Anti-reflux effects of a novel esophagogastric asymmetric anastomosis technique after laparoscopic proximal gastrectomy

BACKGROUND Reflux esophagitis is a common postoperative complication of proximal gastrectomy.There is an urgent need for a safer method of performing esophageal-gastric anastomosis that reduces the risk of reflux after proximal gastrectomy.We hypothesize that a novel technique termed esophagogastric asymmetric anastomosis(EGAA)can prevent postoperative reflux in a safe and feasible manner.To observe a novel method of EGAA to prevent postoperative reflux.METHODS Initially,we employed a thermal stress computer to simulate and analyze gastric peristalsis at the site of an esophagogastric asymmetric anastomosis.This was done in order to better understand the anti-reflux function and mechanism.Next,we performed digestive tract reconstruction using the EGAA technique in 13 patients who had undergone laparoscopic proximal gastrectomy.Post-surgery,we monitored the structure and function of the reconstruction through imaging exams and gastroscopy.Finally,the patients were followed up to assess the efficacy of the anti-reflux effects.RESULTS Our simulation experiments have demonstrated that the clockwise contraction caused by gastric peristalsis and the expansion of the gastric fundus caused by the increase of intragastric pressure could significantly tighten the anastomotic stoma,providing a means to prevent the reverse flow of gastric fluids.Thirteen patients with esophagogastric junction tumors underwent laparoscopic proximal gastrectomy,with a mean operation time of 304.2±44.3 min.After the operation,the upper gastroenterography in supine/low head positions showed that eight patients exhibited no gastroesophageal reflux,three had mild reflux,and two had obvious reflux.The abdominal computed tomography examination showed a valve-like structure at the anastomosis.During followup,gastroscopy revealed a closed valve-like form at the anastomosis site without stenosis or signs of reflux esophagitis in 11 patients.Only two patients showed gastroesophageal reflux symptoms and mild reflux esophagitis and were treated with proton pump inhibitor therapy.CONCLUSION EGAA is a feasible and safe surgical method,with an excellent anti-reflux effect after proximal gastrectomy.

Content Determination of Total Flavonoids from Paulownia fortunei Flower

[Objectives]The research aimed to explore the determination method for content of total flavonoids from Paulownia fortunei flower.[Methods]Rutin was taken as control.By comparing absorption characteristics of total flavonoids in NaNO_(2)-Al(NO_(3))_(3)-NaOH and AlCl_(3) chromogenic system,an appropriate method for the determination of total flavonoids from P.fortunei flower was screened,and the method was verified by methodology.On the basis of single factor experiment,the coloration time of the method was optimized by orthogonal experiment.[Results]NaNO_(2)-Al(NO_(3))_(3)-NaOH chromogenic system was more suitable for the determination of total flavonoids from P.fortunei flower,and the adding standard recovery was between 99.2%and 105.5%,and RSD was 2.18%,with better repeatability,precision,stability and accuracy.The optimized coloration time of NaNO_(2),Al(NO_(3))_(3) and NaOH was 6,6,and 10 min.Under the condition,average content of total flavonoids from P.fortunei flower was 3.78%,and RSD was 2.05%.[Conclusions]The optimized NaNO_(2)-Al(NO_(3))_(3)-NaOH chromogenic method is simple,rapid,and accurate,and could be used as a method for the determination of total flavonoids from P.fortunei flower.

Network pharmacology studies on Reduning injection in treatment of COVID-19

Background:Network pharmacology was used to explore the mechanism of the Chinese patent medicine Reduning injection in the treatment of corona virus disease 2019.Methods:The chemical constituents and targets of Qinghao(Artemisiae annuae herba),Jinyinhua(Lonicerae japonicae flos),Zhizi(Gardeniae fructus)in the Chinese patent medicine Reduning injection were obtained from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform,and the target related to corona virus disease 2019 was searched in GeneCards database,then perform Venn analysis on the targets of corona virus disease 2019 and the Chinese patent medicine Reduning injection,to screen the compounds and targets of the Chinese patent medicine Reduning injection in the treatment of corona virus disease 2019.The String platform was used to construct the protein-protein interaction network,and key targets were screened.Cytoscape 3.5.1 was used to construct the active traditional Chinese medicine-chemical composition-target-disease network to screen the key active components,and the gene ontology function and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis were performed on the common target through DAVID(6.8)online analysis data tool to predict the mechanism of action.Results:Fifty-two active ingredients and 232 targets were selected from the Chinese patent medicine Reduning injection,including 44 targets related to corona virus disease 2019.A total of 310 gene ontology biological processes and 94 Kyoto Encyclopedia of Genes and Genomes signaling pathways were obtained,which were mainly involved in inflammation,viral infection,bacterial infection,immune response and substance metabolism,et al.Conclusion:The mechanism of the Chinese patent medicine Reduning injection in the treatment of corona virus disease 2019 may be related to antivirus,bacteriostasis,anti-inflammatory and antifebrile,immune regulation and metabolism regulation,et al.

