Objective To analyze the causal relationship between gut microbiota and tic disorder based on Mendelian randomization (MR). Methods A total of 196 known microbiota (9 phyla, 16 classes, 20 orders, 32 families, and 119 genera) in the human intestinal microbiota dataset downloaded from the MiBioGen database were selected as the exposure factors, and the dataset of tic disorder (finn-b-KRA_PSY_TIC) containing 172 patients and 218620 controls was downloaded from the genome-wide association study database as the outcome variable. Inverse variance weighted was used as the main analysis method, and the causal relationship between gut microbiota and tic disorder was evaluated using odds ratio (OR) and its 95% confidence interval (CI). Horizontal pleiotropy was tested by MR-Egger intercept and MR-PRESSO global test, heterogeneity was assessed by Cochran’s Q test, and sensitivity analysis was performed by leave-one-out method. Results Inverse variance weighted results showed that the Family Rhodospirillaceae [OR=0.398, 95%CI (0.191, 0.831), P=0.014], Order Rhodospirillales [OR=0.349, 95%CI (0.164, 0.743), P=0.006], and Parasutterella [OR=0.392, 95%CI (0.171, 0.898), P=0.027] had negative causal relationships with tic disorder. The Genus Lachnospira [OR=8.784, 95%CI (1.160, 66.496), P=0.035] and Candidatus Soleaferrea [OR=2.572, 95%CI (1.161, 5.695), P=0.020] had positive causal relationships with tic disorder. In addition, MR-Egger intercept and MR-PRESSO global test showed no horizontal pleiotropy, Cochran’s Q test showed no heterogeneity, and leave-one-out sensitivity analysis showed the results were stable. Conclusions A causal relationship exists between gut microbiota and tic disorder. The Family Rhodospirillaceae, Order Rhodospirillales, and Parasutterella are associated with a decreased risk of tic disorder, while the Genus Lachnospira and Candidatus Soleaverea can increase the risk of tic disorder.
目的探讨保留幽门的胰十二指肠切除术(PPPD)的手术适应证、捆绑式胰肠吻合术的特点及胃排空障碍的治疗。方法12例均行PPPD，消化道重建按Child法，胰肠吻合均采用捆绑式胰肠吻合。结果除1例术后第21天并发切口裂开、肺栓塞死亡外，其余11例均顺利出院，平均住院时间24 d，随访1年，1例术后8个月死亡，余均健在。结论PPPD是治疗胰头癌及壶腹周围癌的一种具有广阔应用前景的术式，捆绑式胰肠吻合有望作为胰肠吻合的标准术式。
ObjectiveTo systematically review the prevalence of cognitive impairment in patients with sarcopenia. MethodsThe PubMed, EMbase, Web of Science, Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect studies related to the objectives from inception to December 10, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 14.0 software. ResultsA total of 27 studies were included. The overall prevalence rate of cognitive impairment in sarcopenia was 36.1% (95%CI 29.4% to 42.8%). Subgroup analysis showed that the prevalence in Europe was higher than that in other areas. The prevalence of nursing home residents was highest. ConclusionCurrent evidence shows that the prevalence of cognitive impairment in patients with sarcopenia is high. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To investigate the risk factors of early allograft dysfunction (EAD) following C-Ⅱ donation after cardiac death (DCD) liver transplantation. Methods The data of 46 donors and recipients of C-ⅡDCD liver transplantation between March 2012 and August 2015 were retrospectively analyzed. The baseline data such as democracy, death cause, donor warm ischemic time (DWIT) and cold ischemic time (CIT) in EAD group and the non-EAD group (control group) was compared, and whether these factors were risk factors of EAD was investigated by univariate and multivariate analyses. Statistical cut-off values for significant factors of the unfavorable analysis were defined by receiver operating characteristics (ROC) analysis. The 6-month and 1-year graft survival rate were compared. Results The EAD group had a longer DWIT compared with the group [(17.6±4.7) and (12.7±6.2) minutes, P=0.009]; meanwhile, the EAD group had a longer CIT compared with the control group [(13.7±4.7) and (11.0±3.5) hours, P=0.020]. The other factors in both groups showed no statistical significance (P>0.05). The ROC curve revealed the cut-off values of DWIT and CIT were 17.50 minutes [area under the curve (AUC)=0.713, P=0.020] and 9.85 hours (AUC=0.723, P=0.015), respectively. The multivariate logistic regression analysis showed the DWIT [odds ratios (OR)=1.340, 95% confidence interval (CI)(1.042, 1.654), P=0.008] and CIT [OR=1.396, 95% CI (1.075, 1.698), P=0.015] were all independent risk factors of EAD. The 6-month and 1-year graft survival rate of the EAD group and the control group was 85.7% vs. 92.3% (P=0.607) and 71.4% vs. 84.6% (P=0.587), respectively. Conclusions EAD may occured in C-Ⅱ donors with DWIT≥17.50 minutes or CIT≥9.85 hours in DCD liver transplantation. The livers can be used as a resource for clinical use and also have a good outcome.
