The scientific understanding of pain has stayed on a traditional classic “pain pathway” for many years. However, with the continuous progress of clinical diagnosis, this pathway obviously cannot explain all pain phenomena, and the understanding and interpretation of pain needs to be updated. Based on the influence of comprehensive medicine based on philosophy and the continuous summary and research of clinical cases of somatic symptoms, this paper takes the biological defense mechanism as the basic starting point, analyzes the position of pain in the biological defense mechanism, and reinterprets and defines pain from the new point of view of comprehensive medicine with the new perspective of biological defense mechanism. In addition, this paper also presents the new treatment principles of pain according to the occurrence mechanism through the perspective of biological defense and psychosomatic mechanism, and puts forward new principles of treatment and the view that “defense” is the fundamental purpose of all biology, aiming to provide a reference for the reinterpretation of more diseases and the research on the nature of biological behavior.
The emergence of single-cell sequencing technology enables people to observe cells with unprecedented precision. However, it is difficult to capture the information on all cells and genes in one single-cell RNA sequencing (scRNA-seq) experiment. Single-cell data of a single modality cannot explain cell state and system changes in detail. The integrative analysis of single-cell data aims to address these two types of problems. Integrating multiple scRNA-seq data can collect complete cell types and provide a powerful boost for the construction of cell atlases. Integrating single-cell multimodal data can be used to study the causal relationship and gene regulation mechanism across modalities. The development and application of data integration methods helps fully explore the richness and relevance of single-cell data and discover meaningful biological changes. Based on this, this article reviews the basic principles, methods and applications of multiple scRNA-seq data integration and single-cell multimodal data integration. Moreover, the advantages and disadvantages of existing methods are discussed. Finally, the future development is prospected.
ObjectiveTo evaluate the quality of life after sentinel lymph node biopsy (SLNB) in patients with breast cancer. MethodsFrom January 2004 to December 2006, 591 patients with breast cancer who were suitable for SLNB were divided into SLNB group (n=339) and axillary lymph node dissection (ALND) group (n=252). All patients didn’t have the upper extremity joints disease, the vascular nerve disease, and the cervical spondylosis previously. Results①In patients with SLNB, the circumferences of upper arm in one, two, and three weeks after operation were similar to those before operation (P=0.232, P=0.318, and P=0.415, respectively). While, in patients with ALND, the circumferences of upper arm in one or two weeks after operation were significantly bigger than those before operation (P=0.011, P=0.041, respectively), and the circumference in three weeks after operation was similar to that before operation (P=0.290). ②In patients with SLNB, the outreach angles of shoulder joint in one and two weeks after operation were significantly smaller than those before operation (P=0.031, P=0.043, respectively), and the angle in three weeks after operation was similar to that before operation (P=0.196). However, in patients with ALND, the angles in one, two or three weeks after operation were significantly smaller than those before operation (all Plt;0.001). ③The retention time of drainage tube in patients with ALND who received breast conserving surgery or mastectomy was significantly longer than that in patients with SLNB who received mastectomy (all Plt;0.001). ④The infection rate and the sensory disjunction rate in patients with ALND were significantly higher than those in patients with SLNB (P=0.002, Plt;0.001, respectively). ConclusionsFor patients with lymph node negative breast cancer, SLNB could decrease postoperative complications, and improve the quality of life. It could also save money by reducing hospital stay.
