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@#Abstract: Objective To investigate the current status of streptomycin resistance of Yersinia pestis caused by point mutations of rpsL gene in Qinghai, so as to provide theoretical basis for precise clinical medication and prevention of drug resistance of human plague outbreak in South area of Qinghai Province in the future. Methods A total of 104 representative strains of Yersinia pestis collected from plague patients, vector insects and intermediate hosts in South area of Qinghai Province from 1957 to 2009 were screened, isolated and cultured by Hiss agar plates. The DNA of representative Yersinia pestis was extracted by sodium dodecyl sulfate lysis and phenol-chloroform method. The primers forward primer and reverse primer and TaqMan-MGB probes probe1 [FAM] and probe2 [VIC] were designed for the rpsL gene of streptomycin resistance gene in China. Real-time PCR with TaqMan-MGB fluorescent probe was used to detect the mutations of rpsL gene in streptomycin resistance locus of 104 strains of Yersinia pestis in South area of Qinghai Province. Results The FAM test results of 104 strains in South area of Qinghai Province were positive, corresponding to the detection of rpsL (128 : A ), RFU peak >1 000,negative <200. VIC test results of all tested strains were negative, corresponding to the detection of rpsL (128:G), RFU peak <200, positive >1 000. That is, no strains with rpsL gene mutation related to streptomycin resistance were found in the 104 strains of Yersinia pestis in Qingnan Province. Conclusion This study provides basic data on the distribution of streptomycin resistance of Yersinia pestis in South area of Qinghai Province, and lays a foundation for preventing the occurrence of drug resistance and clinical treatment of Yersinia pestis in South area of Qinghai Province.
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@#Abstract: Objective To investigate the clustered regularly interspaced short palindromic repeats (CRISPR) genotypes and regional distribution of Yersinia pestis strains in the natural plague foci of Hainan Tibetan Autonomous Prefecture of Qinghai Province (referred to as "Hainan prefecture") and provide a scientific basis for plague prevention and control in this area. Methods A total of 36 representative Yersinia pestis strains, which were isolated from different host animals and insect vectors from 1954 to 2009 in Hainan Prefecture, were selected as experimental subjects. The DNAs were extracted using the traditional sodium dodecyl sulfate decomposition and phenol-chloroform method. Three pairs of CRISPR primers (YPa, Ypb, YPc) were used for PCR amplification, sequencing and analysis of the DNA of the tested strains, respectively, as a means to identify the CRISPR genotypes of Yersinia pestis in Hainan Prefecture. Results A total of 17 spacers were observed among 36 strains of Yersinia pestis, including 9 of YPa, 5 of YPb and 3 of YPc. All strains were divided into 5 CRISPR gene clusters (Cb2, Cb4 ', Ca7, Ca7 ', Ca35 ') and 6 genotypes (G1, G9, G22, G22-A1 ', G26-A1 ', G26-A1 'A4 -). The G26-a1 ' was the main genotype, which was distributed in Gonghe, Guide and Xinghai County, and the G22 is the second type, which was distributed in Gonghe and Guide County. Conclusions The genetic polymorphism of CRISPR loci of Yersinia pestis strains in Hainan was high, and the regional distribution characteristics of Yersinia pestis strains with different genotypes were significant.