Purpose Observation on changes of choroidal circulation in 21 cases (42 eyes) of retinal dystrophies. Methods Fundus fluorescein angiography (ICGA) were used for comparartive analyses of the retinal and choroidal blood circulation of 21 cases (42 eyes) of retinal dystrophic diseases. Results The changes of choroidal circulation,i.e.slow perfusion or filling defects were observed in four kinds of retinal dystrophies. Conclusion ICGA may assist in providing valuable informations on choroidal circulation of retinal dystrophic diseases. (Chin J Ocul Fundus Dis,1998,14:88-91)
Epilepsy is defined as a disorder of brain neural function, characterized by the persistent possibility of seizures, which are usually sudden, brief, and recurrent. Cognition is a process of receiving information from the external world and analyzing and processing it, such as memory, language, visual-spatial, executive, calculation, comprehension, and judgement. With the increasing awareness of health, more and more scholars have begun to pay attention to the relationship between cognitive dysfunction and epilepsy. Data shows that over 80% of epilepsy patients have lower cognitive abilities than healthy people, and over 50% of patients have significant cognitive problems, which have a negative impact on their quality of life even greater than the seizures themselves. Cognitive impairment in epilepsy patients not only hinders their own treatment progress, but also has a negative impact on their daily life, academic and job performance, which brings huge care and economic pressure to their families and a heavy economic burden to the whole society. This review aimed to assess cognitive modules and provide key information for early diagnosis and treatment of patients.
Objective To explore the effect of preoperative hypothyroidism on postoperative cognition dysfunction (POCD) in elderly patients after on-pump cardiac surgery. Methods Patients who were no younger than 50 years and scheduled to have on-pump cardiac surgeries were selected in West China Hospital from March 2016 to December 2017. Based on hormone levels, patients were divided into two groups: a hypo group (hypothyroidism group, thyroid stimulating hormone (TSH) >4.2 mU/L or free triiodothyronine 3 (FT3) <3.60 pmol/L or FT4 <12.0 pmol/L) and an eu group (euthyroidism group, normal TSH, FT3 and FT4). The mini-mental state examination (MMSE) test and a battery of neuropsychological tests were used by a fixed researcher to assess cognitive function on 1 day before operation and 7 days after operation. Primer outcome was the incidence of POCD. Secondary outcomes were the incidence of cognitive degradation, scores or time cost in every aspect of cognitive function. Results No matter cognitive function was assessed by MMSE or a battery of neuropsychological tests, the incidence of POCD in the hypo group was higher than that of the eu group. The statistical significance existed when using MMSE (55.56% vs. 26.67%, P=0.014) but was absent when using a battery of neuropsychological tests (55.56% vs. 44.44%, P=0.361). The incidence of cognitive deterioration in the hypo group was higher than that in the eu group in verbal fluency test (48.15% vs. 20.00%, P=0.012). The cognitive deterioration incidence between the hypo group and the eu group was not statistically different in the other aspects of cognitive function. There was no statistical difference about scores or time cost between the hypo group and the eu group in all the aspects of cognitive function before surgery. After surgery, the scores between the hypo group and the eu group was statistically different in verbal fluency test (26.26±6.55 vs. 30.23±8.00, P=0.023) while was not statistically significant in other aspects of cognitive function. Conclusion The incidence of POCD is high in the elderly patients complicated with hypothyroidism after on-pump cardiac surgery and words reserve, fluency, and classification of cognitive function are significantly impacted by hypothyroidism over than other domains, which indicates hypothyroidism may have close relationship with POCD in this kind of patients.
Objective To study the effects of partial axillary lymph node dissection (PALD) on prognosis and upper limb function in patients with breast cancer. Methods Ninety-eight breast cancer patients with stage Ⅰ and Ⅱ were randomly divided into two groups and different surgical procedures following modified mastectomy were performed: partial axillary lymph node (level Ⅰ and Ⅱ) dissection (PALD) group (n=48) and total axillary lymph node (levelⅠ, Ⅱ and Ⅲ) dissection (TALD) group (n=50). The longterm positive relapse rate and upper limb function between 2 groups were compared. Results During the follow-up of 5 to 10 years (average 4.5 years), there were 2 cases (4.2%) of local recurrence on chest wall and one case (2.1%) of recurrence in axillary lymph node and one case (2.1%) of recurrence in supraclavicular lymph node in PALD group, and 2 cases (4.0%) of local recurrence on chest wall and no axillary lymph node recurrence and one case (2.0%) of recurrence in supraclavicular lymph node happened in TALD group. There was no statistical difference between PALD group and TALD group (Pgt;0.05). The incidence of upper limb edema and dysfunction was 4.2% (2/48) in PALD group and 16.0%(8/50) in TALD group (P＜0.01). There was no significant statistical difference of 5year and 10year survival rate between PALD group and TALD group (89.6% vs. 88.0%， 79.2% vs. 78.0%，Pgt;0.05). Conclusion PALD may reduce upper limb dysfunction after operation in patients with stage Ⅰ and Ⅱ breast cancer, and does not increase prognostic risk.