Objective To explore the diagnostic value of miRNAs for pancreatic cancer. Methods PubMed, Scopus, Web of Science, CBM, CNKI, WanFang Data and VIP databases were retrieved from inception to December 31st 2015, to collect diagnostic accuracy studies about miRNAs for pancreatic cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies by using the QUADAS-2 tool. Then meta-analysis was performed using MetaDiSc 1.4 and Stata 12.0 softwares. Results A total of 40 articles involving 109 studies were included. The results of meta-analysis showed that the pooled Sen, Spe, +LR, –LR and DOR were 0.81 (95%CI 0.80 to 0.82), 0.77 (95%CI 0.75 to 0.78), 3.15 (95%CI 2.78 to 3.58), 0.27 (95%CI 0.24 to 0.31) and 13.58 (95%CI 10.89 to 16.94), respectively. The AUC of SROC was 0.86 (95%CI 0.84 to 0.88). Subgroups analysis showed that: as to diagnostic accuracy, Caucasian was superior to Asian (AUC=0.89vs. 0.84); multiple-miRNAs profiling-based assays was superior to single miRNA assays (AUC=0.91vs. 0.84). Conclusion Current evidence suggests that miRNA has potential diagnostic value for pancreatic cancer, particularly using multiple miRNAs. Due to limited quality of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo analyze the characteristics and risk factors of lymph node metastasis in thoracic esophageal squamous cell carcinoma (ESCC).MethodsThe clinical data of 407 patients with ESCC who underwent radical resection of esophageal carcinoma from December 2012 to October 2018 in our hospital were retrospectively analyzed. There were 390 males and 17 females with a median age of 63 (38-82) years. Esophageal lesions were found in 26 patients of upper thoracic segment, 190 patients of middle thoracic segment and 191 patients of lower thoracic segment. ResultsAmong the patients, 232 (57.0%) were found to have cervical, thoracic and/or abdominal lymph node metastasis. The lymphatic metastasis rates of cervical, upper, middle, lower mediastinal nodes and abdominal nodes were 0.7%, 8.8%, 21.4%, 16.7% and 37.1%, respectively. The adjacent lymph node metastasis alone occurred in 50.0% patients, and the multistage or skip lymph node metastasis accounted for 29.3% and 20.7%, respectively. Multivariate analysis showed that the length of esophageal lesion, T stage, degree of tumor differentiation, vascular cancer embolus and nerve invasion were independent risk factors for lymph node metastasis.ConclusionThe rates of lymph node metastasis are similar in the upper, middle and lower thoracic ESCC. The main pattern of lymph node metastasis is the adjacent lymph node metastasis, followed by multistage and skip lymph node metastases. The length of esophageal lesion, T stage, degree of tumor differentiation, vascular cancer embolus and nerve invasion are independent factors for lymph node metastasis. The operation and dissection range should be selected according to the location of tumor and the characteristics of the lesion.
ObjectiveTo systematically review the efficacy of five types of rehabilitation exercises, including Baduanjin, aquatic exercise, Taijiquan, somatosensory exercise and whole body vibration training for the intervention of motor function in stroke patients. MethodsWeb of Science, PubMed, EMbase, The Cochrane Library, CNKI, CBM, CSJD and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of rehabilitation exercise interventions for motor function in stroke patients from inception to October 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, network meta-analysis was performed by using R and ADDIS software. ResultsA total of 50 RCTs involving 1 838 patients were included. The results of the meta-analysis showed that all five types of rehabilitation exercises were superior to conventional rehabilitation group in terms of balance in stroke patients (P<0.05), with the best ranking occupied by Baduanjin. In terms of lower limb strength, only the aquatic exercise was superior to conventional rehabilitation (P<0.05). In terms of walking function, somatic training and aquatic exercise were superior to conventional rehabilitation (P<0.05), with somatic exercises ranking first. ConclusionCurrent evidence shows that Baduanjin has an advantage in improving the balance, somatosensory interactive game exercise has an advantage in improving the walking capability and aquatic exercise has an advantage in improving the lower limb strength of stroke patients. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review studies on evaluating the quality evaluation index and the transformation application effect evaluation index of domestic related scientific and technological achievements, to analyze and identify the key elements of evaluating the " production-transformation” of scientific and technological achievements, and to provide the methodological support for the establishment of evaluation system for the transformation and application of domestic scientific and technological achievements.MethodsWe searched CNKI, WanFang Data, SinoMed and VIP databases from inception to December 2016. In addition, manual retrieval and tracing references were also used to collect researches. Two reviewers screened literatures, extracted data, and descriptive analysis was performed to assess the results.ResultsA total of 18 studies on the production quality of the technological achievements and 12 studies on the transformation and application effect of the technological achievements were included. The results of systematic reviews showed that: the evaluation of production quality of technological achievements were mainly established from the benefits, characteristics, value, effect and source, and input of technological achievements; the evaluation of transformation and application of technological achievements were mainly established from researching and development ability, transforming ability and transformation effect of technological achievements.ConclusionsThe evaluation of technological achievements covers 2 key links: the production quality, transformation and application effect of technological achievements that are mutually complementary to each other. At the same time, the value elements are found in the production quality, transformation and application of technological achievements, namely scientific value, discipline value, economic value and social value. Therefore it is necessary to establish the evaluation of production quality, transformation and application effect of technological achievements based on the value.
