Beta-lactam antibiotic resistance among Escherichia coli isolates from patients with urinary tract infections in Vietnam:A systematic review and meta-analysis

Objective:To investigate the evolving patterns of antimicrobial resistance against beta-lactam antibiotics in Escherichia coli isolates from urinary tract infection patients in Vietnam,covering the period from 2005 to 2022.Methods:29 Descriptive studies published between 2010 and 2022 in English and Vietnamese were included in the analysis.Data on resistance rates to beta-lactam antibiotics,including cephalosporins and carbapenems,were extracted and analyzed.Weighted pooled resistance rates were calculated using random-effects models.Annual trends in resistance were assessed using linear regression analysis.Results:Among the beta-lactam antibiotics studied,Escherichia coli exhibited varying levels of resistance,with cephalosporins showing higher resistance rates compared to carbapenems.Weighted pooled resistance rates were 66%for cefotaxime,65%for ceftriaxone,54%for ceftazidime,and 56%for cefepime.In contrast,carbapenems demonstrated lower resistance rates,with weighted pooled resistance rates ranging from 3%to 4%for meropenem,ertapenem,and imipenem.Resistance rates were also observed for amoxicillin/clavulanate(35%),ticarcillin/clavulanate(26%),and piperacillin/tazobactam(12%).Significant annual increases in resistance were noted for imipenem(0.56%,P<0.001).Conclusions:This study highlights the critical issue of antimicrobial resistance in urinary tract infections in Vietnam and emphasizes the importance of prudent antibiotic use and the regular monitoring of resistance patterns.These insights are useful for guiding healthcare professionals in optimizing treatment strategies and for policymakers in formulating evidence-based clinical guidelines to combat antibiotic resistance effectively.

Immunomodulatory and chemopreventive effects of resveratrol on the digestive system cancers

Resveratrol(RSV),the primary polyphenol found in grapes,has been revealed to have anti-inflammatory properties by reducing the capacity of the peripheral blood mononuclear cells to produce pro-inflammatory cytokines,including IL-1β,IL-6,IL-1ra and TNFα.Considering the close association between chronic inflammation and cancer development,RSV’s immunomodulatory properties are one way by which the polyphenol may inhibit cancer initiation,proliferation,neovascularization,and migration.Resveratrol influences the generation of microtumor environment which is one of the key factors in cancer progress.In addition to immunomodulation,RSV inhibits cancer development by expressing anti-oxidant effects,causing cell cycle arrest,stimulating the function of certain enzymes,and activating cell signaling pathways.The end outcome is one of the various forms of cell death,including apoptosis,pyroptosis,necroptosis,and more,as it has been observed in vitro.RSV has been shown to act against cancer in practically every organ,while its effects on colon cancer have been documented more frequently.It is remarkable that longer-term clinical studies that may have established the potential for this natural substance to serve as a therapeutic adjuvant to traditional anti-cancer medications were not prompted by the encouraging outcomes seen with cancer cells treated with non-toxic doses of resveratrol.The current review aims to assess the recent findings about the immunological and anti-cancer characteristics of RSV,with a particular emphasis on cancers of the digestive tract,as a challenge for future clinical research that may contribute to the better prognosis of cancer.

Sequential Analysis in the Identification of 3rd Order System Tract in the Abidjan Margin

The use of sequential stratigraphy concept, based on well logs, sedimentology, and biostratigraphy, has shed light on the complex mechanisms controlling sedimentary accumulations. Consequently, identifying these mechanisms allows us to predict the hydrocarbon generation potential of source rocks. In the Ivorian offshore sedimentary basin, certain studies have contributed to understanding and characterizing the petroleum system. However, these previous works did not integrate biostratigraphic data to highlight sedimentary facies. This study, conducted on two wells in the Abidjan margin, is crucial as it helps us comprehend the geometry of fossil sediments in relation to sea level variations. It will also aid in reconstructing the basin-filling history and predicting the distribution of rocks capable of trapping oil, determining lowstand systems tracts (reservoir rocks), transgressive systems tracts, and highstand systems tracts (cap rocks). Lithological analysis revealed predominantly clayey sedimentation with sandy layers. Well log data facilitated the delineation of formation boundaries and highlighted reservoirs consisting of sands, sandstones, limestones, and occasionally intercalated shales. Integrating these analysis results with biostratigraphic interpretations based on foraminifera and palynomorphs revealed that the traversed formations were deposited in a transitional environment ranging from Coniacian to Maastrichtian ages. Applying sequential stratigraphy concept from well logging resolved dating issues encountered in microfossil-poor or microfossil-free zones. The results of the Coniacian-Maastrichtian age sequential subdivision were aligned with the chart.