Effect of feedback health education on postoperative rehabilitation of patients with lumbar disc herniation: a cluster randomised trials

Aims and objective:A theoretical model based on guided postoperative rehabilitation with feedback was developed for patients with lumbar intervertebral disc protrusion to explore the effects of feedback-based health education.Patients were assessed in terms of disease knowledge,general self-efficacy,medical behaviour,and the Oswestry disability index(ODI).During postoperative rehabilitation,nursing staff provided health education regarding lumbar intervertebral disc protrusion.Design:The CONSORT 2010 statement extension for cluster randomized trials checklist(Campbell et al.,2012)was used to guide reporting outcomes(File S1).Methods:The methods were based on previous research on the feedback method of health education.A cluster randomized controlled trial design was used.From March 2019 to January 2020,patients who underwent spinal surgery at a first-class tertiary hospital were enrolled,and 76 met the inclusion criteria for lumbar disc disease(lumbar disc herniation,LDH).Patients were divided into an experimental group and a control group,with 38 patients in each group.Feedback-based health education was conducted for the experimental group,and routine health education was provided for the control group.Disease knowledge,general self-efficacy,compliance behaviour,and ODI scores were compared between the two groups.The intervention effect was compared between groups by means of t tests.SPSS 23.0 was used for statistical analysis,and P<0.05 was considered statistically significant.The research was reported according to CONSORT statement.Results:1.Comparison of baseline data between the two groups before the intervention.Before the intervention,there was no statistically significant difference between the two groups in terms of general demographic data,disease-related data,disease knowledge,general self-efficacy,compliance behaviour,or ODI(P>0.05).2.Comparison of relevant indicators between the two groups of patients before and after the intervention.(1)One,four and 12 weeks after surgery,the disease knowledge,general self-efficacy and postoperative compliance behaviour of the experimental group were significantly higher than those of the control group(P<0.05).(2)At 1,4 and 12 weeks after surgery,the ODI of the experimental group was significantly lower than that of the control group(P<0.05).Conclusions:Feedback-based health education is conducive to improving disease knowledge,general self-efficacy and compliance behaviour and reducing ODI scores in patients with LDH.Relevance to clinical practice:This study provides nurses worldwide with a reference for health education during postoperative rehabilitation for lumbar disc herniation.

The Contribution of Health Education to the Falling Incidence within Hospital Premises in China

Falling is the second leading cause of accidental injury to death worldwide.It is estimated that more than 80%of the people die each year in low and middle-income countries.Falling is also the leading cause of death among the elderly in China.Among them,the falling rate in 2016 increased by 5%compared with 2006.Although not fatal,those who fell and have a disability,which may face significant economic risks associated with subsequent long-term care needs,especially for the elderly[凹].It may be essential to use evidence-based guidelines for proving health education to address the issue of preventing hospitalization for the elderly.This article will combine the author's practical experience to examine the contribution of health education to prevent falls and explore its application and development in China.Lastly,it will explain barriers to health education.

The application research progress of intelligent robot in orthopedics

This paper introduces the application of intelligent robot in orthopedic treatment and nursing research progress,and summarizes the advantages and disadvantages of intelligent robot,the prospect.The aim is to help medical staff understand the basic overview of intelligent robot,and learn cutting-edge knowledge,promote the deep integration of intelligent robot technology and orthopedics field,and provide reference for the future research direction of intelligent robot technology in orthopedics field.

What we know about axons in Parkinson’s disease

Tremendous research efforts have been made regarding the pathogenesis of Parkinson’s disease(PD).However,there are still no effective strategies to restore midbrain dopaminergic(mDA)innervation and prevent disease progression.One possibility is that we may have been neglecting the role of axons in mDA neuronal degeneration.This review first summarizes mDA axon development during the early stage of PD and discusses how axon guidance defects contribute to PD vulnerability.Furthermore,we review axonal transport dysregulation in the numerous PD-related genetic mutations,including Parkin,PINK1,DJ1,LRRK2 and SNCA.The evidence suggests that proper axonal transport is crucial for neuronal function and survival.Finally,advanced tools for axonal studies were evaluated,including light-sheet and super-resolution microscopy.These adapted microscopes have been used to help solve questions unanswered before.Overall,the role of axon terminals in the initiation of the degeneration cascade remains undeciphered,and more research in the related area may be conducted further to restore dopamine levels in the striatum to alleviate the motor complications of PD.

