swallowing time of patients in the experimental group was shorter than that in the control group, and the cricopharyngeal muscle expansion and hyoid bone displacement were greater than those in the control group (all P＜0.01). No adverse events or complications occurred during the treatment. Conclusion Routine rehabilitation combined with routine electroacupuncture or modified VitalStim electroacupuncture can improve the swallowing function of stroke survivors with CPD by increasing the hyoid bone displacement and relieving the cricopharyngeal muscle spasm, and modified VitalStim electroacupuncture has better clinical efficacy.

Abstract:Objective To investigate the differences in intestinal flora characteristics between infertile patients with polycystic ovary syndrome (PCOS) and tubal obstruction and healthy women of childbearing age. Methods A total of 30 female infertile patients, who met the inclusion criteria in Reproductive Medicine Center, The First Hospital of Lanzhou University from Sep. to Dec. 2020, were enrolled and divided into PCOS infertility group (n＝20) and tubal obstruction infertility group (n＝10). Healthy women of childbearing age who underwent prenatal testing in the same hospital during the same period were recruited as healthy control group (n＝10). Fecal and blood samples were collected from each group of the participants, the characteristics of intestinal flora were detected by 16S rRNA gene sequencing, and their relationship with clinical parameters was analyzed. Results The relative abundance of Firmicutes in the PCOS infertility group and tubal obstruction infertility group were significantly decreased compared with the healthy control group at phylum level (both P＜0.05), while the relative abundances of Bacteroidota and Proteobacteria were significantly increased in the PCOS infertility group (both P＜0.05). Compared with the tubal obstruction infertility group, the relative abundance of Firmicutes was decreased and that of Proteobacteria was increased in the PCOS infertility group (both P＜0.05). Firmicutes and follicle-stimulating hormone (FSH), Bacteroidota, Proteobacteria, Actinobacteriota and total cholesterol (TC), and Actinobacteriota and homeostasis model assessment of insulin resistance (HOMA-IR) were all positively correlated in the PCOS infertility group (all P＜0.05), while Firmicutes and TC, Desulfobacterota and fasting blood glucose (FBG), and Fusobacteriota and HOMA-IR were negatively correlated (all P＜0.05). In the tubal obstruction infertility group, Campilobacterota and luteinizing hormone/FSH ratio, unidentified bacteria and triglyceride, and Firmicutes and estradiol were positively correlated (all P＜0.05), while Campilobacterota and HOMA-IR, and unidentified bacteria and waist-hip-ratio were all negatively correlated (all P＜0.05). Conclusion The composition of intestinal flora in infertility patients with PCOS and tubal obstruction is disordered and related to glucose and lipid metabolism.

Abstract:Objective To analyze the clinical pregnancy status of embryos derived from non-pronucleus (0PN) zygotes and one pronucleus (1PN) zygotes in short-term in vitro fertilization (IVF) fresh transplant cycles, and to explore the clinical value of these embryos. Methods The laboratory data of 524 fresh transplant cycles of 524 infertile patients who received short-term IVF-embryo transfer treatment at Department of Reproductive Medicine, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan. 2016 to Jan. 2020 were retrospectively analyzed. The transfer cycles were divided into group A and group B according to the embryo source. The embryos in group A were derived from 0PN or 1PN zygotes, and those in group B were derived from two pronuclei (2PN) zygotes. According to the number of embryos transferred, the single-embryo transferred ones were divided into group A1 (with embryos derived from 0PN or 1PN zygotes) and group B1 (with embryos derived from 2PN zygotes); and the double-embryo transferred ones were divided into group A2 (with embryos derived from 0PN＋0PN zygotes, 1PN＋1PN zygotes, or 1PN＋0PN zygotes) and group B2 (with embryos derived from 2PN＋2PN zygotes). Clinical and laboratory data and pregnancy outcomes were compared between groups A and B, A1 and B1, and A2 and B2, respectively. Results The numbers of eggs obtained per cycle in group B and group B2 were significantly greater than those in group A and group A2, respectively (both P＜0.01), while there was no significant difference between group A1 and group B1 (P＞0.05). There were no significant differences in implant rate, clinical pregnancy rate, abortion rate or live birth rate between group A and group B, group A1 and group B1, or group A2 and group B2 (all P＞0.05). Conclusion In the short-term IVF fresh transfer cycle, the cycle with more number of eggs obtained per cycle is more likely from embryos derived from 2PN zygotes. There is no significant difference in pregnancy outcome between embryos derived from 0PN/1PN zygotes and 2PN zygotes in short-term IVF fresh transfer cycle. Embryos derived from 0PN/1PN zygotes can be transferred with informed consent of the patient.

