[Anastomotic vessels between superior mesenteric artery and inferior mesenteric artery: controversies and advances]

The anastomotic vessels between the superior mesenteric artery and the inferior mesenteric artery are vital to maintain the blood supply of the anastomosis and residual colon after colectomy. However, current studies of anastomotic vessels are facing four major obstacles: confusing nomenclature, large variability in data, diversification of research methods and incomplete information records. The existence of marginal artery has been widely proved, and its significance for blood supply is well recognized by relevant studies. In contrast, the Riolan's arch, whose connotations constantly changed over history, can not refer to a specific structure accurately. Researchers should abolish the controversial names such as Riolan's arch, select appropriate research methods and record the anastomotic vessels in detail, so as to improve the comparability between different results. The study of anastomotic vessels can help us to identify potential vascular disease, select the appropriate surgical approach, and provide appropriate treatment of the vessels in the operating area, so as to provide a theoretical foundation and practical basis for fine surgical maneuvers.

[Effect and influence factors of cardiopulmonary resuscitation in children with congenital heart disease in pediatric intensive care unit]

Objective: To investigate the prognostic factors of children with congenital heart disease (CHD) who had undergone cardiopulmonary resuscitation (CPR) in pediatric intensive care unit (PICU) in China. Methods: From November 2017 to October 2018, this retrospective multi-center study was conducted in 11 hospitals in China. It contained data from 281 cases who had undergone CPR and all of the subjects were divided into CHD group and non-CHD group. The general condition, duration of CPR, epinephrine doses during resuscitation, recovery of spontaneous circulation (ROSC), discharge survival rate and pediatric cerebral performance category in viable children at discharge were compared. According to whether malignant arrhythmia is the direct cause of cardiopulmonary arrest or not, children in CHD and non-CHD groups were divided into 2 subgroups: arrhythmia and non-arrhythmia, and the ROSC and survival rate to discharge were compared. Data in both groups were analyzed by t-test, chi-square analysis or ANOVA, and logistic regression were used to analyze the prognostic factors for ROSC and survival to discharge after cardiac arrest (CA). Results: The incidence of CA in PICU was 3.2% (372/11 588), and the implementation rate of CPR was 75.5% (281/372). There were 144 males and 137 females with median age of 32.8 (5.6, 42.7) months in all 281 CPA cases who received CPR. CHD group had 56 cases while non-CHD had 225 cases, with the percentage of 19.9% (56/281) and 80.1% (225/281) respectively. The proportion of female in CHD group was 60.7% (34/56) which was higher than that in non-CHD group (45.8%, 103/225) (χ²=4.00, P=0.045). There were no differences in ROSC and rate of survival to discharge between the two groups (P>0.05). The ROSC rate of children with arthythmid in CHD group was 70.0% (28/40), higher than 6/16 for non-arrhythmic children (χ²=5.06, P=0.024). At discharge, the pediatric cerebral performance category scores (1-3 scores) of CHD and non-CHD child were 50.9% (26/51) and 44.9% (92/205) respectively. Logistic regression analysis indicated that the independent prognostic factors of ROSC and survival to discharge in children with CHD were CPR duration (odds ratio (OR)=0.95, 0.97; 95%CI: 0.92~0.97, 0.95~0.99; both P<0.05) and epinephrine dosage (OR=0.87 and 0.79, 95%CI: 0.76-1.00 and 0.69-0.89, respectively; both P<0.05). Conclusions: There is no difference between CHD and non-CHD children in ROSC and survival rate of survival to discharge was low. The epinephrine dosage and the duration of CPR are related to the ROSC and survival to discharge of children with CHD.

Copolymerization of CO2, propylene oxide, and itaconic anhydride with double metal cyanide complex catalyst to form crosslinked polypropylene carbonate

In this study, a high-activity Zn–Co double metal cyanide complex was synthesized and used to catalyze the ternary polymerization of carbon dioxide, propylene oxide, and itaconic anhydride to produce a new class of polypropylene carbonates characterized by excellent performance and low ether content. The number average molecular weight of the terpolymer was as high as 2.14 × 105 g·mol−1, and the polydispersity index was as high as 1.58. In the case of PPCIAn3, the 5% weight loss temperature increased by 70°C, the total weight loss temperature increased by 100°C, the tensile strength increased by 6.6 MPa, and the elongation at break decreased to 14.5% with respect to traditional polypropylene carbonate. The apparent efficiency of the catalyst was as high as 45.79 gpolymer/gcatalyst, indicating its high catalytic activity. 1H-NMR spectrometry, gel permeation chromatography, differential scanning calorimetry, thermogravimetric analysis, and in situ Fourier-transform infrared spectroscopy were used to characterize the polymerization process and the structural properties of the obtained terpolymers.

[Research progress of sexual dysfunction following rectal cancer surgery]

Sexual dysfunction with the incidence of 5%-90% is a common postoperative complication of rectal cancer and the ratio of men and women is similar. Sexual function is innervated by the abdominal-pelvic autonomic nerve. Different sexual dysfunctions can be caused by different parts and degrees of injury in autonomic nerve during operations of rectal cancer. With the development of pelvic autonomic nerves preservation in rectal cancer radical resection, postoperative sexual function can be protected. There may be many factors increasing the incidence of postoperative sexual dysfunction in rectal cancer, such as postoperative psychological factors, stoma, abdominal-perineal resection and radiotherapy. The effects of laparoscopic surgery, robotic surgery, transanal total mesorectal excision and lateral lymph node dissection on postoperative sexual function remain controversial. Based on the multidisciplinary cooperation model, attention should be paid to psychological intervention of patients and their partners. In clinical practice, for male using phosphodiesterase-5 inhibitors, vacuum erectile devices, injection of vasodilators through the penis or urethra, and for female local application of estrogen and lubricants in the vagina are effective treatment for postoperative sexual dysfunction of rectal cancer. In addition, stem cell therapy has a promising prospect for sexual dysfunction.

