One-half layer pancreaticojejunostomy with the rear wall of the pancreas reinforced: A valuable anastomosis technique.

BACKGROUND: Postoperative pancreatic fistula (POPF) is one of the most common and serious complications after pancreaticoduodenectomy (PD). To effectively reduce the incidence of POPF, we designed a new type of pancreaticojejunostomy (PJ), which was termed one-half layer PJ with the rear wall of the pancreas reinforced. AIM: To explore the clinical application value of this new technique. METHODS: We compared 62 patients who had undergone PD by either the traditional duct-to-mucosa anastomoses or the new one-half layer PJ with the rear wall of the pancreas reinforced method at our hospital from May 2015 to September 2019. All 62 patients were operated by the same surgeon experienced in both procedures. We retrospectively analyzed patient characteristics, perioperative outcomes, and surgical results. RESULTS: There was no significant difference between the two groups in basic information except the postoperative hospital stays, 14.7 ± 5.4 d in the traditional duct-to-mucosa anastomoses group and 12.0 ± 4.2 d in the one-half layer PJ group (P = 0.042). In terms of postoperative complications, the one-half layer PJ group had a lower rate of POPF than the traditional group. The overall number of cases with POPF was 8 (24.2%) in the traditional group and 2 (6.9%) in the one-half layer group (P = 0.017). Additionally, the rate of grades B and C POPF was lower in the one-half layer group (3.4%) compared with that (12.1%) in the traditional group (P = 0.010). One patient died due to hemorrhage caused by severe pancreatic fistula in the traditional group. CONCLUSION: One-half layer PJ with the rear wall of the pancreas reinforced is a safe and feasible procedure that can successfully reduce the rate of POPF. It may be a promising technique for PJ after PD.

Use of GLP1RAs and occurrence of respiratory disorders: A meta-analysis of large randomized trials of GLP1RAs.

OBJECTIVES: No large sample studies have been designed to evaluate the efficacy of glucagon-like peptide-1 receptor agonists (GLP1RAs) in the primary and secondary prevention of respiratory disorders. We aimed at evaluating the relationship between use of GLP1RAs and occurrence of 12 kinds of respiratory disorders. METHODS: Large randomized placebo-controlled trials of GLP1RAs were included. We conducted meta-analysis using random effects model and measured heterogeneity using I2 . Treatment effect was presented as risk ratio (RR) and 95% confidence interval (CI). RESULTS: Seven trials including 55 922 participants were included in meta-analysis. The occurrence rates of various respiratory disorders were low, with the minimum of 0.02% (pulmonary fibrosis) and the maximum of 2.31% (pneumonia). Although not reaching statistical significance, GLP1RAs versus placebo showed the reduced trends in the risks of nine kinds of respiratory disorders including pneumonia (RR 0.89, 95% CI 0.78-1.01), squamous cell carcinoma of lung (SCCL; RR 0.55, 95% CI 0.25-1.21), asthma (RR 0.82, 95% CI 0.51-1.32), and chronic obstructive pulmonary disease (COPD; RR 0.89, 95% CI 0.73-1.10), but the increased trend in interstitial lung disease (ILD; RR 1.89, 95% CI 0.87-4.08). GLP1RAs had neutral effects on two other respiratory disorders. Heterogeneity in any meta-analysis was absent or low. CONCLUSION: GLP1RAs show the reduced trends in the risks of nine kinds of respiratory disorders (eg, pneumonia, SCCL, asthma, and COPD), but the increased trend in the risk of ILD. However, these findings need to be validated by further studies due to the low incidence rates of all the respiratory disorders.

MicroRNAs involving in cold, wounding and salt stresses in Triticum aestivum L.

MicroRNAs (miRNAs) play critical roles in post-transcriptional regulation and act as important endogenous regulators to various stresses. Cold, wounding and high-salinity are three common environmental stress stimuli influencing crops growth and development. In this study, we identified 31 known miRNAs and 3 novel miRNAs in wheat. Moreover, 19 stress-regulated miRNAs using RT-qPCR data in which the effects of three stresses were surveyed from the known miRNAs. Among them, 16, 12 and 8 miRNAs were regulated under cold, wounding and high-salinity treatments, respectively. Of which 4 miRNAs were highly responsive to cold stress in wheat by northern blot, and 6 wounding-regulated and 3 high-salinity-regulated miRNAs were detected. Meanwhile, miR159, miR393 and miR398 were responsive to multiple stress stimuli. Besides, 2 novel miRNAs were regulated by cold stress. While, the analyses of targets suggested miR159, miR398 and miR6001 could responses to stress conditions in regulation pathways. Taken together, the results of this study suggest that wheat miRNAs may play important roles in response to abiotic stress.