Abstract:Objective To explore the antagonistic effect of nucleic acid aptamer on cytotoxicity of palytoxin (PLTX). Methods The cytotoxicity of PLTX on mouse embryonic fibroblast cell line NIH-3T3, Chinese hamster ovary cell line CHO-K1 and immortalized human keratinocyte cell line HaCaT and the antagonistic effect of aptamer 13-S3 to PLTX (with the concentration ratio of 1∶1) were detected and compared by cytotoxicity experiment. The hemolytic effect of PLTX on sheep erythrocytes and the inhibitory effect of aptamer on the hemolytic activity of PLTX were detected by erythrocyte hemolysis test. Results The cytotoxicity test showed that the half inhibitory concentration (IC₅₀) of HaCaT cells was (1.24±0.93) nmol/L, that of CHO-K1 cells was (3.95±0.78)×10^-3 nmol/L, and that of NIH-3T3 cells was (5.18±1.92)×10^-3 nmol/L. Compared with the PLTX control group, the survival rates of HaCaT cells were significantly increased in different concentration (9.3×10^-4, 9.3×10^-3, 9.3×10^-2, 9.3×10^-1, 9.3, and 93.3 nmol/L) PLTX＋aptamer 13-S3 groups (all P＜0.05). At the concentration of 12.5 nmol/L PLTX, compared with the PLTX＋aptamer N7-T (the specific aptamer of nodularin-R) group, the hemolysis rate of PLTX＋aptamer 13-S3 group decreased more significantly (P＜0.05), indicating that the aptamer 13-S3 could specifically inhibit the hemolytic activity of PLTX on sheep erythrocytes. Conclusion The survival rate of HaCaT cells has a good gradient response to the change of PLTX concentration (9.3×10^-4-93.3 nmol/L), and corresponding concentration of nucleic acid aptamers can antagonize the cytotoxicity of PLTX on HaCaT cells. At a concentration of 12.5 nmol/L PLTX, the corresponding concentration of aptamer can effectively inhibit the hemolytic activity of PLTX on sheep erythrocytes and play a cytoprotective role.

Abstract:Objective To explore the efficiency and effect of self-developed automatic cutting instrument for cutting microskins, and evaluate its effect in repairing full-thickness skin defects of rats. Methods The efficiency and effect of the automatic cutting instrument in preparing microskins were evaluated by comparing with that cut by hand. The microskins prepared by mechanical cutting (experimental group) and manual cutting (control group) were observed by hematoxylin-eosin (H-E) staining, and the tissue activity of the unit mass microskins of the experimental group and the control group was detected by cell counting kit 8 (CCK-8) assay. The microskins of the experimental group and the control group were transplanted into the rat model of full-thickness skin defect at the ratio of 1∶20, and the rate of wound epithelialization was observed. Masson staining, collagen Ⅳ immunofluorescence staining and Ki-67 immunohistochemical staining were used to detect the structure and arrangement of collagen fibers, the formation of basement membrane and the proliferation of wound cells. Results The time required for cutting 2 cm×3 cm skin by using the automatic cutting instrument was 5 min, and the manual cutting time with tissue scissors was about 40 min. The results of H-E staining showed that the microskins in the experimental group had intact structure, but those cut by hand was not, their epidermis was seriously damaged. CCK-8 assay showed that the activity index of skin grafts in the experimental group was significantly higher than that in the control group (［0.067981±0.004467］ mg^-1 vs ［0.045168±0.002698］ mg^-1, P＜0.01). On the 24^th day after transplantation, the rate of wound epithelialization in the experimental group was (78.6±2.3)%, which was significantly higher than that in the control group (［27.2±1.9］%, P＜0.01). Masson staining showed that the thickness of granulation tissue in the experimental group was significantly lower than that in the control group, and the arrangement of collagen was loose and regular. In the experimental group, the wound basement membrane formed well and the basal layer cells proliferated obviously, while in the control group, the basement membrane formed poorly and the basal layer cells did not proliferate obviously. Conclusion The self-developed automatic cutting instrument has the advantages of high efficiency of cutting microskins, intact structure and high tissue activity retention, and can quickly repair the animal model of full-thickness skin defect at 1∶20 amplification ratio. It has different characteristics from that of traditional manual cutting microskins, and has a good application prospect.

