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Objective:To study the safety and feasibility of en-bloc lymph node dissection in laparoscopic radical resection for gallbladder cancer(GBC).Methods:The clinical data of 87 patients who underwent laparoscopic radical resection for GBC at Zhejiang Provincial People's Hospital from January 2014 to February 2022 were retrospectively analyzed. There were 26 males and 61 females, aged 67.0 (59.0, 72.0) years old. The patients were divided into the en-bloc dissection group ( n=29) and the non-en-bloc dissection group ( n=58) based on whether en-bloc lymph node dissection was carried out. Differences in general data, tumor characteristics, operation, recurrence and survival were compared between the two groups. Postoperative survival status of these patients was followed-up by telephone. Results:The number of lymph nodes dissected in the en-bloc dissection group was 9.0(8.0, 12.0), which was significantly higher than the 8.0(4.8, 11.0) in the non-en-bloc dissection group ( Z=-2.39, P=0.017). There were no significant differences in age, gender, preoperative blood biochemical indexes, tumor carbohydrate antigen 19-9, tumor stage, nerve and vascular invasion, operation time, intraoperative blood loss, postoperative drainage tube retention time, postoperative hospital stay, and incidences of postoperative complications (biliary fistula, abdominal hemorrhage and abdominal infection) between the two groups (all P>0.05). The median survival was longer in the en-bloc group than in the non-en-bloc group (21 vs. 15 months), and the median relapse-free survival time was 18 months in the en-bloc group compared with 10 months in the non-en-bloc group. However, there were no significant differences in postoperative cumulative survival and recurrence-free survival between the two groups (all P>0.05). Conclusion:En-bloc lymphadenectomy was safe and feasible in laparoscopic radical GBC surgery, with more lymph nodes being removed than the non-en-bloc lymphadenectomy group.
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BackgroundBeing complex and highly heterogeneous with regard to the etiology and clinical manifestations of depression， neuroimaging studies make a breakthrough for exploring the biological subtypes of depression， while the current data-driven approach for the identification of subtyping depression using structural magnetic resonance imaging （MRI） data is insufficient. ObjectiveTo explore the biological subtypes of depression using diffusion tensor imaging （DTI） and machine learning methods. MethodsA total of 127 patients with depression who attended Beijing Anding Hospital from September 2017 to August 2021 and met the Diagnostic and Statistical Manual of Mental Disorders， fourth edition （DSM-IV） diagnostic criteria were included， and another 80 healthy individuals matched for gender and age were recruited through advertisements in surrounding communities during the same period. DTI findings， demographic characteristics and clinical data were collected from all participants. Tract-based spatial statistics （TBSS） and the Johns Hopkins University （JHU） white matter probability maps were used to extract fractional anisotropy （FA） values of white matter tracts. A semi-supervised machine learning technique was used to identify the subtypes， and the FA values for whole brain white matter of patients and controls were compared. ResultsPatients with depression were classified into two biological subtypes. FA values in multiple tracts including corpus callosum and corona radiata of subtype I patients were smaller than those of healthy controls （P<0.01， FDR corrected）， and FA values in middle cerebellar peduncle， left superior cerebellar peduncle and left cerebral peduncle of subtype II patients were larger than those of healthy controls （P<0.01， FDR-corrected）. Baseline Hamilton Depression Scale-17 item （HAMD-17） score yielded no statistical difference between subtype I and subtype II patients （P>0.05）， while subtype I patients scored lower on HAMD-17 than subtype II patients after 12 weeks of treatment （t=2.410， P<0.05）. ConclusionDepression patients exhibit two biological subtypes with distinct patterns of white matter damage. Furthermore， the subtypes respond differently to the medication treatment. ［Funded by the National Key Research and Development Program of China （number， 2016YFC1307200）， the Scientific Research and Cultivation Program of Beijing Municipal Hospitals （number，PX2023066）， Beijing Anding Hospital， Capital Medical University （number，YJ201904， YJ201911）； www.chictr.org.cn number： ChiCTR-OOC-17012566］
