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45), mechanical lithotripsy requirement (RCTs P = .92; non-RCTs P = .47), pancreatitis (RCTs P = .48; non-RCTs P = .45), bleeding (RCTs P = .95; non-RCTs P = .60), infection of biliary (RCTs P = .58; non-RCTs P = .29), perforation (RCTs P = .32; non-RCTs P = .37).

This systematic review suggests that there no significant difference in the efficacy and safety of dilation of short and long duration for removal of bile duct stones with EPBD.

This systematic review suggests that there no significant difference in the efficacy and safety of dilation of short and long duration for removal of bile duct stones with EPBD.

Microsurgical clipping and endovascular coiling are the main methods against unruptured intracranial aneurysm (UIA). The craniotomy of surgical clipping may increase the risk of cerebrospinal fluid leakage and infection, damage the brain tissue, produce excessive stimulation to the nerves and blood vessels around the aneurysm, and cause the corresponding neurological deficit. Endovascular coiling could significantly reduce the mortality and disability rate than surgical clipping technique, which made endovascular coiling to become the first choice for the treatment of UIA. However, the long-term results showed attenuated favorable outcomes of coiling over clipping, so it is still in debate whether to clip or to coil. Therefore, we try to conduct a randomized, controlled, prospective trial to assess the long term safety of endovascular coiling therapy against UIA compared with microsurgical clipping technique.

Parallel-group randomization (11) is generated through the random number generator in Microsoft Excel 2010. In this trial, blinding to patients, physicians, and outcome assessors is not possible. Endovascular coiling or surgical clipping will be performed once for each patient in treatment group or control group, respectively. The mRS, overall mortality rate, disability rate, morbidity rate, and occurrence of a major aneurysm recurrence measured at 6 month and 1 year will be recorded.

The findings will be helpful for the choice of endovascular coiling or surgical clipping by assessing the long term efficacy and safety of both operations against UIA.

OSF Registration number DOI 10.17605/OSF.IO/QYE9F.

OSF Registration number DOI 10.17605/OSF.IO/QYE9F.

To determine the effect of earthquake on sleep quality of adults who had experienced Tangshan Earthquake either as infants or fetuses and also investigate whether CRHR1 polymorphism influenced sleep quality in subjects exposed to seismic stress.Totally 556 subjects were enrolled in the current study and were divided into 3 groups, those who had experienced Tangshan Earthquake as infants (group I) or fetuses (group II), and those who had not experienced Tangshan Earthquake (group III). Sleep was evaluated using the Pittsburgh Sleep Quality Index (PQSI). Three single nucleotide polymorphisms of the CRHR1 gene were analyzed.Fifty two (9.4%) subjects had sleep disturbance, including 17 (9.9%) subjects in group I, 24 (13.4%) subjects in group II, and 11 (5.3%) subjects in group III (χ2 = 7.373, P = .025). Moreover, subjects with CRHR1 genotype T/T had a significantly lower rate of sleep disturbance (7.8%) than subjects with genotype C/T and C/C (14.7%; χ2 = 4.845, P  = .028). Furthermore, subjects with rs7209436up II, and 11 (5.3%) subjects in group III (χ2 = 7.373, P = .025). Moreover, subjects with CRHR1 genotype T/T had a significantly lower rate of sleep disturbance (7.8%) than subjects with genotype C/T and C/C (14.7%; χ2 = 4.845, P  = .028). Furthermore, subjects with rs7209436 genotype C had an approximately 2-fold increase in the risk of sleep disturbance versus those who were not genotype C (OR = 1.978, 95% CI (1.045, 3.744).Prenatal and postnatal exposure to seismic stress significantly increases subsequent risk of sleep disturbance in adulthood.

The objective of the present study was to assess the allelic variations of Cytochrome P450 (CYP) enzymes Cytochrome P450 2C19 (CYP2C19), Cytochrome P450 2C9 (CYP2C9), and Cytochrome P450 2D6 (CYP2D6) as they play a major role in drug metabolism. The interindividual genetic variabilities of these enzymes can account for different responsiveness as well as concentration fluctuations for a particular drug.During the period of 2017 to 2018 a total of 54 patients have received pharmacogenetic testing at the Department of Genetics and Molecular Medicine at Kaunas Clinics. According to the genotype-metabolic phenotypes of CYP2C19, CYP2D6, CYP2C9 enzymes patients were classified according to the guidelines by Clinical Pharmacogenetics Implementation Consortium (CPIC) normal metabolizers (NMs), intermediate metabolizers (IMs), rapid metabolizers (RMs), ultrarapid metabolizers (UMs), and poor metabolizers (PMs).CYP2C19 enzyme allelic distribution 18 patients (33.33%) with ∗1/∗1 genotype were NMs; 14 patients (25.93%)atic activity so were accounted as PMs; CYP2C9 enzyme allelic distribution 44 patients (81.48%) with∗1/∗1 genotype were NMs; 10 patients (18.52%) with ∗1/∗2;∗1/∗3 genotypes were IMs.The results of our study indicate that deviations from the normal enzymatic activity is common amongst Lithuanian people and combinatory genotyping of CYP2D6, CYP2C9, and CYP2C19 has to be promoted as an advanced method because of most commonly prescribed medicines like analgesics, antihypertensive, antidepressants are metabolized by multiple pathways involving enzymes in the CYP450 family.