Enhancing m^(6)A modification in the motor cortex facilitates corticospinal tract remodeling after spinal cord injury

Spinal cord injury typically causes corticospinal tract disruption. Although the disrupted corticospinal tract can self-regenerate to a certain degree, the underlying mechanism of this process is still unclear. N6-methyladenosine(m^(6)A) modifications are the most common form of epigenetic regulation at the RNA level and play an essential role in biological processes. However, whether m^(6)A modifications participate in corticospinal tract regeneration after spinal cord injury remains unknown. We found that expression of methyltransferase 14 protein(METTL14) in the locomotor cortex was high after spinal cord injury and accompanied by elevated m^(6)A levels. Knockdown of Mettl14 in the locomotor cortex was not favorable for corticospinal tract regeneration and neurological recovery after spinal cord injury. Through bioinformatics analysis and methylated RNA immunoprecipitation-quantitative polymerase chain reaction, we found that METTL14 regulated Trib2 expression in an m^(6)A-regulated manner, thereby activating the mitogen-activated protein kinase pathway and promoting corticospinal tract regeneration. Finally, we administered syringin, a stabilizer of METTL14, using molecular docking. Results confirmed that syringin can promote corticospinal tract regeneration and facilitate neurological recovery by stabilizing METTL14. Findings from this study reveal that m^(6)A modification is involved in the regulation of corticospinal tract regeneration after spinal cord injury.

Cholecystectomy and the risk of alimentary tract cancers:A systematic review

AIM: To investigate the association between cholecystectomy and gastro-intestinal tract(GIT) cancers.METHODS: We conducted a systematic review according to the PRISMA guidelines. A MEDLINE search was performed with predefined search criteria for English Language articles on the association between cholecystectomy and GIT cancers. Additional articles were retrieved by manual search of references. All relevant articles were accessed in full text. Data onstudy type; cases; controls; country; effect estimate; adjustments for confounders and quality of publication were extracted. The quality of the publications were scored by adherence to the STROBE checklist. The data for each part of the GIT were presented in separate tables.RESULTS: Seventy-five studies and 5 meta-analyses satisfied the predefined criteria for inclusion and were included in this review. There were inconsistent reports and no strong evidence of an association between cholecystectomy and cancers of the oesophagus(Adenocarcinoma), pancreas, small bowel and rightsided colon cancers. In squamous cancer of the oesophagus, cancers of the stomach, liver, bile ducts, small bowel and left sided colon cancers, good quality studies suggested a lack of association with cholecystectomy. Equally, distal colon and rectal cancers were found not to be associated with cholecystectomy. Several mechanisms for carcinogenesis/promotion of carcinogensis have been proposed. These have focused on a role for bile salts in carcinogenesis with several potential mutagenic molecular events and gut metabolic hormones signaling cell proliferation or initiation of carcinogenesis.CONCLUSION: This is a comprehensive review of the association between GIT cancers and cholecystectomy. This review found no clear association between cholecystectomy and GIT cancers.

