[Clinical application of inferior pancreaticoduodenal artery management in laparoscopic pancreaticoduodenectomy].

Objective: To investigate the clinical effect of proper management of inferior pancreaticoduodenal artery (IPDA) in laparoscopic pancreaticoduodenectomy (LPD). Methods: This is a retrospective case series study. The clinical and pathological data of 70 patients who received LPD due to pancreatic head tumors, periampullary tumors, or distal common bile duct tumors in the Pancreatic Center of the Second Clinical College of Guangzhou University of Chinese Medicine from January to December 2022 were retrospectively collected. There were 47 males(67.1%) and 23 females(32.9%),aged (59.9±12.8)years(range:13 to 87 years).The procedure of IPDA exposure was as follows:a middle approach was utilized to expose the right half of superior mesenteric artery(SMA) and its right branches between the SMA and superior mesenteric vein(SMV) in superior colonic region. In the subcolonic region,SMA trunk exposure via dissection along the jejunal artery from feet to head and identification the association between IPDA and jejunal artery were prior to IPDA root ligation and dissection. The safety and efficacy of intraoperative IPDA handling were assessed based on surgical videos. Follow-up was carried out in outpatient clinic or by telephone, and outpatient follow-up was conducted once every 1 to 3 months after surgery. Results: The percentage of total LPD was 98.6%(69/70),with all patients achieving R0 resection. Nine cases(12.9%) were involved in combined vascular resection and reconstruction,with 1 case (1.4%) requiring additional upper abdominal incision for vascular and gastrointestinal reconstruction,while the remaining eight cases (11.4%) were completed laparoscopically. The operative time was (432.7±115.4)minutes(range:282 to 727 minutes), and the blood loss was (140.0±125.7)ml(range:20 to 800 ml). Only two patients(2.9%) received fresh frozen plasma transfusion,with an average volume of 650 ml. Reliable ligation and safe handling of the IPDA were achieved in 91.4%(64/70) of cases, with 8.6%(6/70) suffering from IPDA injury-related bleeding. No one was converted to opened surgery. Pathologically,the mean tumor size was (3.3±1.6)cm (range:1 to 7 cm),and the mean number of harvested lymph nodes was 17.0±7.3(range:0 to 46). Lymph node metastasis was observed in 13 cases (18.6%). Five cases (13.2%) developed grade B pancreatic fistula,while no grade C pancreatic fistula occurred. Other complications included bile leakage in one case(1.4%),delayed gastric emptying in two cases(2.9%), lymphatic leakage in 2 cases(2.9%),intra-abdominal infection in 9 cases(12.9%),and fat liquefaction of surgical incision in 1 case(1.4%). Two cases(2.9%) experienced postoperative intra-abdominal bleeding,one due to mesangial bleeding of lesser curvature of the stomach and the other due to oozing from the hepatic arterial sheath. These bleeding events were not concerned with IPDA. The average length of postoperative hospital stay was (15.2±4.6)days(range:9 to 28 days). Conclusion: Proper intraoperative management of IPDA in LPD might reduce IPDA-related bleeding during and after surgery and improve the safety of LPD.

[Development and evaluation of the simplified Chinese versions of motion sickness susceptibility questionnaire].