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Owing to the increasing incidence and prevalence of inflammatory bowel disease (IBD) worldwide, effective and safe treatments for IBD are urgently needed. Hydrogen sulfide (H2S) is an endogenous gasotransmitter and plays an important role in inflammation. To date, H2S-releasing agents are viewed as potential anti-inflammatory drugs. The slow-releasing H2S donor 5-(4-hydroxyphenyl)-3H-1,2-dithiole-3-thione (ADT-OH), known as a potent therapeutic with chemopreventive and cytoprotective properties, has received attention recently. Here, we reported its anti-inflammatory effects on dextran sodium sulfate (DSS)-induced acute (7 days) and chronic (30 days) colitis. We found that ADT-OH effectively reduced the DSS-colitis clinical score and reversed the inflammation-induced shortening of colon length. Moreover, ADT-OH reduced intestinal inflammation by suppressing the nuclear factor kappa-B pathway. In vivo and in vitro results showed that ADT-OH decreased intestinal permeability by increasing the expression of zonula occludens-1 and occludin and blocking increases in myosin II regulatory light chain phosphorylation and epithelial myosin light chain kinase protein expression levels. In addition, ADT-OH restored intestinal microbiota dysbiosis characterized by the significantly increased abundance of Muribaculaceae and Alistipes and markedly decreased abundance of Helicobacter, Mucispirillum, Parasutterella, and Desulfovibrio. Transplanting ADT-OH-modulated microbiota can alleviate DSS-induced colitis and negatively regulate the expression of local and systemic proinflammatory cytokines. Collectively, ADT-OH is safe without any short-term (5 days) or long-term (30 days) toxicological adverse effects and can be used as an alternative therapeutic agent for IBD treatment.
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Humans , Mice , Animals , Gastrointestinal Microbiome , Intestinal Barrier Function , Mice, Inbred C57BL , Colitis/metabolism , Inflammatory Bowel Diseases/drug therapy , Inflammation , Anti-Inflammatory Agents/pharmacology , Disease Models, AnimalABSTRACT
Cancer is considered as one of the major diseases endangering human health in the world, it is urgent to find a safer and more efficient treatment for cancer therapy. Gene therapy with ribonucleic acid (RNA) drugs could regulate the expression of tumor related genes, and exhibit good anti-tumor therapeutic potential in preclinical and clinical trials. Based on the differences between tumor tissues and normal tissues in microenvironment signal characteristics such as pH, specific enzyme concentration or redox gradient, various microenvironment responsive nanocarriers had been studied and developed to deliver RNA drugs to tumor tissues and cells, improving the anti-tumor efficacy of RNA drugs and reducing toxic and side effects. This paper reviews the pathophysiological characteristics of tumor microenvironment and various strategies of tumor microenvironment responsive nanocarriers, in order to provide reference for the design of safe and efficient RNA drug delivery system for cancer therapy.
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Objective: To compare the short-term efficacy and long-term prognosis of laparoscopic and laparotomy radical resection for gallbladder cancer(GBC). Methods: From January 2010 to December 2020,the clinical data and survival information for 133 patients who underwent radical resection of GBC at the Department of Hepatopancreatobiliary Surgery,Zhejiang Provincial People's Hospital,were retrospectively collected. Eighty patients(23 males and 57 females) underwent laparoscopic radical resection and had a median age(M(IQR)) of 66.0(12.8)years(range:28.0 to 82.0 years). Fifty-three patients(45 males and 8 females) who received laparotomy were 63.0(6.0)years old(range:45.0 to 80.0 years old). There were no significant differences in age,gender,body mass index,preoperative albumin,preoperative total bilirubin,N stages,vascular invasion,peri-neural invasion or tumor differentiation between the laparoscopic and laparotomy group(all P>0.05). But there were significant differences in preoperative CA19-9(Z=-2.955, P=0.003), preoperative ALT level(Z=-2.801,P=0.031) and T stage (χ2=19.110,P=0.007) between the two groups. A non-parametric test was used for quantitative data. χ2 test or Fisher exact probability method was used for count data. Results: Patients in the laparoscopic group did not differ from those in the laparotomy group in terms of length of operation,number of lymph node yield,number of positive lymph nodes,the incidence of intraoperative gallbladder rupture,incidence of postoperative bile leakage,abdominal bleeding or abdominal infection,30-day mortality,90-day mortality, the incidence of incision implantation or peritoneal cavity metastasis(all P>0.05). Patients in the laparoscopic group showed less intraoperative bleeding(100.0(200.0)ml vs. 400.0(250.0)ml)(Z=-5.260,P<0.01),fewer days with drainage tube indwelling(6.0(3.8)days vs. 7.0(4.0)days)(Z=-3.351, P=0.001), and fewer postoperative days in hospital(8.0(5.0)days vs. 14.0(7.5)days)(Z=-6.079,P<0.01) than those in the laparotomy group. Patients in the laparoscopic group displayed better overall survival (P<0.01) and progression-free survival (P<0.01). Subgroup analysis for GBC of T1b-T2 and T3 stages revealed comparable overall survival and progression-free survival between the laparoscopic and laparotomy groups (P>0.05). Conclusions: Laparoscopic radical resection can achieve long-term survival for GBC comparable to that with open surgery. Laparoscopic radical resection has advantages over open surgery regarding surgical trauma and postoperative recovery.