Effect of emodin on mobility signal transduction system of gallbladder smooth muscle in Guinea pig with cholelithiasis

Objective: To study the effect of emodin on protein and gene expressions of the massagers in mobility signal transduction system of cholecyst smooth muscle cells in guinea pig with cholesterol calculus. Methods: The guinea pigs were randomly divided into 4 groups, such as control group, gall-stone(GS) group, emodin group and ursodesoxycholic acid(UA) group. Cholesterol calculus models were induced in guinea pigs of GS, emodin and UA groups of induced models by lithogenic diet, while emodin or UA were given to the corresponding group for 7 weeks. The histomorphological and ultrastructure change of gallbladder were detected by microscope and electron microscope, the content of plasma cholecystokinin(CCK) and [Ca^(2+)]i were analyzed successively by radioimmunoassay and flow cytometry. The protein and mR NA of Gsα, Giα and Cap in cholecyst cells were determined by western blotting and real time polymerase chain reaction(RT-PCR). Results: Emodin or UA can relieve pathogenic changes in epithelial cells and muscle cells in gallbladder of guinea pig with cholesterol calculus by microscope and transmission electron microscope. In the cholecyst cells of GS group, CCK levels in plasma and [Ca^(2+)]i decreased, the protein and m RNA of GS group were downregulated,the protein and m RNA of Gi and Cap were up-regulated. Emodin significantly decreased the formative rate of gallstone, improved the pathogenic change in epithelial cells and muscle cells, increased CCK levels in plasma and [Ca^(2+)]i in cholecyst cells, enhanced the protein and mR NA of Gs in cholecyst cells, reduced the protein and mR NA of Gi and Cap in cholecyst cells in guinea pig with cholesterol calculus. Conclusion: The dysfunction of gallbladder contraction gives rise to the disorders of mobility signal transduction system in cholecyst smooth muscle cells, including low content of plasma CCK and [Ca^(2+)]i in cholecyst cells, abnormal protein and mRNA of Gs, Gi and Cap. Emodin can enhance the contractibility of gallbladder and alleviate cholestasis by regulating plasma CCK levels, [Ca2+]i in cholecyst cells and the protein and mR NA of Gs, Gi and Cap.

Endoscopic stenting for inoperable malignant biliary obstruction: A systematic review and meta-analysis

AIM: To analyze through meta-analyses the benefits of two types of stents in the inoperable malignant biliary obstruction.METHODS: A systematic review of randomized clinical trials(RCT) was conducted, with the last update on March 2015, using EMBASE, CINAHL(EBSCO), MEDLINE, LILACS/CENTRAL(BVS), SCOPUS, CAPES(Brazil), and gray literature. Information of the selected studies was extracted in sight of six outcomes: primarily regarding dysfunction, complication and reintervention rates; and secondarily costs, survival, and patency time. The data about characteristics of trial participants, inclusion and exclusion criteria and types of stents were also extracted. The bias was mainly assessed through the JADAD scale. This meta-analysis was registered in the PROSPERO database by the number CRD42014015078. The analysis of the absolute risk of the outcomes was performed using the software Rev Man, by computing risk differences(RD) of dichotomous variables and mean differences(MD) of continuous variables. Data on RD and MD for each primary outcome were calculated using the MantelHaenszel test and inconsistency was qualified and reported in χ2 and the Higgins method(I2). Sensitivity analysis was performed when heterogeneity was higher than 50%, a subsequent assay was done and other findings were compiled. Student's t-test was used for the comparison of weighted arithmetic means regarding secondary outcomes.RESULTS: Initial searching identified 3660 studies; 3539 were excluded through title, repetition, and/or abstract, while 121 studies were fully assessed and were excluded mainly because they did not compare self-expanding metal stents(SEMS) and plastic stents(PS), leading to thirteen RCT selected, with 13 articles and 1133 subjects meta-analyzed. The mean age was 69.5 years old, that were affected mostly by bile duct(proximal) and pancreatic tumors(distal). The preferred SEMS diameter used was the 10 mm(30 Fr) and the preferred PS diameter used was 10 Fr. In the metaanalysis, SEMS had lower overall stent dysfunction compared to PS(21.6% vs 46.8%, P < 0.00001) and fewer re-interventions(21.6% vs 56.6%, P < 0.00001), with no difference in complications(13.7% vs 15.9%, P = 0.16). In the secondary analysis, the mean survival rate was higher in the SEMS group(182 d vs 150 d, P < 0.0001), with a higher patency period(250 d vs 124 d, P < 0.0001) and a lower cost per patient(4193.98 vs 4728.65 Euros, P < 0.0985).CONCLUSION: SEMS are associated with lower stent dysfunction, lower re-intervention rates, better survival, and higher patency time. Complications and costs showed no difference.