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Objective@#To evaluate the efficacy and safety of Hong's pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy.@*Methods@#A retrospective analysis was carried out on 184 patients who underwent laparoscopic pancreaticoduodenectomy using Hong's pancreaticojejunostomy (the Hong’s pancreaticojejunostomy group) compared with 100 patients who underwent laparoscopic pancreaticoduodenectomy using traditional pancreaticojejunostomy (the traditional pancreaticojejunostomy group) at Department of Second Hepatobiliary and Pancreatic Surgery, the First Bethune Hospital of Jilin University, from April 2016 to December 2018. The differences between the two anastomotic methods in operation time, pancreaticojejunostomy time, intraoperative blood loss, postoperative hospital stay, postoperative complications, and incidences of pancreatic fistula were compared.@*Results@#The operation time, pancreaticojejunostomy time and intraoperative blood loss of the Hong's pancreaticojejunostomy group were significantly less than the traditional pancreaticojejunostomy group [(278.2±49.3) min vs. (337.3±67.4) min, (33.7±6.6) min vs. (46.8±8.5) min, (123.1±44.7) ml vs. (203.8±138.6) ml], respectively, (all P<0.05). There were no significant differences in postoperative hospital stay and pancreatic fistula rates between the two groups (all P>0.05).@*Conclusions@#Hong's pancreaticojejunostomy was safe, rapid and effective compared with traditional pancreaticojejunostomy. It did not increase the incidence of pancreatic fistula.
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ObjectiveTo investigate the clinical effect and safety of the enhanced recovery after surgery (ERAS) strategy in the perioperative period of pancreaticoduodenectomy (PD). MethodsA retrospective analysis was performed for the clinical data of 100 patients who underwent PD in The First Hospital of Jilin University from August 2012 to July 2016. The patients were divided into ERAS group and control group according to the management mode during the perioperative period, with 50 patients in each group. The patients in the control group were given routine management, and those in the ERAS group were given ERAS management. The two groups were compared in terms of mortality rate, incidence rate of complications, time of operation, diet, intestinal function, length of postoperative hospital stay, hospital costs, secondary surgical intervention, and readmission rate. The t-test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsTwo patients in the control group and one in the ERAS group died after surgery. There were no significant differences in mortality, reoperation, and readmission rates between the two groups (all P＞0.05). Compared with the control group, the ERAS group had a significantly lower incidence rate of complications (31.0% vs 56.3%, χ2=5.84, P=0.016) and significantly shorter time to first flatus, time to diet, time to ambulation, and time to removal of drainage tube and other tubes (all P＜0.001). There were significant differences between the ERAS group and the control group in length of hospital stay (14.3±1.2 d vs 18.5±1.8 d, t=13.73, P＜0.001) and total hospital costs ［10.7±1.4 ten thousand yuan vs 13.2±4.1 ten thousand yuan, t=4.08, P＜0.001］. ConclusionThe ERAS strategy is safe and effective in the perioperative period of PD and can significantly reduce hospital costs, shorten the length of hospital stay, standardize perioperative management, diminish clinical variability, and thus help patients to achieve enhanced recovery. Therefore, it holds promise for clinical application.
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Objective ToobservetheclinicaleffectandefficacyofprostaglandinE1(PGE1),thedrugformicrocirculationimprovement, inthetreatmentofacutepancreatitis(AP).Methods Atotalof80patientswithmild-to-moderateAPwhowerehospitalizedandtreated in Second Department of Hepatobiliary and Pancreatic Surgery of the First Hospital of Jilin University from May 2014 to January 2015 were enrolled and randomized into two groups.Forty-four patients in control group received the conventional comprehensive therapy for AP,and 36 patients in experiment group received PGE1 in addition to the conventional therapy.The time to disappearance of abdominal symptoms and the time for serum and urine levels of amylase and serum levels of lipase,C-reactive protein (CRP),and procalcitonin (PCT)to re-turn to normal were compared between the two groups.The independent-samples t-test was applied for comparison of continuous data be-tween the two groups,and the chi-square test or Fisher′s exact test was applied for comparison of categorical data between the two groups. Results ThetwogroupshadsignificantdifferencesinthetimeforserumlevelsofamylaseandCRPandpercentageofneutrophilstoreturn to normal and hospital costs (P=0.041,0.030,0.012,and 0.026,respectively).PGE1 quickly relieved abdominal pain and distention, reducedtheserumlevelofamylase,shortenedthelengthofhospitalstay,andreducedhospitalcosts.Conclusion PGE1hasgoodclinical effect and safety in the treatment of AP,and can be applied as an adjuvant drug in the comprehensive therapy for AP.