Objective: To develop and evaluate the simplified Chinese versions of motion sickness susceptibility questionnaire (MSSQ)-long (MSSQ-L) and MSSQ-short (MSSQ-S). Methods: A cross-sectional study was conducted in May 2023 among 3 426 university students at North China University of Science and Technology. The Chinese versions of MSSQ-L and MSSQ-S were distributed, and item selection for Simplified Chinese versions of MSSQ-L and MSSQ-S was performed based on item response rates, item-total correlations, Cronbach's alpha coefficients, and standard deviations. Forty-five male and forty-five female participants were recruited from the initial survey population to complete Coriolis acceleration endurance testing and fill out the simplified Chinese versions of MSSQ-L and MSSQ-S, and Graybiel symptom severity score questionnaire. Internal consistency, external consistency, criterion validity, discriminant validity, and predictive accuracy for motion sickness severity were assessed. Results: A total of 3 111 valid responses were received for the Chinese versions of MSSQ, yielding an effective response rate of 90.8% (3 111/3 426). Among the 3 111 students surveyed, there were 965 males and 2 146 females, with a mean age of (19.5±1.4) years. The highest usage rates for item were observed for cars (98.9%, 3 077/3 111) and buses (98.8%, 3 073/3 111). The simplified Chinese versions of MSSQ-L and MSSQ-S consisted of four and eight items, respectively. The Cronbach's alpha coefficients were 0.900 and 0.953 for the simplified Chinese versions of MSSQ-S and MSSQ-L, respectively, with test-retest reliabilities of 0.895 and 0.908. Criterion validity coefficients were 0.814 and 0.765 for the simplified Chinese versions of MSSQ-S and MSSQ-L, respectively. In terms of discriminant validity, significant differences were observed between mild and moderate susceptibility groups [0(0, 3) vs 6(2, 10), P=0.006] and between moderate and severe susceptibility groups [6(2, 10) vs 9(6, 13), P=0.030] for the simplified Chinese version of MSSQ-S. Significant differences were also observed between mild and moderate susceptibility groups [5(0, 3) vs 7(3, 10), P=0.001], but not between moderate and severe susceptibility groups [7(3, 10) vs 7(3, 10), P=0.081] for simplified Chinese version of MSSQ-L. The overall predictive accuracy for motion sickness severity improved from 55.6% (50/90) to 62.2% (56/90) for the simplified Chinese version of MSSQ-S and from 54.4% (49/90) to 58.9% (53/90) for the simplified Chinese version of MSSQ-L, but with no statistically significant differences (both P>0.05). Conclusions: The simplified Chinese versions of MSSQ-L and MSSQ-S demonstrates good reliability and validity. The simplified Chinese version of MSSQ-S exhibits satisfactory discriminant validity, and can serve as a simple and efficient tool for assessing motion sickness susceptibility.

Quercetin suppresses cell survival and invasion in oral squamous cell carcinoma via the miR-1254/CD36 cascade in vitro.

OBJECTIVE: This study aimed to investigate the effects of quercetin on the proliferation and invasion in oral squamous cell carcinoma (OSCC) and examine its effect on the activation of the miR-1254/CD36 signaling pathway. METHODS: Proliferation and invasion experiments were performed in the OSCC cell line CAL-27 in which miR-1254 was overexpressed or inhibited. The levels of miR-1254 and CD36 were determined using quantitative real-time polymerase chain reaction and Western blotting assays. RESULTS: Quercetin significantly suppressed the proliferation and invasion of CAL-27 cells in a dose-dependent manner, while up-regulating miR-1254 and down-regulating CD36. The overexpression of miR-1254 also considerably down-regulated CD36 and enhanced the ability of quercetin to inhibit CAL-27 cell survival and invasion. Conversely, the inhibition of miR-1254 significantly up-regulated CD36 and antagonized the inhibitory effects of quercetin. CONCLUSION: Our study suggests that quercetin might suppress the progression of OSCC by activating the miR-1254/CD36 signaling pathway, indicating its potential as a treatment against OSCC.

[Clinical experience of laparoscopic pancreatoduodenectomy via orthotopic resection].