FoxO4 is the main forkhead transcriptional factor localized in the gastrointestinal tracts of pigs

Forkhead box （Fox） proteins play critical roles in the regulation of differentiation, proliferation, immunity and aging of cells. Most studies on Fox proteins are limited to cultured cells and rodent. The aim of the current study is to detect by immunohistrochemistry whether FoxO1, FoxO3a and FoxO4 proteins are localized in the stomach and intestine of the pig. The results showed that FoxO4 exists in the mucosa in all parts of the stomach and intestine; FoxO3a exists mainly in the lamina propria and muscularis of some parts. However, FoxOl is not detectable in all parts of the stomach and intestine. Collectively, the results of the present study indicate that there exists a distinct expression pattern of Fox proteins, and that FoxO4 is a primary forkhead transcriptional factor localized in the gastrointestinal tracts of the pig.

Study on soils under shifting cultivation and other land use categories in Chittagong Hill Tracts, Bangladesh

Soil samples were collected and analyzed from 25 sites of three hilly regions （Rangamati, Banderban and Khagrachari） for an understanding of the impact of denudation and land use on soils in Chittagong Hill Tracts, Bangladesh. There were natural forests, bushy land, slashed sites, slashed and burnt sites, and the sites prepared for shifting cultivation, one year after shifting cultivation and two years after shifting cultivation. The soils were generally yellowish brown to reddish brown, sandy to sandy clay loam, strongly acid, and well to excessively drained on steep slopes with considerable variation among the sites and land use categories. Bulk density was the highest in sites of one year after shifting cultivation （1.52 g·cm^-3） and the lowest in forested sites （1.38 g·cm^-3）. Water holding capacities were, however, statistically similar in all sites. Organic carbon varied from 0.54% （slashed and burnt sites） to 1.55% （forested sites） and total N ranged from 0.05% （shifting cultivation for one year） to 0.13% （forested sites）. Available phosphorus （Bray ＆ Kurtz-2 P） was the maximum in forested sites （12.32 mg·kg^-l）, and it did not differ significantly in other sites. Contents of available Ca, Mg and K were also higher in the bushy lands and forested sites than cleared and shifting cultivated sites.

Immunocytochemical Identification and Localization of Diffuse Neuroendocrine System (DNES) Cells in Gastrointestinal Tract of Channel Catfish (Ictalurus punctatus)

To detect distribution and relative frequency of diffuse neuroendocrine system （DNES） cells in the gastrointestinal tract of channel catfish （lctalurus punctatus）, the intestinal tract of channel catfish was divided into seven portions from proximal to distal： the enlarged area after oesophagus, cardia, fundus, pylorus, and anterior, middle, and posterior intestine. Immunohistochemical method using the strept avidin-biotin-complex （SABC） was employed. All antisera between seven portions of the channel catfish were compared statistically using statistical package for the social science （SPSS）. Five types of DNES ceils were determined： neuropeptide Y-immunoreactive （NPY-IR） cells were demonstrated in both anterior and middle intestine; serotonin （5-HT） immunoreactive cells were detected throughout the whole gastrointestinal tract; vasoactive intestinal peptide （VIP） positive cells were at the highest frequency in pylorus; glucagon-immunoreactive （GLU-IR） cells were moderate in number in the fundus and anterior, middle intestine, and no immunoreactivity was determined in the other portions; somatostatin （SOM） positive cells were more abundant in the anterior and middle intestine. The regional distribution and relative frequency of immunoreactive cells in the channel catfish, Ictalurus punctatus, are essentially similar to those of other fish. However, some characteristics are observed in this species, which further proved that the diversity of the physiological function of DNES cells was based on their morphology.