Abstract:Objective To explore the mechanism of Buyang Huanwu decoction in inhibiting pulmonary neutrophil inflammatory activation under the pathological condition of acute respiratory distress syndrome (ARDS). Methods The bronchoalveolar fluid (BALF) of ARDS patients treated and untreated by Buyang Huanwu decoction were obtained, and the contents of inflammatory factors (tumor necrosis factor α［TNF-α］, interleukin ［IL］-1β, IL-6, and IL-4) were detected by enzyme-linked immunosorbent assay (ELISA). Neutrophils were isolated at the same time, and the expression of IL-4 receptor α (IL-4Rα), hypoxia-inducible factor 1α (HIF-1α) and cleaved cysteine aspartic acid specific protease (caspase) 3 was detected by Western blotting. The primary neutrophils with silenced IL-4Rα were pretreated with rats drug serum of Buyang Huanwu decoction, and then ARDS in vitro model was established by lipopolysaccharide (LPS) and hypoxia induction. The contents of inflammatory factors in cell supernatant were detected by ELISA, the cell proliferation activity and apoptosis were detected by cell counting kit 8 and flow cytometry, respectively. Results Compared with the routine treatment group, the contents of TNF-α, IL-1β and IL-6 in the BALF of Buyang Huanwu decoction treatment group were significantly decreased (all P＜0.01), while the content of IL-4 was increased slightly (P＞0.05). Compared with the patients in the routine treatment group, the expression of IL-4Rα and cleaved caspase 3 was significantly increased in the BALF-derived neutrophils of ARDS patients in the Buyang Huanwu decoction treatment group, while the expression of HIF-1α was significantly decreased (all P＜0.01). Compared with neutrophils cultured under normal conditions, the contents of TNF-α, IL-1β and IL-6 were significantly increased in the supernatants of neutrophils cultured under LPS and hypoxia for 48 h, and the cell proliferation activity was also significantly increased (all P＜0.01). Compared with the cells of the ARDS in vitro model, the contents of the above inflammatory factors were significantly decreased in the supernatants of neutrophils pretreated with Buyang Huanwu decoction drug serum, the cell proliferation activity was significantly decreased, the apoptosis rate was significantly increased (all P＜0.01), while IL-4Rα silencing could reverse the above effects of Buyang Huanwu decoction drug serum (all P＜0.01). Conclusion Buyang Huanwu decoction can inhibit the release of inflammatory factors from neutrophils under ARDS by up-regulating IL-4Rα.

Abstract:Objective To explore the effect of riboflavin on pathological myocardial hypertrophy and fibrosis in mice induced by transverse aortic constriction (TAC), and to preliminarily explore the relationship between this effect and short-chain acyl-CoA dehydrogenase (SCAD). Methods The C57BL/6 mice were randomly divided into 4 groups (n＝10): sham operation＋normal saline (NS) group (sham＋NS group), TAC＋NS group, sham＋riboflavin group, and TAC＋riboflavin group. The mice in each group were gavaged continuously for 5 weeks from 1 week before the operation to 4 weeks after the operation, and the gavage dose of riboflavin was 20 mg·kg^-1·d^-1. The systolic blood pressure of the tail artery of the mice in each group was detected at the 5^th week after the operation, the cardiac structure and function of the mice were evaluated by echocardiography, the heart weight/body weight ratio and heart weight/tibia length ratio were calculated, and the morphological changes of mice hearts were observed; the mRNA expression levels of cardiac hypertrophy markers in mice, the expression levels of mouse myocardial collagen, and the expression and enzymatic activity of SCAD were detected, and the contents of coenzyme flavin adenine dinucleotide (FAD) in myocardial SCAD, adenosine triphosphate (ATP) and free fatty acid were detected. Results Riboflavin could improve TAC surgery-induced pathological myocardial hypertrophy and fibrosis in mice; at the same time, it increased myocardial FAD content, SCAD protein and mRNA expression levels, SCAD enzyme activity, myocardial ATP content, and decreased myocardial free fatty acid content (all P＜0.01). Conclusion Riboflavin can improve pathological myocardial hypertrophy and fibrosis in mice. This effect may be achieved by increasing myocardial FAD content, promoting myocardial SCAD expression, enhancing myocardial fatty acid β oxidation, and improving myocardial energy metabolism.