Poly(propylene carbonate) networks with excellent properties: Terpolymerization of carbon dioxide, propylene oxide, and 4,4ʹ-(hexafluoroisopropylidene) diphthalic anhydride

Poly(propylene carbonate) (PPC) is an emerging low-cost biodegradable plastic with potential application in many fields. However, compared with polyolefin plastics, the major limitations of PPC are its poor mechanical and thermal properties. Herein, a thermoplastic PPC containing cross-linked networks, one-pot synthesized by the copolymerization of carbon dioxide, propylene oxide, and 4,4ʹ-(hexafluoroisopropylidene) diphthalic anhydride, had excellent thermal and mechanical properties and dimensional stability. The weight-average molecular weight and the polymer yield of the PPC5 were up to 212 kg mol−1 and 104 gpolym gcat −1, respectively. The 5% thermal weight loss temperature reached 320°C, and it could withstand a tensile force of 52 MPa. This cross-linked PPC has excellent properties and is expected to be used under extreme conditions, as the material can withstand strong tension and will not deform.

[Comparative study of functional prognosis of transanal total mesorectal excision and conventional total mesorectal excision based on propensity score matching]

Objective: To compare the postoperative functional prognosis of transanal mesorectal excision (taTME) and conventional total mesorectal excision (TME) in rectal cancer. Methods: Totally 49 patients underwent taTME and 478 patients underwent conventional TME at Department of Gastroenterological Surgery, Peking University People's Hospital from January 2015 to December 2019 were retrospectively collected. Propensity score matching method was used to perform 1 versus 1 matching between the taTME and conventional TME groups, and 36 pairs of patients were successfully matched. After matching, the median age of patients in taTME group and conventional TME group was 60.5 (16.0) years and 60.5 (13.0) years (M(Q(R))), respectively, and the proportion of male patients was 66.7% (24/36) and 55.6% (20/36) , respectively. EORTC QLQ-C30 scale was used to assess quality of life, low anterior resection syndrome (LARS) scale and Wexner constipation score were used to evaluate anal function, international prostate symptom score (IPSS) was used to evaluate urinary function,international index of erectile function (IIEF) -5 and female sexual function index (FSFI) score were used to evaluate male and female sexual function, respectively, and generalized anxiety disorder (GAD-7) and patient health questionnaire (PHQ-9) scale were used to evaluate psych function. The t test, Mann-Whitney U test, χ(2) test, and Fisher exact test were used for comparison between groups, and Wilcoxon rank sum test or McNemar test was used for comparison between paired data. Results: There were no significant differences in surgery time, postoperative hospital stays, conversion rate, morbidity rate, surgery cost, and numbers of lymph node yield between the two groups (all P>0.05). Compared with the conventional TME group, the intraoperative blood loss in the taTME group was significantly higher (100 (100) ml vs. 80 (50) ml, U=424.5, P=0.010), the prophylactic stoma rate was significantly higher (96.9%(31/36) vs. 63.6%(21/36), χ(2)=11.218, P<0.01), the total hospitalization cost was significantly lower (74 297.7 (16 746.4) CNY vs. 91 781.3 (26 228.4) CNY, U=413.0, P=0.008). There were no significant differences in anal and urinary function between the two groups (LARS scalescore: Z=-0.513, P=0.608, Wexner constipation score: Z=-0.992, P=0.321, IPSS: Z=-1.807, P=0.071). In terms of psych function, significant difference in GAD-7 scale was seen between the two groups (Z=-2.311, P=0.021), patients with generalized anxiety disorder accounting for 26.7% (8/30) and 46.9% (15/32), respectively. Conclusions: Compared with conventional TME surgery, taTME has a significantly increased blood loss and prophylactic stoma rate. There are no significant difference in the incidence of postoperative anal, urinary, and sexual dysfunction between taTME and conventinal TME. taTME can alleviate the financial burden and general anxiety disorder to a certain extent.

[Transurethral non-contact laser treatment of prostatic hypertrophy]

66 cases of prostatic hypertrophy have been treated by transurethral non-contact Nd:YAG laser irradiation since April 1993. Sixty patients regained unobstructed urination within 1 week and 6 within 2 weeks after operation. The symptoms of the treated group were improved with the necrotic tissues gradually peeling off in 3 to 6 weeks. The short-term follow-up indicated that the prostatic gland distinctly reduced and residual urine decreased or vanished after treatment. Three patients had one of the following complications: urinary tract infection, epididymitis or urinous infiltration. These complications were treated appropriately. This therapy is ideal for the treatment of prostatic hypertrophy.

Application of hematoporphyrin derivative and laser-induced photodynamical reaction in the treatment of lung cancer: a preliminary report on 21 cases

This paper reports results of hematoporphyrin derivative based on photodynamic therapy (PDT) of 24 lung cancer lesions in 21 patients that were followed at least three months. Three of 24 lesions exhibited complete remission and 20 of 24 lesions exhibited a response to PDT. Tumors in twenty of twenty-one patients exhibited visually discernible hematoporphyrin derivative fluorescence upon irradiation with the 514-nm line from an argon ion laser. There were no severe complications due to PDT. The hematoporphyrin derivative, argon iin laser pumped dye laser (rhodamine B) system,and quartz fiber we used in this clinical series were all made in the People's Republic of China.