Objective: To examine the surgical approach, practical cognition as well as clinical effect of the orthotopic resection for laparoscopic pancreatoduodenectomy(OLPD). Methods: From March 2019 to December 2019, 32 cases were treated with laparoscopic pancreatoduodenectomy (LPD) in a novel approach without mobilization of pancreatoduodenum in Pancreas Center of the Second Affiliated Hospital of Guangzhou University of Chinese Medicine.There were 16 male patients and 16 female patients.The mean age was (64.8±9.5) years old.Body mass index was 14.9 to 31.0 kg/m(2).All patients were diagnosed as ampullary or pancreatic head tumors and were not unresectable cases.In the surgical strategy, Kocher's dissociation, turning and pulling of the pancreaticoduodenal region, was not performed first.Anatomy in situ, separation of vessels which enter and exit from pancreas, separation of lymphatics and isolation of tumors were carried out in priority through the combined middle and left posterior approaches.Finally, the pancreatic head and duodenum region was mobilized and the entire resection of pancreas in situ was carried out.Digestive tract reconstruction was performed through Child method. Results: Postoperative pathology showed that 27 cases were pancreatic or ampullary malignant tumors and five cases were benign tumors among 32 patients.The operative time was (357.3±64.3) minutes.The diameter of pancreatic ducts was (3.0±1.0) mm. The pancreas of 20 cases (62.5%) were soft. Five patients suffered from pancreatic fistula (Grade B) and one patient suffered from intra-abdominal hemorrhage postoperatively.No other complications like pancreatic fistula (Grade C) or biliary fistula delayed gastric emptying or mortality were encountered.The postoperative hospital day was (13.7±3.6) days. Conclusions: Combining the multi-angle of the laparoscopic approaches and excising the pancreaticoduodenal specimen in situ, OLPD is a kind of surgical method which can realize the concept of no touch tumor surgery.Patients who undergo the OLPD can receive better treatments and results.

Development of an x-ray detector by polycrystalline diamond and its application in Z-pinch x-ray detection.

Large-grain-sized polycrystalline diamond films are fabricated by electron assisted chemical vapor deposition. A pure SP3 carbon bond in the cubic lattice structure is confirmed by Raman spectrum analysis. The grain size is on the order of several hundreds of µm or larger. Interlaced-finger electrodes are imprinted onto a 6 × 6 mm2 × 500 µm film to fabricate the x-ray detector. The width of every finger is 25 µm, and the distance between nearby fingers is 25 µm. Strong x ray irradiates when a pulsed current flows through a double-layer nested tungsten wire array in the Z-pinch. This diamond detector now works as one of the main x-ray detectors for the Z-pinch device. The diamond detector is calibrated using a plastic scintillator. The comparison between the signal measured by these two methods confirms that the large-grain-sized polycrystalline diamond is a good candidate for the detection of nanosecond pulsed x ray.

[Investigation and analysis of social security in patients with lung diseases in Kaizhou district of Chongqing].

Objective: To analyze the social insurance guarantee of pneumoconiosis patients in Kaizhou from 2006 to 2018, and to provide basis for the prevention and treatment of pneumoconiosis in the future. Methods: The social security situation of pneumoconiosis patients in Kai Zhou District in 2006-2018 years was analyzed. Results: There were 3357 cases of pneumoconiosis in Kaizhou District, with a social security rate of 99%; 79.4% of the coal mine pneumoconiosis patients, 87.5% of whom enjoy industrial injury insurance; the majority of the Xiangyu Railway pneumoconiosis patients were over 60 years old, accounting for 3.4%, all enjoy special treatment of Xiangyu Railway; the former township enterprises restructure pneumoconiosis patients, mainly under 60 years old, accounting for 3.4%. Among them, 79% enjoy work-related injury insurance, and 15.2% were rural poverty victims. Conclusion: Kaizhou district provides better social security for pneumoconiosis patients in this area, which can provide basis for formulating social security policies for pneumoconiosis patients in other areas.

[Investigation on social security of pneumoconiosis patients in Chongqing].