Abstract:Objective To study the role of P2X4 receptor (P2X4R) in a cell model of Parkinson’s disease (PD). Methods Treat human neuroblastoma cells SH-SY5Y with 6-hydroxydopamine (6-OHDA) to establish a Parkinson’s disease cell model and detect the expression of P2X4R. P2X4R was silenced in SH-SY5Y cells, cell viability was detected by cell counting kit 8 (CCK-8), cell apoptosis was detected by flow cytometry, and the expression of apoptosis factors and pannexin 1 (PANX1) was detected by Western blotting. Western blotting was used to detect the expression of Toll-like receptor 2 (TLR2) protein when P2X4R was silenced, P2X4R was inhibited and PANX1 was overexpressed. TLR2 was overexpressed in PD model cells, and cell viability, apoptosis, and apoptotic factor expression were examined. Results P2X4R protein and mRNA expression levels in PD model cells treated with 100 and 150 μmol/L 6-OHDA were higher than those in control group (all P＜0.05). After P2X4R silence, the apoptosis of PD model cells was significantly decreased and cell survival rate was significantly increased; and the protein expression of cysteine aspartic acid specific protease (caspase) 3, cleaved caspase 3 and PANX1 was significantly decreased (all P＜0.05). The expression of TLR2 protein in PD model cells was decreased after silencing P2X4R and inhibiting P2X4R (both P＜0.05). The expression of TLR2 protein was significantly decreased after PANX1 overexpression (P＜0.05). After TLR2 overexpression, the protein expression of caspase 3 and cleaved caspase 3 was significantly decreased (both P＜0.05), and the cell survival rate was increased. Conclusion P2X4R may reduce apoptosis of PD model cells by regulating PANX1 and TLR2 expression.

Abstract:Objective To compare the protective effects of Wuling capsule on CCl₄-induced hepatic fibrosis rats before and after process optimization. Methods SD rats were randomly divided into 9 groups: control group, model group, positive control group (silymarin) and low (0.25 g/kg)-, medium (0.5 g/kg)- and high (1.0 g/kg)-dose of Wuling capsule new process and original process groups, with 10 rats in each group. The rat model with liver fibrosis was established by intraperitoneal injection of CCl₄ solution (dissolved in olive oil, at a dosage of 2 mL/kg), twice a week for 8 weeks except control group. The rats in the treatment groups were administered by gavage at the second week for 6 consecutive weeks. At the end of the experiment, the wet weights of the rat liver and spleen were examined and the viscera indexes were calculated. Serum biochemical indexes (alanine aminotransferase ［ALT］, aspartate aminotransferase ［AST］, alkaline phosphatase ［ALP］, total bile acid ［TBA］, and albumin ［ALB］) and superoxide dismutase (SOD) activity were detected. Hematolyxin-eosin staining and Masson staining were used to observe the pathological structure and fibrosis degree of liver tissues. The level of α-smooth muscle actin (α-SMA) in rat liver tissues was detected by immunohistochemistry. The levels of interleukin (IL)-6, IL-1β and tumor necrosis factor α (TNF-α) in serum were determined by enzyme-linked immunosorbent assay. The mRNA relative expression levels of collagen (COL) Ⅰ, COL Ⅲ, COL Ⅳ and nuclear factor κB (NF-κB) in the liver were determined by quantitative polymerase chain reaction (qPCR). Results Both the new and original process groups of Wuling capsule improved the liver pathological structure of CCL4-induced hepatic fibrosis rats and reduced the degree of hepatic fibrosis. Compared with the model group, the contents of ALT, AST, ALP and TBA in serum were significantly decreased (P＜0.05); serum ALB content and SOD activity were significantly increased (P＜0.05); the α-SMA positive area ratio in liver tissues decreased (P＜0.05); the contents of serum IL-6, IL-1β and TNF-α were significantly decreased (P＜0.05); and the mRNA expression levels of COL Ⅰ, COL Ⅲ, COL Ⅳ and NF-κB in liver tissues were significantly down-regulated (P＜0.05). The experimental results of TBA, α-SMA and COL Ⅲ in the new process group were significantly better than those in the original process group. Conclusion Both the new technology and original technology of Wuling capsule have protective effects on CCl₄-induced hepatic fibrosis in rats, but some indexes of the new technology are better than those of the original technology group.