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Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Gallbladder Neoplasms/surgery , Laparoscopy , Laparotomy , Prognosis , Retrospective Studies , Treatment OutcomeABSTRACT
Objective:To investigate the diagnosis and treatment of intravascular large B-cell lymphoma (IVLBCL).Methods:The clinical data of 1 patient with adrenal IVLBCL in Zhongda Hospital Southeast University in May 2020 were retrospectively analyzed, and the relevant literature was reviewed.Results:The patient was an elderly male with recurrent fever of unknown cause at initial stage, and was finally diagnosed as adrenal IVLBCL based on the results of laboratory, imaging and adrenal biopsy at different stages. After multiple courses of R-COP in combination with Bruton tyrosine kinase (BTK) inhibitor, the patient achieved complete remission.Conclusions:IVLBCL is rare and it lacks specific clinical symptoms. PET-CT and pathological biopsy can help in the diagnosis of it. R-COP combined with BTK inhibitor is effective in the treatment of biphenotype IVLBCL.
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A spinal cord injury is a serious disease, and there is currently no effective treatment. The inflammatory reactions start within a few hours after damages to spinal cord tissues and peak within a few days and they may continue for several years. Reducing the inflammatory response after the spinal cord injury is one of the important treatment strategies. Butyrate and β-hydroxybutyrate are two closely related substances. They have similar structures and differ in only one hydroxyl group. They have attracted widespread attention because of their good anti-inflammatory properties in many diseases. Recently it has been demonstrated that butyrate and β-hydroxybutyrate can inhibit the activity of the NF-κB / NLRP3 inflamma-some signaling pathway and reduce the expression of pro-inflammatory factors; or by enhancing the level of antioxidant molecules, it can reduce the inflammatory response after spinal cord injury. Therefore, butyrate and β-hydroxybutyrate may be promising treatments after a spinal cord injury. Here we review the structure and production of butyrate and β-hydroxybutyrate, the mechanism of anti-inflammatory effects in a spinal cord injury, and the treatment prospects, in order to provide theoretical references for researchers in this field.
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Treatment and rehabilitation of spinal cord injury has been a major problem in the medical field‚ and little progress has been achieved in the improvement of neuronal function following injury. Secondary damage is the main cause of neurological dysfunction after spinal cord injury‚ and inflammation is the most important pathological process in the secondary injury stage. In the acute phase‚ it is believed that the reduction of secondary damage by inhibiting neuroinflammation can reduce the damage of nerve function and achieve neuroprotection. The inflammasome is a type of protein complex‚ which is assembled and named by the receptor proteins of the NLRs family and the PHYIN family of pattern recognition receptors as the main framework. Common inflammasomes include NLRP1‚ NLRP3‚ NLRC4 (IPAF)‚ and AIM2 etc. When infected or stimulated by injury‚ inflammasomes assemble in the cytoplasm and activate the pro-inflammatory protease caspase-1. Activated caspase-1 promotes the maturation and secretion of pro-inflammatory cytokines IL-1β and IL-18 on the one hand‚ and mediates pyroptosis on the other hand. Pyroptosis is a way of programmed cell death induced under pathological conditions of inflammation and stress. Cell swelling and rupture and the release of cell contents are its main characteristics. Both pro-inflammatory cytokines and intracellular substances released by pyroptosis can be used as pro-inflammatory signals to trigger an inflammatory response. Recently‚ it has been discovered that inflammasomes participate in the activation of the inflammatory cascade after spinal cord injury by inducing the release of pro-inflammatory factors and mediating pyroptosis‚ and then aggravate secondary neuroinflammation. Targeted inhibition of the activation of inflammasomes can reduce the inflammatory response‚ promote the survival of nerve cells‚ and achieve neuroprotective effects. Therefore‚ the inflammasome is expected to become a new target for the treatment of spinal cord injury. This article reviewed the structure of the inflammasome and its role in spinal cord injury‚ activation mechanism and treatment‚ which may provide ideas for the follow-up research.