Polycystic ovary syndrome (PCOS) is one of the common diseases of reproductive endocrine metabolism in gynecology, and it is also a common and difficult disease affecting female reproductive endocrine health. PCOS characterized by insulin resistance and hyperandrogenemia, the clinical manifestations are polychaemia, acne, obesity, infertility, menstrual disorders and so on. Clinical treatment of patients with PCOS ovulatory dysfunction infertility is mainly treated with ovulation-promoting drugs, insulin sensitizer, hyperandrogenemia drugs and other drugs Healing. It is found that the sensitivity of patients to ovulation promotion is poor, and it is often necessary to increase the dosage of drugs to increase ovulation rate, thus increasing the risk of ovarian hyperstimulation syndrome, and the recurrence rate is higher after withdrawal. Moxibustion therapy has shown strong advantages in the treatment of PCOS, and the curative effect is accurate. Therefore, this paper will carry out a systematic evaluation a meta-analysis can we get the result.

The results of this study will provide reliable evidence for the efficacy and safety of moxibustion therapy in the treatment of PCOS.

The results of this study will provide reliable evidence for the efficacy and safety of moxibustion therapy in the treatment of PCOS.

The purpose of this research is to analyze and introduce a new emergency medical service (EMS) transportation scenario, Emergency Medical Regulation Center (EMRC), which is a temporary premise for treating moderate and minor casualties, in the 2015 Formosa Fun Color Dust Party explosion in Taiwan. In this mass casualty incident (MCI), although all emergency medical responses and care can be considered as a golden model in such an MCI, some EMS plans and strategies should be estimated impartially to understand the truth of the successful outcome.Factors like on-scene triage, apparent prehospital time (appPHT), inhospital time (IHT), and diversion rate were evaluated for the appropriateness of the EMS transportation plan in such cases. The patient diversion risk of inadequate EMS transportation to the first-arrival hospital is detected by the odds ratios (ORs). In this case, the effectiveness of the EMRC scenario is estimated by a decrease in appPHT.The average appPHTs (in minutes) of mild, moderate, and sevehigh appPHT, diversion rate, and OR value in severe patients, the EMS transportation plan is distinct from a prevalent response and develops adaptive weaknesses of MCIs in current disaster management. Application of the EMRC scenario reduces the appPHT and alleviates the surge pressure upon emergency departments in an MCI.

The platelet-albumin-bilirubin (PALBI) grade plays critical role in evaluating liver function. However, the change of PALBI grade from the preoperative to postoperative period in predicting patient outcomes after hepatectomy remains unclear.A total of 489 HCC patients who underwent hepatectomy in West China Hospital between January, 2010 and June, 2016 were analyzed retrospectively.ΔPALBI grade was calculated by PALBI grade at the first postoperative month - preoperative PALBI grade.ΔPALBI >0 was considered as stable; otherwise, worse PALBI grade was considered. Kaplan- Meier method and Cox proportional hazard regression analyses were performed for survival analysis. Prognostic model was constructed by nomogram method.Three hundred forty two patients and 147 patients were classified into training group and validation group, respectively. click here In the training group, results from Cox model suggested that worse PALBI grade (HR 1.328, 95% CI 1.010-1.746, P = .042), tumor size (HR 1.460, 95% CI 1.058-2.015, P = .0 worse recurrence free (RFS) and overall survival (OS). The prognostic model incorporating the change of PALBI grade constructed in training group and tested in the validation group could perform well in predicting the outcomes.Postoperative change of PALBI grade was independently risk factor related with prognosis. Prognostic model incorporating the change of PALBI grade might be a useful index to predict the prognosis of HCC patients following hepatectomy.

The association between Glutathione S-transferase Pi 1(GSTP1) genetic polymorphism (rs1695, 313A>G) and cyclophosphamide-induced toxicities has been widely investigated in previous studies, however, the results were inconsistent. This study was performed to further elucidate the association.A comprehensive search was conducted in PubMed, Embase, Web of Science, China National Knowledge Infrastructure, and Wan Fang database up to January 5, 2020. Risk ratios (RRs) and 95% confidence intervals (95% CIs) were used to estimate the association between GSTP1 rs1695 polymorphism and cyclophosphamide-induced hemotoxicity, gastrointestinal toxicity, infection, and neurotoxicity.A total of 13 studies were eventually included. Compared with the GSTP1 rs1695 AA genotype carriers, patients with AG and GG genotypes had an increased risk of cyclophosphamide-induced gastrointestinal toxicity (RR, 1.61; 95% CI, 1.18-2.19; P = .003) and infection (RR, 1.57; 95% CI, 1.00-2.48; P = .05) in the overall population. In the subresults confirmed an essential role for the GSTP1 rs1695 polymorphism in the prediction of cyclophosphamide-induced myelosuppression, gastrointestinal toxicity, and infection in SLE or lupus nephritis syndrome patients. More studies are necessary to validate our findings in the future.

Benign neoplasm of the endobronchial tree is quite rare, while endobronchial lipoma is extremely rare. Tracheobronchial aspergillosis is a relatively uncommon but severe form of invasive aspergillosis involving the tracheobronchial tree.

A 54-year-old male presented to our hospital for investigation and treatment of a cough and hemoptysis.

The diagnosis was confirmed as endobronchial lipoma with tracheobronchial aspergillosis.

The patient received pneumonectomy and voriconazole treatment.

The patient's postoperative course was uneventful, and he was discharged 10 days after surgery. The patient had no evidence of the fungal infection and recurrence during 1 year of follow-up.

Endobronchial lipoma is a rare benign lung tumor, and this is the first report of endobronchial lipoma with tracheobronchial aspergillosis. In patients with suspected endobronchial lipoma, especially those who present with hemoptysis as the initial symptom, it is advisable to exclude coexistent aspergillosis.

Endobronchial lipoma is a rare benign lung tumor, and this is the first report of endobronchial lipoma with tracheobronchial aspergillosis.