Abstract:Chikungunya fever (CHIKF) is an acute infectious disease caused by Chikungunya virus (CHIKV) and characterized by fever, rash and chronic joint pain. CHIKF has become one of the important global public health issues, with about 1 million cases in more than 100 countries and regions around the world each year. Vaccination is the most important, effective and economical means to prevent infectious diseases. However, due to insufficient funding for basic researches and clinical trials, as well as the continuous adaptive mutations of the virus, the development process of vaccine against CHIKV is generally slow. No licensed vaccine is yet available to prevent CHIKF, but there have been several vaccine candidates undergoing clinical trials. This review briefly summarizes the research progress on CHIKV vaccines in recent years.

Abstract:Immune checkpoint molecules are involved in the functional regulation of T cells to prevent them from attacking their own tissues and play an important role in the homeostasis of immune response. Immune checkpoint inhibitors (ICIs) can restore the ability of the immune system to kill tumors when the immune system is suppressed, providing an effective method for the treatment of most malignant tumors, and have become a research focus of tumor therapy. However, the wide application of ICIs in the treatment of malignant tumors has led to immune-related adverse events in the cardiovascular system, among which cardiotoxicity is one of the more common ICIs-based immunotoxic reactions, such as cardiomyopathy, myocarditis and fatal heart failure, but it is easy to be ignored. This article reviews the adverse reactions of different ICIs to the heart and their prevention and treatment.

Abstract:This article reviewed recent progress in non-interventional diagnosis of endometriosis, including serum and tissue markers, screening methods with genomics/proteomics and spectrum analysis, application of diagnostic scoring system and algorithm model, application of image parameters, new technologies and new operation skills in imaging diagnosis. The diagnostic efficacy, clinical feasibility and disadvantage were analyzed. Based on the current research status of endometriosis diagnosis, it is believed that a better diagnosis scoring system can provide evidence for rapid differential diagnosis, diagnostic algorithm based on multiple markers can promote diagnosis accuracy, and new imaging technologies can improve the diagnostic sensitivity and differential diagnostic ability.

Abstract:Objective To comprehensively evaluate the dietary and nutritional status of naval soldiers for the improvement of military nutrition and adjustment of food supply. Methods A total of 141 units were sampled in this survey, covering all categories of soldiers in the Navy. Based on The method of nutrition survey and assessment in armed forces (GJB1636A-2016), the daily per capita food intake and nutrient intake of each unit were calculated by weighing method and accounting method. At the same time, the average daily energy consumption of each person was calculated by the 24 h life observation method. The physical examination and nutrition-related disease questionnaire were also conducted. Results It was found that the main nutritional problems of the soldiers were the coexistence of nutrient deficiency and overnutrition caused by the imbalance of dietary structure, leading to the occurrence of nutrition-related diseases. The lack of nutrition knowledge and weak concepts of nutrition and health may be the reason for the above problems. Conclusion According to the problems found in the investigation, countermeasures should be taken as soon as possible to provide strong support for improving the nutrition level and physical fitness to build up a world-class navy.