Gastrointestinal complications of systemic sclerosis

Systemic sclerosis is an autoimmune disease characterized by progressive skin thickening and tightness.Pulmonary interstitial fibrosis and kidney damage are the most important indicators for mortality;however,the gastrointestinal tract is the most commonly damaged system.Virtually all parts of the gastrointestinal(GI)tract can be involved,although the esophagus is the most frequently reported.The mechanisms that cause such extensive damage are generally unclear,but vascular changes,immunological abnormalities,excessive accumulation of collagen in the submucosa,smooth muscle atrophy and neuropathy may participate because these are the most common histological findings in biopsies and autopsies.Most patients with GI tract involvement complain about dyspepsia,nausea,vomiting,abdominal bloating/distension,and fecal incontinence.These symptoms are generally mild during the early stage of the disease and are likely ignored by physicians.As the disease becomes more advanced,however,patient quality of life is markedly influenced,whereby malnutrition and shortened survival are the usual consequences.The diagnosis for systemic sclerosis is based on manometry measurements and an endoscopy examination.Supportive and symptomatic treatment is the main therapeutic strategy;however,an early diagnosis is critical for successful management.

Harnessing neural activity to promote repair of the damaged corticospinal system after spinal cord injury

As most spinal cord injuries （SCIs） are incomplete, an important target for promoting neural repair and recovery of lost motor function is to promote the connections of spared descending spinal pathways with spinal motor circuits. Among the pathways, the corticospinal tract （CST） is most associated with skilled voluntary functions in humans and many animals. CST loss, whether at its origin in the motor cortex or in the white matter tracts subcortically and in the spinal cord, leads to movement impairments and paraly- sis. To restore motor function after injury will require repair of the damaged CST. In this review, I discuss how knowledge of activity-dependent development of the CST--which establishes connectional speci- ficity through axon pruning, axon outgrowth, and synaptic competition among CST terminals--informed a novel activity-based therapy for promoting sprouting of spared CST axons after injur in mature animals. This therapy, which comprises motor cortex electrical stimulation with and without concurrent trans-spi- nal direct current stimulation, leads to an increase in the gray matter axon length of spared CST axons in the rat spinal cord and, after a pyramidal tract lesion, restoration of skilled locomotor movements. I discuss how this approach is now being applied to a C4 contusion rat model.

Optical coherence tomography in detection of dysplasia and cancer of the gastrointestinal tract and bilio-pancreatic ductal system

Optical coherence tomography(OCT) is an optical imaging modality that performs high-resolution,cross-sectional,subsurface tomographic imaging of the microstructure of tissues.The physical principle of OCT is similar to that of B-mode ultrasound imaging,except that it uses infrared light waves rather than acoustic waves.The in vivo resolution is 10-25 times better(about 10 μm) than with high-frequency ultrasound imaging,but the depth of penetration is limited to 1-3 mm,depending upon tissue structure,depth of focus of the probe used,and pressure applied to the tissue surface.In the last decade,OCT technology has evolved from an experimental laboratory tool to a new diagnostic imaging modality with a wide spectrum of clinical applications in medical practice,including the gastrointestinal(GI) tract and pancreatic-biliary ductal system.OCT imaging from the GI tract can be done in humans by using narrow-diameter,catheter-based probes that can be inserted through the accessory channel of either a conventional front-view endoscope,for investigating the epithelial structure of the GI tract,or a side-view endoscope,inside a standard transparent ERCP catheter,for investigating the pancreatico-biliary ductal system.Esophagus and the esophago-gastric junction has been the most widely investigated organ so far;more recently,also duodenum,colon and pancreatico-biliary ductal system have been extensively investigated.OCT imaging of the gastro-intestinal wall structure is characterized by a multiple-layer architecture that permits an accurate evaluation of the mucosa,lamina propria,muscularis mucosae,andpart of the submucosa.The technique may be,therefore,used to identify pre-neoplastic conditions of the GI tract,such as Barrett's epithelium and dysplasia,and evaluate the depth of penetration of early-stage neoplastic lesions.OCT imaging of the pancreatic and biliary ductal system could improve the diagnostic accuracy for ductal epithelial changes and the differential diagnosis between neoplastic and non-neoplastic lesions.