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Aim To develop an LC-MS/MS method for the determination of prucalopride(PCP)in human plasma.Methods Prucalopride -13CD3(dPCP)was used as the internal standard.The analytes were extracted from human plasma through liquid-liquid extraction method using ethyl acetate, followed by being dried, and then the reconstitution was injected into LC-MS/MS systems.Agilent ZORBAX SB C18(3.0×100 mm, 3.5 μm)column and isocratic elution system composing of methanol and 1 mmol·L-1 ammonium acetate(80:20, V/V)provided chromatographic separation of PCP and dPCP.AB Sciex API4000 mass spectrometer equipped with an electrospray ionization source in positive ion mode was employed for mass detection, and data acquisition was carried out in multiple reaction monitoring(MRM)mode.The mass transition ion-pair was followed as m/z 368.4/196.0 for PCP and m/z 374.4/198.0 for dPCP.Results PCP and dPCP were eluted at 3.6 min, with no interference in human blank plasma.PCP in human plasma showed good linearity over the concentration range of 0.058 96-7.547 μg·L-1 with the correlation coefficient of 0.996 3-0.999 6.The lower limit of quantitation of this method was 0.058 96 μg·L-1.The intra-batch and inter-batch accuracy ranged from 98.29% to 108.2%, with good precision(CV<5.2%).The average matrix factors of normal, haemolysed and lipaemic matrix human samples all ranged from 96.48% to 106.3% with CV less than 8.39%.The average extraction recoveries of PCP at low, medium and high concentrations were 89.88%, 95.27% and 94.52% respectively, with CV less than 7.21%.PCP was stable in human samples after 6 h at room temperature, 60 h at -20 ℃, 56 days or three freeze-thaw cycles at -80 ℃; meanwhile, the processed plasma samples remained stable after being stored for 24 hours in autosampler at 8 ℃.Furthermore, PCP in human blood samples was proved to be stable after 4 h at room temperature.Conclusions The present LC-MS/MS method for the determination of PCP in human plasma was convenient, accurate, sensitive, stable, specific and reproducible and was proved to be suitable for the clinical pharmacokinetics and bioequivalence studies of PCP preparations.
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OBJECTIVE@#To explore the characteristics and rules of acupoint sensitization phenomena based on knee osteoarthritis (KOA), one of the clinical dominant diseases of acupuncture-moxibustion.@*METHODS@#In combination with literature and expert experiences, the acupoints with the highest use frequency in treatment of KOA were screened, e.g. Heding (EX-LE 2), Liangqiu (ST 34), Mingmen (GV 4), Neixiyan (EX-LE 4), Ququan (LR 8) and Dubi (ST 35). In 814 patients with KOA and 217 healthy subjects, the acupoint temperature, mechanic pain threshold and pressure pain threshold were detected separately. Using machine learning method, the sensitization was judged at each acupoint.@*RESULTS@#Compared with healthy subjects, the acupoint temperature was increased and the mechanic pain threshold and pressure pain threshold were reduced in KOA patients (P<0.05). Besides, the cut-off value was presented to distinguish whether the acupoint was sensitized or not. The results of machine learning showed that the highest prediction accuracy of acupoint sensitization was 86.7% (Shenshu [BL 23]) and the lowest one was 73.9% (Heding [EX LE 2]). The prediction accuracy at the third clinical stage trial was higher, the highest was 93.3% (Ququan [LR 8]) in KOA patients.@*CONCLUSION@#It is confirmed that the acupoint sensitization reflects the characteristics of disease and is correlative with the conditions of illness, which may provide the reference for the auxiliary diagnosis and condition assessment of KOA.
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Humans , Acupuncture Points , Acupuncture Therapy , Moxibustion , Osteoarthritis, Knee/therapy , Treatment OutcomeABSTRACT
This article summarizes the structure of China’s current social health insurance system and reviews the development status of China’s private health insurance (PHI). China’s medical security system is mainly composed of two parts: basic medical insurance (BMI) and PHI. Among them, the BMI provides reimbursement of basic medical expenses for the insured persons according to different proportions. PHI is a necessary supplement to the BMI and provides assistance to the insured persons in the event of illness or accident. By having PHI, people can obtain medical protection outside the coverage of BMI. In the development of PHI in China, the total medical cost is high and the insurance market size is large, but the proportion of PHI expenditure is low and the personal burden is high. Through this Chinese case, it will be helpful for mutual development between Korean PHI and national health insurance, for Korean insurance companies to enter the Chinese market, and for removing the medical burden on the people.