Abstract:Objective To analyze the risk factors of non-infectious fever after uterine myomectomy. Methods The clinical data of 146 patients who underwent myomectomy in our hospital from Jan. 2021 to Jan. 2022 were retrospectively analyzed. Postoperative non-infectious fever refers to the body temperature≥38 ℃ within 48 h after operation, and there is no evidence of infection. Univariate analysis was used to analyze the influence of age, preoperative and postoperative hemoglobin concentration, perioperative antibiotic use, maximum size of myomas, number of myomas, suture mode, operation mode, whether to penetrate the endometrium during operation, whether to perform uterine cavity operation at the same time, operation time and other factors on postoperative non-infectious fever. Multivariate binary logistic regression analysis was performed on the selected suspected risk factors. Results Among the 146 patients, 25 had postoperative non-infectious fever and 121 had normal body temperature. Univariate analysis showed that operation time, operation mode, suture mode, number of myomas, maximum size of myomas, history of cesarean section, preoperative and postoperative hemoglobin concentration, preoperative and postoperative hemoglobin reduction and postoperative hospital stay would affect the postoperative non-infectious fever (all P＜0.05). The results of multivariate logistic regression analysis showed that the operation time (odds ratio ［OR］ ＝1.01, 95% confidence interval (CI) 1.00-1.02, P＝0.03), operation mode (OR＝5.03, 95% CI 1.74-14.56, P＜0.01) and the number of myomas (OR＝1.33, 95% CI 1.05-1.68, P＝0.02) were independent risk factors for the occurrence of postoperative non-infectious fever (all P＜0.05). Conclusion The independent risk factors of non-infectious fever after myomectomy include operation time, operation mode and number of myomas. These factors should be intervened in clinical work.

Abstract:Objective To investigate the improvement of gastrointestinal symptoms in patients after laparoscopic cholecystectomy (LC), and analyze the influencing factors. Methods The clinical data of LC patients in Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan. 2020 to Dec. 2021 were analyzed retrospectively. The patients were older than 18 years, and those with malignant tumors were excluded. The general information (including course of disease, underlying diseases, previous surgical history, and preoperative examination), surgical-related data (including conversion to laparotomy, biliary tract injury, and whether to place an abdominal drain), and postoperative complications (including bile leakage, hemorrhage, abdominal infection, incision infection, and side injury) of patients were collected. All the patients were followed up for 6 months and investigated with the gastrointestinal symptom rating scale (GSRS). Results Among the 173 patients, 84 (48.55%) were males and 89 (51.45%) were females, with an average age of (54.12±13.38) years. The median time of onset was 6.00 (1.75, 24.00) months. The median total score of GSRS after operation was 0 (0, 1), which was significantly lower than that before operation (3 ［0, 5］) (P＜0.01). One hundred and ten (63.85%) cases complained of abdominal pain before operation and it decreased to 16 (9.25%) cases after operation (P＜0.01). Twelve (6.94%) cases presented heartburn and acid regurgitation before operation and 6 (3.47%) cases after operation (P＜0.05). There were 38 (21.97%) cases of nausea and vomiting before operation and 2 (1.16%) cases after operation (P＜0.01). Upper abdominal discomfort occurred in 35 (20.23%) cases before operation and 1 (0.58%) case after operation (P＜0.01). Abdominal distension was found in 41 (23.70%) cases before operation and 11 (6.36%) cases after operation (P＜0.01). Postoperative diarrhea occurred in 26 (15.03%) cases, with an increase of 14 cases (P＜0.01). Conclusion The gastrointestinal symptoms of patients after LC are significantly improved. The GSRS score can be used to comprehensively and intuitively analyze the changes of the above symptoms before and after the operation. The reasons for the persistent abdominal pain and diarrhea of patients after surgery need to be further analyzed with a large sample.