Photodynamic therapy for middle-advanced stage upper gastrointestinal carcinomas: A systematic review and meta-analysis

AIM To determine the therapeutic effect of photodynamic therapy(PDT) for middle-advanced stage upper gastrointestinal carcinomas. METHODS We searched PubM ed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Database from inception to April 2018 for randomized controlled studies. These studies compared PDT with other palliative therapies(radiotherapy, chemotherapy, or Nd:YAG laser) and compared PDT, radiotherapy, or chemotherapy alone with PDT combined with chemotherapy/radiotherapy. In our meta-analysis, both fixed and random effects models were used to estimate the risk ratio(RR) for dichotomous outcomes(the response rate and one-year survival rate).RESULTS Ten random controlled clinical studies with 953 patients were included in the analysis. The effective rate for PDT was better than that of radiotherapy or Nd:YAG laser for the treatment of middle-advanced upper gastrointestinal carcinomas [RR = 1.36; 95% confidence interval(CI): 1.13-1.65; P = 0.001]. In addition, PDT combined with chemotherapy had significantly better efficacy and a higher one-year survival rate than PDT or chemotherapy alone(significant remission rate, RR = 1.62; 95%CI: 1.34-1.97; P < 0.00001; one-year survival rate, RR = 1.81; 95%CI: 1.13-2.89; P = 0.01).CONCLUSION PDT is a useful method for the treatment of middleadvanced stage upper gastrointestinal carcinomas. PDT combined with chemotherapy or radiotherapy can enhance its efficacy and prolong survival time.

Water quality of Kaptai reservoir in Chittagong Hill Tracts of Bangladesh

A study was conducted in Kaptai reservoir, one of the largest man-made freshwater lakes of South-east Asia, to determine present status of water quality and its suitability for fishing and other uses. Water samplings were from middle part of the reservoir at 0.2 and 0.8 fractional depths at five different locations from upstream to downstream viz. Burburichara, Maichchari, Subolong, Basanthakum, and Rangamati. Water analyses show that concentrations of NO3-N, K＋ and total P, and suspended solid at all the sampling stations were beyond the recommended values for fish culture. Concentrations of Na^＋, Ca^2＋, Mg^2＋, SO4^2-, Cl^-, total dissolved solid （TDS）, dissolved oxygen （DO） and chemical oxygen demand （COD） were within the standards for aquaculture. Concentrations of NO3-N, SO4^2-, K＋ and total P showed no definite trend with depths, locations as well as rainy and dry seasons. Water pH, conductivity, Na^＋ and HCO3- contents were lower in rainy season, and DO and COD higher at almost all the locations in both the depths, compared with dry season. Total solids and concentrations of TDS, DO, COD, Ca^2＋, Mg^2＋ and Na^＋ were higher in upstream and decreased gradually towards downstream in the reservoir. Concentrations of DO and Ca2＋ and pH were higher and Mg2＋ less at 0.2-fractional depth than those at 0.8-fractional depth at almost all the locations. The reservoir is in mesotrophic condition containing high concentration of NO3-N and total P, in alarming status with the presence of excessive suspended solids from urban pollution around the town. It is necessary to adopt measures for protecting water quality in the reservoir due to such deteriorations.

HER2 aberrations and heterogeneity in cancers of the digestive system: Implications for pathologists and gastroenterologists

Management of cancers of the digestive system has progressed rapidly into the molecular era. Despite the significant recent achievements in the diagnosis and treatment of these patients, the number of deaths for these tumors has currently plateaued. Many investigations have assessed the role of HER2 in tumors of the digestive system in both prognostic and therapeutic settings, with heterogeneous results. Novel testing and treatment guidelines are emerging, in particular in gastric and colorectal cancers. However, further advances are needed. In this review we provide a comprehensive overview of the current state-ofknowledge of HER2 alterations in the most common tumors of the digestive system and discuss the operational implications of HER2 testing.