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Objective:To observe the effect of electroacupuncture based on transcranial magnetic stimulation (TMS) on wakefulness for consciousness disorder. Methods:From January, 2015 to October, 2019, 30 inpatients with consciousness disorder from the General Hospital of Western Theater Command were randomly divided into control group (n = 15) and observetion group (n = 15), Both groups received TMS, and the observetion group received electroacupuncture at Baihui (GV20), Shenting (GV24), bilateral Neiguan (PC6) bilateral Hegu (LI4) and bilateral Yongquan (KI1) in addition, for three months. They were tested the latency of the mismatch negativity (MMN), and assessed with Glasgow Coma Scale (GCS) and persistent vegetative state (PVS) score before, and one month and three months after treatment. Results:The latency of MMN decreased more in the observetion group than in the control group three months after treatment (t = 2.159, P < 0.05). Conclusion:Combination of electroacupuncture on TMS is more effective on wakefulness for consciousness disorder.
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Objective:To systematically evaluate the effect of targeting mitochondria on spinal cord injury animal models, and provide experimental evidence. Methods:Literatures about animal experiments of targeting mitochondria treatment for spinal cord injury were searched in PubMed, Web of Science, Web of Knowledge, CNKI and Wanfang database from establishment to February, 2021. Three researchers independently screened the literatures and extracted the data, and they were summarized by qualitative analysis. Results:Eleven animal experimental studies were enrolled, including 548 animals with spinal cord injury. Six studies selected male or female Sprague-Dawley rats, and the rats in eight studies weighed 150~275 g. The animal models of spinal cord injury in all studies focused on T9~T11 contusive spinal cord injury, but there were differences in the use of spinal cord strikers and striking strength. The type, time, frequency, concentration and dosage of intervention drugs were all different. Due to the large heterogeneity of the included studies in animal species, animal models and outcome measures, qualitative analysis was conducted. Conclusion:Targeting mitochondria for spinal cord injury in animals could promote the recovery of motor function, reduce the damaged spinal cord tissue and increase the remaining tissue, enhance the ability of anti-oxidation and anti-apoptosis, and enhance mitochondrial biogenesis. Limited by the number and quality of included studies, the above conclusions need to be verified by more high-quality studies.
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Objective:To investigate the effects of iridoid-rich fraction from Valeriana jatamansi Jones (IRFV) on neuronal pyroptosis in rats with acute spinal cord injury, and to explain the related mechanism of neuroprotection. Methods:Twenty-four healthy male Sprague-Dawley rats were randomly divided into sham-operated group, model group and treatment group, with eight rats in each group. The model of spinal cord injury was established by using a medical aneurysm clip in the latter two groups. Only the lamina was removed without injury to the spinal cord in the sham-operated group. Four hours after the operation, the treatment group was given IRFV solution 10 mg/kg, the model group and the sham-operated group were given the same volume of sodium carboxymethyl cellulose (CMC-Na) solution, for seven days. The rats were sacrificed to detected the pathological changes and the residual area of spinal cord tissue through HE staining. The apoptosis of nerve cells of the spinal cord tissue at the perilesional area was detected by TUNEL fluorescent staining. The levels of interleukin (IL)-1 and IL-18 in serum were detected by ELISA Kit and the expression of NLRP3, Caspase-1 and GSDMD were detected by Western blotting. Results:Compared with the sham-operated group, the residual area of spinal cord tissue decreased (P < 0.05), and the positive rate of TUNEL staining, the level of IL-1 and IL-18, and the expression of pyroptosis-associated proteins (NLRP3, Caspase-1 and GSDMD) increased (P < 0.05) in the model group. Compared with the model group, the pathological condition of the spinal cord tissue improved and the residual area of the spinal cord tissue increased (P < 0.05); the positive rate of TUNEL staining, the level of IL-1 and IL-18 and the expression of NLRP3, Caspase-1 and GSDMD decreased (P < 0.05) in the treatment group. Conclusion:IRFV could attenuate the inflammatory response to exert neuroprotective effects, which may be related to the regulation of NLRP3/Caspase-1 signaling pathway to inhibit the neuronal pyroptosis in rats with acute spinal cord injury.