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The role of myeloid-derived suppressor cells (MDSCs)in promoting inflammatory response and immune escape of tumor cells and the mechanism by which MDSCs promote the development and progression of tumors are reviewed.This could provide a new way for the investigation of immunological mechanism of liver fibrosis and liver cancer.Besides,MDSCs may be an effective therapeutic target for liver cirrhosis and liver cancer.
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Objective To study the effect of percutaneous transhepatic gallbladder drainage (PTGBD) combined with laparoscopic cholecystectomy (LC) in treatment of acute severe cholecystitis.Method The perioperative data of patients treated with PTGBD combined with LC and patients treated with emergency LC were analyzed.Results There were no significant difference between the two groups on surgical duration (t =0.601,P =0.551) and postoperative hospital stay (t =0.979,P =0.331).Blood loss [PTGBD + LC (79.43 ± 46.27) ml,LC (125.84 ± 64.18) ml ; t =3.641,P ＜ 0.05],peritoneal drainage time [PTGDB + LC (3.29 ± 1.58) d,LC (4.63 ± 2.31) d ; t =3.131,P ＜ 0.05] and postoperative oral intake time [PTGBD +LC (2.91 ±1.58)d,LC (4.21 ±2.22)d; t =2.669,P＜0.05] were significantly different between the two groups.The rate of laparotomy,mortality and postoperative complications in the emergency LC group were higher than those in the PTGBD combined with LC group.Conclusions PTGBD combined with LC in the treatment of acute severe cholecystitis was significantly better than emergency LC.
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Objective To evaluate the diagnosis and treatment of residual gallbladder.Methods The diagnosis of residual gallbladder depends on a history of previous cholecystectomy and postoperative existent symptoms suggesting cholecystitis.In this series the diagnosis was finally established by ultrasonography and laparotomy in 52 cases.Results Ten cases received laparoscopic residual cholecystectomy,32 cases underwent residual cholecystectomy,7 cases did residual cholecystectomy plus common bile duct exploration,1 case was treated with residual cholecystectomy,common bile duct exploration and left lateral lobe hepatectomy,1 case with residual cholecystectomy,common bile duct exploration,cholangioenterostomy,1 case by radical resection of residual gallbladder cancer.Conclusions Residual gallbladder is a secondary disease,diagnosis is not difficult,surgery has certain difficulty,the application of intraoperative ultrasound and choledochoscope has great value.
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Objective To evaluate effects of two different preoperative biliary drainages on patients of malignant obstructive jaundice complicated with acute cholangitis.Methods Retrospective analysis was made on effects of two preoperative biliary drainages of ultrasound-guided percutaneous transhepatic cholangial drainage (PTCD) and endoscopic nasobiliary drainage (ENBD) in cases of malignant obstructive jaundice complicated with acute cholangitis.Results Days of preoperative drainage(t =3.217,P ＜ 0.05) and declines of bilirubin level after drainage (t =3.178,P ＜ 0.05) were significantly better in ENBD group (26 cases) than PTCD group (22 cases).There were no significant differences between two groups in operation time length and intraoperative blood loss after drainage.However,postoperative hospital stay (t =2.542,P ＜ 0.05) and overall stay (t =3.172,P ＜ 0.05) were significantly shorter in ENBD group compared with PTCD group.Conclusions When preoperative biliary drainage is indicated in the cases of malignant jaundice before radical surgery,ENBD should be the first choice over DTCD.
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Objective To investigate the relationships between Cyclooxygenase(COX-2) and angiogenesis and expressions of COX-2 and vascular endothelial growth factor(VEGF) in thyroid cancer and its clinical significance.Methods Immunohistochemistry was used to detect the expressions of COX-2 and VEGF in 60 thyroid cancer,(15 thyroid)adenomas and 10 normal thyroid tissues.Results The expression rates of COX-2 and VEGF in thyroid cancer were higher than those in thyroid adenomas and normal tissues(P