Community ecology and spatial distribution of trees in a tropical wet evergreen forest in Kaptai national park in Chittagong Hill Tracts, Bangladesh

We investigated the floristic composition, woody species diversity and spatial distribution of trees in a tropical wet evergreen forest in Kaptai national park in Chittagong Hill Tracks, Bangladesh. We recorded 25 families, 37 genera, 40 species and 1771 woody individuals in a 0.09 ha plot. Euphorbiaceae and Moraceae were the most species- rich families, and Castanopsis, Ficus and Terminaliawere the most species-rich genera. Bursera serrata Wall. ex Colebr. was the dominant species in terms of highest importance value （13%）. Trema orientalis （L.） B1 was typically a light demanding species as it appeared in the top can- opy with only one individual having the seventh highest IV, but had no regeneration. The expected maximum number of species （Smax） was 140, indicating that many species may invade the forest as the Sm~ is greater than the recorded total number of species. The nature of the disappear- ance and appearance of species in the present forest reflects instability of floristic composition. The values of Shannon＇s index H＇ and Pielou＇s index J＇ （evenness） were 3.36 bit and 0.63, respectively. These values show moderately high species diversity as compared to other subtropical forests in the tropics. In addition, a sample area of 200 m2 in this forest would be sufficient for measuring the diversity indices H＂ and ,/＇, whereas the trend of J＇may indicate the rate of equality of individuals among the different species decreased with increasing area. The distribu- tion pattern for the total stand was completely random. However, the dominant species showed aggregate distribution for small areas, but random distribution for large areas. The spatial association between species showed that the strongest positive interspecific association occurred between Streblus asper Lour. and Castanea indica Roxh. （09 = 0.51）. As a whole, most species were weakly associated with each other, of which 58% species associations were completely negative. The result of cluster analysis showed that species pairs were spatially independent at all or most small clusters; stands of species from all clusters are mosa- ics of complete habitat and pioneer habitat. All patches in this forest community have similar habitat and regeneration niches, which could be a phenomenon for a young growth forest. Thus, the existence of habitat and regeneration niches may be an important factor in the maintenance of diversity in this forest.

T-tube vs no T-tube for biliary tract reconstruction in adult orthotopic liver transplantation:An updated systematic review and metaanalysis

BACKGROUND Whether to use a T-tube for biliary anastomosis during orthotopic liver transplantation(OLT)remains a debatable question.Some surgeons chose to use a T-tube because they believed that it reduces the incidence of biliary strictures.Advances in surgical techniques during the last decades have significantly decreased the overall incidence of postoperative biliary complications.Whether using a T-tube during OLT is still associated with the reduced incidence of biliary strictures needs to be re-evaluated.AIM To provide an updated systematic review and meta-analysis on using a T-tube during adult OLT.METHODS In the electronic databases MEDLINE,PubMed,Scopus,ClinicalTrials.gov,the Cochrane Library,the Cochrane Hepato-Biliary Group Controlled Trails Register,and the Cochrane Central Register of Controlled Trials,we identified 17 studies(eight randomized controlled trials and nine comparative studies)from January 1995 to October 2020.The data of the studies before and after 2010 were separately extracted.We chose the overall biliary complications,bile leaks or fistulas,biliary strictures(anastomotic or non-anastomotic),and cholangitis as outcomes.Odds ratios(ORs)with 95%confidence intervals(CIs)were calculated to describe the results of the outcomes.Furthermore,the test for overall effect(Z)was used to test the difference between OR and 1,where P≤0.05 indicated a significant difference between OR value and 1.RESULTS A total of 1053 subjects before 2010 and 1346 subjects after 2010 were included in this meta-analysis.The pooled results showed that using a T-tube reduced the incidence of postoperative biliary strictures in studies before 2010(P=0.012,OR=0.62,95%CI:0.42-0.90),while the same benefit was not seen in studies after 2010(P=0.60,OR=0.76,95%CI:0.27-2.12).No significant difference in the incidence of overall biliary complications(P=0.37,OR=1.41,95%CI:0.66-2.98),bile leaks(P=0.89,OR=1.04,95%CI:0.63-1.70),and cholangitis(P=0.27,OR=2.00,95%CI:0.59-6.84)was observed between using and not using a T-tube before 2010.However,using a T-tube appeared to increase the incidence of overall biliary complications(P=0.049,OR=1.49,95%CI:1.00-2.22),bile leaks(P=0.048,OR=1.91,95%CI:1.01-3.64),and cholangitis(P=0.02,OR=7.21,95%CI:1.37-38.00)after 2010.A random-effects model was used in biliary strictures(after 2010),overall biliary complications(before 2010),and cholangitis(before 2010)due to their heterogeneity(I2=62.3%,85.4%,and 53.6%,respectively).In the sensitivity analysis(only RCTs included),bile leak(P=0.66)lost the significance after 2010 and a random-effects model was used in overall biliary complications(before 2010),cholangitis(before 2010),bile leaks(after 2010),and biliary strictures(after 2010)because of their heterogeneity(I2=92.2%,65.6%,50.9%,and 80.3%,respectively).CONCLUSION In conclusion,the evidence gathered in our updated meta-analysis showed that the studies published in the last decade did not provide enough evidence to support the routine use of T-tube in adults during OLT.