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Nanotechnology has been widely used in the field of pharmaceutics. In recent years, research projects related to nanotechnology account for a high proportion (nearly 90%) in the application and funded projects of pharmaceutics (application code is H3408) of National Natural Science Foundation of China (NSFC). In addition, there are many other research directions in the field of pharmaceutics. This paper makes statistics and analysis on the research projects of pharmaceutics without nanotechnology funded by NSFC from 2001 to 2020, so as to provide reference for the pharmaceutical researchers to reasonably choose research direction.
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Objective:To compare the treatment outcomes between laparoscopic versus open radical resection for hilar cholangiocarcinoma (HCCA).Methods:From January 2017 to January 2020, the clinical data of 34 patients who underwent radical resection for HCCA were retrospectively collected and analyzed. These patients were divided into the laparotomy group ( n=17) and the laparoscopic group ( n=17) based on the operation they received. Clinical data including perioperative outcomes, oral re-intake time, first out-of-bed activity time, drainage tube removal time, postoperative hospital stay, 30-day and 90-day mortality rates were compared between groups. Results:Of 34 patients who underwent radical for HCCA in the study, there were 16 males and 18 females, aged (64.3±1.7) years. The mean operation time of the laparotomy group was significantly less than those in the laparoscopic group [(436.2±33.4) vs (522.1±24.0) min, P<0.05]. The 2 groups showed comparable results in extent of operation, intraoperative bleeding, incidences of portal vein reconstruction, yields of lymph nodes, and tumor diameter. The laparoscopic group showed advantage trends over the laparotomy group in incidences oral re-intake time [(4.7±0.3) vs (4.6±0.3) days], first out-of-bed activity time [(2.9±0.4) vs (2.2±0.3) days], drainage tube removal time [(12.7±1.3) vs (11.1±1.0) days] and postoperative hospital stay [(18.3±1.7) vs (15.8±1.3) days], but the differences failed to reach statistical significance ( P>0.05). Conclusion:Compared with open surgery, laparoscopic radical resection of HCCA in properly selected patients, was safe and feasible. There were comparable clinical outcomes.
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Objective:To study the technical and essential steps in laparoscopic selective devascularization with paraesophageal veins-preservation.Methods:To retrospectively analyze the clinical data of 13 cirrhotic patients who underwent laparoscopic selective pericardial devascularization for portal hypertension at the Department of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People's Hospital from January 2019 to March 2020. There were 9 males and 4 females with age ranging from 41 to 83 years (median 51 years). The operative time, intraoperative blood loss, postoperative complications and follow-up data were analyzed.Results:All the 13 patients completed theoperation, no patient stopped the operation or transferred to laparotomy. The operation time was (170±32) min.The intraoperative bleeding was (160±30) ml. The postoperative hospital stay was (6.1±1.1) days. There were no complications, including pancreatic leakage and intra-abdominal infection. On follow-up which ranged from 1 to 15 months, one patient developed portal vein thrombosis, no upper gastrointestinal rebleeding.Conclusions:Preservation of esophageal veins in laparoscopic selective devascularization is an accurate surgery which requires close teamwork and rich experience in laparoscopic surgery. The preservation of the main trunk of the gastric coronary vein and integrity of the esophageal veins are the keys to the surgery which is safe and feasible.