Objective: To investigate the living conditions, insurance coverage, and assistance of pneumoconiosis patients diagnosed in Chongqing from May 2006 to May 2018. Methods: A cross-sectional survey was conducted in July 2018, and 40 890 pneumoconiosis patients from occupational diseases report management agency were obtained. 34 625 cases meeting the inclusion criteria were investigated, and descriptive statistical analysis was performed on the data. Results: There were 34 625 cases of pneumoconiosis patients alive in Chongqing, and 22730 (65.6%) had participated in work-related injury insurance, 6 308 (18.2%) had participated in basic medical insurance for urban employees which were still effective. 27 056 (78.1%) had participated in cooperative insurance for urban and rural residents which were still effective. 4 393 (12.7%) received assistance for the residents in need in urban and rural areas. 5827 (16.8%) benefited the policy of "Xiangyu Railway". There were 7 961 cases (2.4%) whose work-related injury insurance had expired did not get one-off compensation, and did not receive any assistance. Conclusion: Most of the patients with pneumoconiosis in Chongqing obtained protection in terms of work-related injury insurance, medical insurance, civil assistance and poverty alleviation to a certain extent, but the strength of the guarantee is not enough. Patients with pneumoconiosis might suffer from poverty caused by illness. It is recommended to improve the system of work-related injury insurance benefits, establish special funds for pneumoconiosis patients, strengthen health education and health promotion for pneumoconiosis patients, and strengthen the management of pneumoconiosis patients.

[Analysis on social security of pneumoconiosis patients in two areas of Chongqing from 2006 to 2018].

Objective: To investigate the current status of social security among pneumoconiosis patients from two areas of Chongqing, China with different economic levels from 2006 to 2018, and to provide a reference for the development of security policy for pneumoconiosis patients. Methods: The current status of social security was analyzed for pneumoconiosis patients from A and B counties of Chongqing who were diagnosed from 2006 to 2018, and a comparative analysis was performed. Results: From 2006 to 2017, there was a significant increase in the number of newly diagnosed pneumoconiosis patients in A county, while the number of newly diagnosed pneumoconiosis patients remained relatively stable in B county. As of May 2018, there were 5738 pneumoconiosis patients in A county and 4155 pneumoconiosis patients in B county. Among the 5738 pneumoconiosis patients in A county, 5335 (93%) had employers, and among these patients, 2729 (47.6%) received one-time compensation from occupational injury insurance, and currently 1884 (32.8%) were covered by the insurance. Among the 4155 pneumoconiosis patients in B county, 2482 (59.7%) received one-time compensation from occupational injury insurance, and currently 3062 (73.7%) were covered by the insurance. The social security rate of pneumoconiosis patients was 71.0% in A county and 81.4% in B county, and there was a significant difference in the distribution of social security among pneumoconiosis patients between the two counties (χ(2)=4704.9, P<0.01) . Conclusion: Strict implementation of social security policies for pneumoconiosis patients by local governments is the key to solving social assistance for pneumoconiosis patients and improving their quality of life and social security level.

[Epidemiological analysis of new pneumoconiosis among workers in coal industry in Chongqing].

Objective: To analyze the incidence of pneumoconiosis among workers in the coal industry in the past 13 years in Chongqing, understand the different epidemiological characteristics of new pneumoconiosis among workers in the coal industry in the city, provide basic evidence for the prevention and treatment of pneumoconiosis. Methods: Collecting new cases of pneumoconiosis diagnosed in the coal industry in Chongqing in January 2006-May 2018, and analyze its epidemiological characteristics. Results: In January 2006-May 2018, 25329 cases of pneumoconiosis were added to workers in the coal industry in Chongqing, and 23, 328 cases were present, all male. Among the existing cases: coal workers' pneumoconiosis accounted for 89.30%, silicosis accounted for 10.70%; age distribution was 50-59 years old. The main, accounting for 45.19%, the average age of onset was 52.21±7.45 years; the actual dusting age was mainly 10-19 years, the average actual working age was 17.52±8.47 years; the distribution of the work was mainly by the main coal mining (53.20%) ; There are more new cases in enterprises, accounting for 88.86%; distributed in 36 districts and counties. Conclusion: There was a large number of new pneumoconiosis diseases in the coal industry in Chongqing. Different measures should be taken according to the characteristics of different enterprises, and relevant enterprises should be urged to take the initiative to carry out occupational health surveillance, effectively protect the health of workers, improve the coordination mechanism, improve medical security, and gradually realize government assistance and Social care is combined.