Silodosin is effective for treatment of LUTS in men wii BPH： a systematic review

The aim of this study was to systematically review the evidence on the efficacy and safety of silodosin treatments on lower urinary tract symptoms （LUTS） in men with benign prostatic hyperplasia （BPH） from randomized controlled trials. We searched PubMed （1966- December 2011）, Embase （1974-December 2011） and the Cochrane Library Database （2011, Issue 12）. The assessed outcome measures were the change from baseline for the International Prostate Symptom Score （IPSS）, quality of life （QoL） score, peak urine maximum flow rate （Qmax）, QoL related to urinary symptoms and adverse effects. Two authors independently assessed the study quality and extracted data. All data were analysed using RevMan 5.1. The meta-analysis included four randomized controlled trials with a total of 2504 patients. The study durations were each 12 weeks. At the follow-up end points, the pooled results showed that the change from baseline for the silodosin group was significantly higher than the placebo group for the IPSS, QoL score and Qmax（mean difference （MD）=-2.78, P〈O.O0001; MD=-O.42, P--O.O04; MD= 1.17, P〈O.OOOOl,respectively） and patients felt more satisfied with QoL related to urinary symptoms in the silodosin group than the placebo group. Ejaculation disorder was the most commonly reported adverse effect. The pooled results also showed that the silodosin group was superior to the 0.2 mg tamsulosin group with respect to the IPSS and QoL score （IPSS： MD=- 1.14, P=O.02; QoL score： MD=-0.26, P=O.02） and inferior to the 0.2 mg tamsulosin group with respect to Qmax （MD=-0.85, P=O.01）. In contrast, there was no significant difference in the incidence of ejaculation disorder and dizziness between the silodosin and 0.2 mg tamsulosin groups. The current meta-analysis suggested that silodosin is an effective therapy for LUTS in men with BPH and is not inferior to 0.2 mg tamsulosin.

Intestinal pseudo-obstruction in patients with systemic lupus erythematosus: A real diagnostic challenge

Intestinal pseudo-obstruction secondary to systemic lupus erythematosus(SLE) is a rare syndrome described in recent decades. There are slightly over 30 published cases in the English language literature, primarily associated with renal and hematological disease activity. Its presentation and evolution are a diagnostic challenge for the clinician. We present four cases of intestinal pseudo-obstruction due to lupus in young Mexican females. One patient had a previous diagnosis of SLE and all presented with a urinary tract infection of varying degrees of severity during their evolution. We consider that recognition of the disease is of vital importance because it allows for establishing appropriate management, leading to a better prognosis and avoiding unnecessary surgery and complications.