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Objective: Anatomic variations in the perigastric vessels during laparoscopic radical gastrectomy often affect the operator's judgment and prolong the operation time, and even cause accidental injury and surgical complications, and hence the safety and quality of the operation cannot be ensured. In this study, multiple slice CT was reconstructed by 3-dimensional CT simulation software (3D-CT), and 3D-CT images were used to describe the variation of celiac trunk and splenic artery before surgery. The guiding role of the different variation of vessels was analyzed for laparoscopic total gastrectomy+D2 lymph node dissection (LTG+D2LD). Methods: A retrospective cohort study was conducted. Case inclusion criteria: (1) Gastric cancer was at an advanced stage. All the patients were preoperatively examined by digestive endoscopy and 64-row enhanced CT scan, and were histopathologically diagnosed with gastric adenocarcinoma. (2) 3D-CT simulation images were reconstructed to guide the operation. (3) LTG+D2LD surgery was performed by the same surgical team. (4) Clinical data were complete, and all the patients had signed the informed consent. From 2014 to 2018, 98 patients with gastric cancer at the Gastrointestinal Surgery Department of Henan Provincial People's Hospital were enrolled. According to the Adachi classification, celiac trunk variation was divided into common type (Adachi type I) and rare type (Adachi type II-VI). According to the Natsume classification, splenic artery was classified into "flat type" and "curved type". Based on 3D-CT simulation images, variation of celiac trunk and splenic artery was described, and the differences in operation time, intraoperative blood loss and the number of postoperative retrieved lymph nodes were compared between groups with different types of arterial variation. Results: For celiac trunk, common type was found in 84 cases (86%) and rare type was found in 14 cases, including 6 cases (6%) of type II, 2 cases (2%) of type III, 2 cases (2%) of type IV, 3 cases (3%) of type V, 1 case (1%) of type VI. No other types were found. There were no statistically significant differences in clinical characteristics and number of retrieved lymph nodes between patients of the common type group and rare type group (all P>0.05). Compared with common type patients, those of rare type had longer operative time [(321.1±29.0) minutes vs. (295.1±46.5) minutes, t=2.081, P=0.040] and more intraoperative blood loss (median: 66.0 ml vs. 32.0 ml, Z=-4.974, P=0.001). For splenic artery, 41 patients (42%) were flat type and 57 patients (58%) were curved type. There were no statistically significant differences between the two groups in terms of clinical characteristics, intraoperative blood loss, operative time and number of retrieved lymph nodes (all P>0.05). Conclusions: The method of describing the variation in the perigastric vessels by 3D-CT simulation has certain clinical value in laparoscopic radical gastrectomy. The duration of LTG+D2LD is prolonged and the intraoperative blood loss is increased with the variation of celiac trunk, while the variation of splenic artery has no effect on LTG+D2LD.
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Humans , Computer Simulation , Gastrectomy , Gastric Artery/diagnostic imaging , Imaging, Three-Dimensional , Laparoscopy , Lymph Node Excision , Retrospective Studies , Stomach/diagnostic imaging , Stomach Neoplasms/surgery , Tomography, X-Ray ComputedABSTRACT
Objective To investigate the lethal effect of melittin on human hepatocellular carcinoma cell line SMMC-7721 and its possible mechanism. Methods MTT assay was used to investigate the killing effect of different concentrations melittin on human hepatocellular carcinoma cells SMMC-7721. Meanwhile, the inhibitory effect of specific programmed necrosis inhibitors necrostain-1(Nec-1) on melittin killing SMMC-7721 cells was detected. Programmed cell necrosis observed by Hoechst 33342 and PI double staining. The necrotosis rate was detected by flow cytometry. Ultrastructural changes of cell was detected by transmission electron microscopy. The expression of receptor interacting protein 1(RIP1) was detected by Western blotting. Results Compared with the control group, the proliferation activity of SMMC-7721 cells was significantly decreased after treatment with different concentrations of melittin for 24 hours (P < 0. 05) . Cells stained in dark blue and red. Cell membrane integrity was destroyed, organelle swelling, organelle membrane was destroy, that demonstrates cell was necrosis. Westen blotting result showed an increased proportion of RIP1 expression in SMMC-7721 cells. Compared with the melittin group, cell proliferation activity was significantly increased, cell necrotosis rate was decreased, and intracellular RIP1 expression was down-regulated in the Nec-1 pretreatment group. Conclusion Melittin induces cell death in SMMC-7721 cells through the RIP1-mediated programmed necrosis pathway.
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OBJECTIVES@#To establish a predictive equation for commonly used pulmonary ventilation function parameters in children aged 6-<16 years in northeast China.@*METHODS@#A total of 504 healthy children from Liaoning, Jilin, and Heilongjiang provinces of China were selected for the prospective study, among whom there were 242 boys and 262 girls. The JAEGER MasterScreen Pneumo spirometer was used to measure pulmonary ventilation function. With the measured values of 10 parameters, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV@*RESULTS@#The boys aged 9-<10 years and 15-<16 years had significantly higher body height, FVC, and FEV@*CONCLUSIONS@#A new predictive equation for the main pulmonary ventilation function parameters has been established in this study for children aged 6-<16 years in northeast China, which provides a basis for accurate judgment of pulmonary function abnormalities in clinical practice.