Abstract:Objective To analyze the clinical features, diagnosis and treatment and prognosis of hairy cell leukemia (HCL). Methods The clinical data of 11 HCL patients admitted to Fujian Medical University Union Hospital from Jan. 2016 to Feb. 2021 were collected and sorted out, and the clinical features, diagnosis and treatment effects and prognosis of HCL were analyzed. Results There were 7 males and 4 females, the median age at diagnosis was 57 (30-81) years old, and the median time from the onset of clinical symptoms or signs to diagnosis was 5.0 (0.5-26.0) months. At diagnosis, there were 6 cases with lymphoma B symptoms (fever, night sweating, and weight loss), 7 cases with infection (all pulmonary infection), and 3 cases with lymphadenopathy; all cases were accompanied by splenomegaly (3 cases of mild splenomegaly, 2 cases of moderate splenomegaly, and 6 cases of megasplenomegaly). All the 11 patients underwent first-or second-generation sequencing. The positive rate of B-Raf proto-oncogene, serine/threonine kinase V600E mutant type (BRAF^V600E) mutation was 81.82% (9/11); peripheral blood routine showed that the two lines decreased in 4 (36.36%) cases, the three lines decreased in 7 (63.64%) cases, and the monocyte decreased in 9 (81.82%) cases. Among the 11 patients, except 1 patient who received FC regimen (fludarabine 50 mg and cyclophosphamide 0.3 g for the first 3 d) and 1 patient who received R-CVP regimen (rituximab 500 mg for the first day; cyclophosphamide 1.1 g for the second day; vindesine 4 mg for the second day; dexamethasone 15 mg for the first 5 d) in the first course of treatment and changed to cladribine in the next course, the remaining 9 patients received cladribine monotherapy. One patient obtained complete remission after 1 course of treatment with FC regimen. Among the remaining 10 patients, 7 patients were treated with single course of cladribine and 3 patients were treated with 2 courses. Among them, 4 patients were treated with cladribine for 1-3 months, the curative effect was evaluated as partial remission, and the remaining 6 patients reached complete remission after 4-12 months of treatment. The overall response rate of 10 patients to cladribine was 100.00%. Ten of the 11 patients had adverse hematological reactions of grade 2-4 after cladribine treatment: 7 (63.64%, 7/11) cases had neutropenia, 6 (54.55%, 6/11) cases had thrombocytopenia, 4 (36.36%, 4/11) cases developed agranulocytosis with fever, and 3 (27.27%, 3/11) cases developed lung infection or upper respiratory tract infection. The patients with infection symptoms improved after anti-infection and supportive treatment. There were no other adverse reactions except hematological adverse reactions. The median follow-up time of 11 HCL patients was 14 (3-61) months, and the median overall survival and progression-free survival were not reached. During the followed-up, no patients had HCL disease progression, recurrence, or death. Conclusion HCL is a rare clinically indolent hematological tumor, which is sensitive to cladribine and has controllable adverse reactions. Patients with relapsed or refractory HCL can choose to enter clinical trials or consider joint use of other targeted inhibitors or monoclonal antibodies.

Abstract:Objective To investigate the effectiveness of transurethral resection of ureterocele in the treatment of hydronephrosis or hydroureter caused by duplex kidney and deformity of ureter combined with ectopic ureterocele. Methods Nine patients with duplex kidney and deformity of ureter combined with ectopic ureterocele, who were admitted to The First Affiliated Hospital of the Naval Medical University (Second Military Medical University) from Jan. 2013 to Jun. 2021, were enrolled, including 3 patients suffered from lumbago, 2 patients suffered from dysuria, and 2 patients suffered from recurrent urinary tract infection. All patients were diagnosed by urinary ultrasound, intravenous urography, enhanced computed tomography urography, and cystoscopy before operation. All patients underwent transurethral resection of ureterocele. Results The operation was performed successfully on all patients. The operation time was 20-40 min, with an average of (28.3±7.5) min, and the average intraoperative bleeding was less than 20 mL. Double-J stent insertion was used in 3 patients during the operation. The drainage fluid in bladder irrigation was limpid, and bladder irrigation was stopped within 24 h after surgery. The catheters were removed and patients were discharged 2-3 d after surgery. The average postoperative hospital stay was (2.4±1.6) d. The double-J stent was removed 6-8 weeks after the operation. The patients were followed-up after postoperative 1-24 months with ultrasound examination, and all hydronephrosis was relieved, except 3 patients who still had mild hydronephrosis. The symptoms such as soreness of loins, lumbago and dysuria disappeared, and there was no recurrence of urinary tract infection. Conclusion Transurethral resection of ureterocele has advantages of minimal invasion, quick recovery, few complications and high acceptance of patients. It can be the first choice for patients with duplex kidney and deformity of ureter combined with ureterocele with surgical indications.

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