Screening key target genes for pulmonary arterial hypertension based on bioinformatics

Background:Screening key target genes for pulmonary arterial hypertension(PAH)based on bioinformatics to provide a reference for the clinical development of drugs to cure PAH.Methods:The keyword“pulmonary arterial hypertension”was used to search related genes in the National Center for Biotechnology Information database(NCBI).The obtained genes data was input to the database of Database for Annotation,Visualization and Integrated Discovery(DAVID)(Version 6.8)to collect relevant information about pathways and genes.And the data of genes were enriched in 37 pathways and genes with occurrence frequency≥10 were respectively imported into the String database to construct protein-protein interaction(PPI)network diagrams,and the two network diagrams were compared.Results:VEGFA,MAPK1,MAPK3,IL6,JUN and TNF were among the highest-ranked genes in two network diagrams.Conclusion:The pathogenesis of PAH is associated with multiple pathways such as the TGF-βsignaling pathway,PI3K-Akt signaling pathway,MAPK signaling pathway,HIF-1 signaling pathway and so on.The study of VEGFA,MAPK1,MAPK3,IL6,JUN and TNF are closely related to PAH is necessary for us to study further.Through gene interaction network and pathway analysis of disease-associated genes,which will help us to screen the critical target genes of PAH and provide a reference for clinical development of effective drugs for PAH.

Screening key target genes for coronavirus disease 2019 based on bioinformatics and gene network

Objective:To use bioinformatics and gene networks to screen key target genes of coronavirus disease 2019,which provides references for clinical research and development of drugs for coronavirus disease 2019.Methods:Target genes related to coronavirus disease 2019 were screened in the GeneCards and National Center for Biotechnology Information databases,and the obtained gene data were imported into the Database for Annotation,Visualization and Integrated Discovery(Version 6.8)database to collect the related information about pathways and genes.The genes enriched in the first 20 pathways and the genes whose occurrence frequency≥5 were imported into the String database respectively to construct protein-protein interaction network diagram and compare the two network diagrams.Results:TNF,IL-6,IL-2,IL-8,CXCL8,IL1B,CCL2,IFNG,STAT1,MAPK1,MAPK3,MAPK8,TP53 and RELA are ranked top in the two network diagrams,and the frequency of occurrence in the first 20 pathways was≥5.Conclusion:The incidence of coronavirus disease 2019 is associated with multiple signaling pathways,including influenza A,pathways in cancer,toll-like receptor signaling pathway,hypoxia-inducible factor-1 signaling pathway,et al.TNF,IL-6,IL-2,IL-8,CXCL8,IL1B,CCL2,IFNG,STAT1,MAPK1,MAPK3,MAPK8,TP53 and RELA are closely related to coronavirus disease 2019,which needs to be further studied.By analyzing the pathways of the genes related to coronavirus disease 2019 and the interactive network diagrams between the genes,it is helpful to understand the pathogenesis of the disease and provide a reference for clinical research and development of effective drugs for coronavirus disease 2019.

Effect of Baizhu(Rhizoma Atractylodis Macrocephalae)extract on intestinal absorption of brucine and strychnine in vitro and in situ

OBJECTIVE:To investigate the antagonistic effect of the extract of Baizhu(Rhizoma Atractylodis Macrocephalae)(RAM)on the intestinal absorption of brucine and strychnine in Strychnos nux-vomica(NUX)and propose the mechanism of these effects.METHODS:The apparent permeability value(Papp)and absorption rate constant(Ka)were chosen as indices.The everted intestinal sac model and in situ single-pass intestinal perfusion model were used to study the effects of the RAM extract on the absorption of brucine and strychnine.To confirm the results,the brucine and strychnine concentrations in hepatic portal venous blood were determined.Western blotting was used to study P-glycoprotein(P-gp)expression in the Caco-2 cell line.RESULTS:Papp and Ka of brucine and strychnine were significantly increased in the presence of a P-gp inhibitor,but no significant increase was noted in the presence of a tight junction regulator.The RAM extract inhibited the absorption of brucine and strychnine and enhanced P-gp expression.CONCLUSION:The primary absorption mechanism for brucine and strychnine is passive transport,which is affected by P-gp.