ObjectivesTo systematically review the risk factors associated with prediabetes, and to provide reference for prevention and treatment of diabetes mellitus and health education.MethodsPubMed, EMbase, SinoMed, CNKI, WanFang Data and VIP databases were electronically searched to collect case-control studies on the risk factors associated with prediabetes from inception to February 20th, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 13 studies involving 49 168 patients were included. The results of meta-analysis showed that: drinking (OR=1.31, 95%CI 1.04 to 1.65, P=0.02), hypertension (OR=1.75, 95%CI 1.11 to 2.76, P=0.02), abdominal obesity (OR=1.26, 95%CI 1.12 to 1.42, P=0.000 1), and waist to hip ratio (OR=1.77, 95%CI 1.27 to 2.45, P=0.000 6) might be the risk factors for prediabetes. However, dyslipidemia, smoking, physical activity, family history of diabetes, body mass index and waist circumference might not be risk factors for prediabetes.ConclusionsCurrent evidence shows that drinking, hypertension, abdominal obesity and waist-hip ratio may be the influencing factors of pre-diabetes, while other related risk factors are required to be further studied. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo investigate the changes in pulmonary function after video-assisted thoracic surgery (VATS) and robot-assisted thoracic surgery (RATS) segmentectomy.MethodsA total of 59 patients (30 males and 29 females) who underwent segmentectomy in the Affiliated Hospital of Qingdao University from July to October 2017 were included. There were 33 patients (18 males and 15 females) in the VATS group and 26 patients (12 males and 14 females) in the RATS group. Lung function tests were performed before surgery, 1 month, 6 months, and 12 months after surgery. Intra- and inter-group comparisons of lung function retention values were performed between the two groups of patients to analyze differences in lung function retention after VATS and RATS segmentectomy.ResultsThe forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) in the VATS group and the RATS group were significantly lower than those before surgery (P<0.05), and they increased significantly within 6 months after surgery (P<0.05). The recovery was not obvious after 6 months (P>0.05), and they were still lower than those before surgery. In addition, the retentions of FEV1 and FVC in the VATS group and the RATS group were similar in 1 month, 6 months, and 12 months after operation with no statistical difference(P>0.05). ConclusionPulmonary function decreases significantly in 1 month after minimally invasive segmentectomy, and the recovery is obvious in 6 months after the operation, then the pulmonary function recovery gradually stabilizes 12 months after surgery. FEV1 of the patients in the two groups recovers to 93% and 94%, respectively. There is no statistical difference in pulmonary function retention after VATS and RATS segmentectomy.
Near-infrared fluorescence imaging technology, which possesses superior advantages including real-time and fast imaging, high spatial and temporal resolution, and deep tissue penetration, shows great potential for tumor imaging in vivo and therapy. Ⅰ-Ⅲ-Ⅵ quantum dots exhibit high brightness, broad excitation, easily tunable emission wavelength and superior stability, and do not contain highly toxic heavy metal elements such as cadmium or lead. These advantages make Ⅰ-Ⅲ-Ⅵ quantum dots attract widespread attention in biomedical field. This review summarizes the recent advances in the controlled synthesis of Ⅰ-Ⅲ-Ⅵ quantum dots and their applications in tumor imaging in vivo and therapy. Firstly, the organic-phase and aqueous-phase synthesis of Ⅰ-Ⅲ-Ⅵ quantum dots as well as the strategies for regulating the near-infrared photoluminescence are briefly introduced; secondly, representative biomedical applications of near-infrared-emitting cadmium-free quantum dots including early diagnosis of tumor, lymphatic imaging, drug delivery, photothermal and photodynamic therapy are emphatically discussed; lastly, perspectives on the future directions of developing quantum dots for biomedical application and the faced challenges are discussed. This paper may provide guidance and reference for further research and clinical translation of cadmium-free quantum dots in tumor diagnosis and treatment.