Clinical therapeutic evaluation of vacuum sealing drainage and precise ultrasound-guided debridement in the treatment of non-lactational mastitis.

The aim of the present study was to compare the efficacy of vacuum sealing drainage (VSD) and precise ultrasound-guided debridement in the treatment of non-lactational mastitis and to determine the optimal surgical treatment. A set of 60 cases diagnosed with non-lactational mastitis who had received surgical treatment at the Department of Thoracic and Breast Surgery of Xiamen Hospital of Traditional Chinese Medicine (Xiamen, China) between July 2017 and June 2019 were included. According to the surgical method, 30 patients were assigned to the VSD group and 30 patients were assigned to the precise ultrasound-guided debridement group. The clinicopathological data of the two groups were compared. The overall rates of recurrence and new incidence were 6.8 and 8.5%, respectively. The mean total disease course was 5.3 months and all of the patients were cured after treatment. Except for the hospitalization time and postoperative pain scores, the clinicopathological data between the two groups were similar. The hospitalization time in the VSD group was significantly longer than that in the precise ultrasound-guided debridement group. Pain scores on the first and third days after the operation in the precise ultrasound-guided debridement group were significantly higher than those in the VSD group (P=0.008 and 0.001, respectively). In conclusion, the efficacies of VSD and precise ultrasound-guided debridement for the treatment of non-lactational mastitis were generally both satisfactory without significant differences. Of note, the former is suitable for patients with inverted nipples and obvious skin ulcerations, while the latter is mainly suitable for patients with abscesses, small surgical incisions and those who require short hospital stays.

Application Value of a 6-Type Classification System for Common Hepatic Artery Absence During Laparoscopic Radical Resections for Gastric Cancer: A Large-Scale Single-Center Study.

The common hepatic artery (CHA) is an important blood vessel that must be vascularized during D2 lymphadenectomies for gastric cancer. When the CHA is absent, the risk of vascular injury increases.To explore the anatomic classification of CHA absence and its application value in laparoscopic radical resections for gastric cancer.Clinical data were collected prospectively from 2170 gastric cancer patients from June 2007 to December 2013, and the data were analyzed retrospectively. The anatomy of CHA absence was assessed synthetically by combining preoperative CT scans and intraoperative images, which were classified according to the anatomy of replaced hepatic arteries (RHAs) and were grouped into the early-year group (2007-2011) and the later-year group (2012-2013) based on the year in which the operation was performed.CHA absence was noted in 38 cases (1.8%) and was classified into 6 types: type I (replaced CHA [RCHA] from the superior mesenteric artery [SMA] with retropancreatic course, 28), type II (RCHA from the SMA with circumambulated course, 1), type III (RCHA from the aortic artery, 1), type IV (replaced left hepatic artery [RLHA] from the left gastric artery [LGA] and replaced right hepatic artery [RRHA] from the SMA, 5), type V (RLHA from the LGA and RRHA from the celiac artery, 2), and type VI (RLHA from the aberrant gastroduodenal artery and RRHA from the SMA, 1). Of the 38 cases, 17 cases (44.7%) belong to the early-year group, and 21 cases (55.3%) belong to the later-year group. The vascular injury rate was significantly lower in the later-year group than in the early-year group (4.8% [1/21] vs 41.2% [7/17], P = 0.005]. Additionally, the alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBIL) values were significantly lower in the later-year group than in the early-year group on postoperative day 3 (all P < 0.05).A 6-type anatomic classification system can be used to demonstrate variations in features resulting from CHA absence in detail. Knowledge regarding a patient's classification is helpful for surgeons, and vascular injury and liver function damage may be reduced in patients who are properly classified prior to surgery.

Why the Proximal Splenic Artery Approach is the Ideal Approach for Laparoscopic Suprapancreatic Lymph Node Dissection in Advanced Gastric Cancer? A Large-Scale Vascular-Anatomical-Based Study.

Laparoscopic gastrectomy with D2 lymph node (LN) dissection has not yet been widely adopted for advanced gastric cancer because it is technically complicated. Due to the high suprapancreatic lymph nodes metastasis rate (LMR) and the various vascular anatomies, the suprapancreatic LN dissection is a crucial and demanding procedure for radical resection of gastric cancer.To explore the anatomical basis of the proximal splenic artery (SA) approach for laparoscopic suprapancreatic LN dissection and its application in advanced gastric cancer.Laparoscopic suprapancreatic LN dissections were performed in 1551 consecutive advanced gastric cancer patients between June 2007 and November 2013. A total of 994 consecutive patients since January 2011 were selected to compare the clinicopathological characteristics and surgical outcomes between the conventional approach group (330) and the proximal SA approach group (664). In the proximal SA approach, the No. 11p LNs are dissected first, followed by the Nos. 9, 7, and 8a LNs; dissection of the Nos. 5 and 12a LNs is performed last.In the suprapancreatic arteries, the proximal SA had the lowest anatomic variation rate (P < 0.05, each) and maximum diameter (P < 0.05, each) compared with the common hepatic artery (CHA), left gastric artery (LGA), right gastric artery (RGA), and gastroduodenal artery (GDA). In addition, the proximal SA was located closer to the suprapancreatic border than the CHA (P = 0.000). The No. 11p LMR was lower than the Nos. 9, 7, 8a, 5, and 12a LMR (P < 0.01, each). Compared with the conventional approach, the proximal SA approach was associated with less blood loss (P < 0.05), significantly more retrieved total LNs and suprapancreatic LNs (P < 0.01, each).The proximal SA exhibits the most constant and maximum diameter, is located closer to the suprapancreatic border, and exhibits the lowest LMR; therefore, the proximal SA approach is the ideal approach for laparoscopic suprapancreatic LN dissection in advanced gastric cancer.

Side-effects of resveratrol in HepG2 cells: reduced pten and increased bcl-xl mRNA expression.

Resveratrol is a natural compound present in red grapes and red wine, and is often consumed in the human diet. The chemopreventive and chemotherapeutic potential of resveratrol in hepatocellular carcinoma (HCC), one of the most common types of liver cancer, has received much attention in recent years. However, the side-effects of resveratrol stimulation are of concern due to the high doses administered to humans. This study investigated the effects of resveratrol on the mRNA expression of pten and bcl-xl in HepG2 cells using semi-quantitative and quantitative PCR. This study demonstrated that 200 µmol/l resveratrol stimulation for 12 h resulted in the inhibition of HepG2 proliferation, reduced pten and increased bcl-xl mRNA expression. The data suggest that (a) the anticancer mechanism of resveratrol does not involve the induction of pten and inhibition of bcl-xl expression and (b) resveratrol induces a cellular self-protection response, which underlies the cellular chemoresistance against resveratrol in HepG2 cells.