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Objective:Three-dimensional simulation modeling technology was used to conduct three-dimensional reconstruction, classification and measurement for the anatomic structures of colorectal canal, tumor and key blood vessels in patients with rectal cancer before operation. And the accuracy of the data and information obtained for the prediction of anastomotic tension, important types of vascular variant, positioning of anatomical landmarks, etc. in laparoscopic-assisted radical resection of rectal cancer, and the guiding effect of operation was evaluated.Methods:The clinical data of 50 patients with laparoscopic-assisted radical resection of rectal cancer treated in the General Surgery Department, Beijing Ditan Hospital Capital Medical University from January 2019 to February 2021 were analyzed retrospectively, including 31 males and 19 females, aged from 42 to 83 years old, with an average age of (62.72 ±15.21) years. The patients were divided into two groups according to whether the patients underwent three-dimensional simulation reconstruction before operation. The patients who underwent abdomen pelvic enhancement CT and further three-dimensional reconstruction before surgery were taken as reconstruction group ( n=24), and the patients who were only routinely performed abdomen pelvic enhancement CT before operation were taken as control group ( n=26). For the patients in the reconstruction group, the CT images were modeled by Mimics software before operation, and the key data such as the length of colorectal and tumor, the correlation length of rigid structure of pelvic wall, the length of inferior mesenteric artery (IMA) from the bifurcation point of left and right arteria iliaca communis, the type and proportion of IMA variation, the length of left colonic artery (LCA) from the beginning of IMA and the distance between LCA and IMV were measured, and the consistency correlation coefficient (CCC) was analyzed with the actual data obtained during operation. And then the accuracy of three-dimensional simulation modeling technology for surgical guidance was evaluated. MedCalc 19.0 software was used for statistical analysis. Results:In the reconstruction group, regarding the data of each dimension of the model (intestinal tract, pelvic cavity, blood vessels) and the corresponding structural measurements during the operation, the consistent correlation coefficient (CCC) evaluation was more than 0.9. One case was predicted to have free splenic flexure of colon and one case actually had free splenic flexure of colon. The prediction accuracy was 100%. The IMA variants in the reconstruction group were divided into 4 types, all of which were verified by operation. Compared with the control group, the operation time ( P=0.011) and the location time (IMA, P=0.043; LCA, P=0.007; IMV, P=0.034) of each vessel in the reconstruction group were shorter, and the amount of intraoperative blood loss was less ( P=0.017). Conclusion:The application of three-dimensional simulation modeling technology before operation is helpful for the operator to accurately predict the intraoperative anastomotic tension, the type of IMA variation and the related diameter length, based on which the accurate operation plan can be made to guide the operation.
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Objective:To study the impact of anticoagulant therapy starting at different platelet levels on the incidences of portal vein thrombosis (PVT) after splenectomy and devascularization.Methods:From January 2014 to January 2017, 125 patients with liver cirrhosis and portal hypertension underwent splenectomy and pericardial devascularization in Beijing Ditan Hospital, Capital Medical University. All patients routinely received anticoagulant therapy. There were 85 patients who had a platelet count greater than >100×10 9/L (the study group) and 40 patients who had a platelet count greater than >300×10 9/L (the control group). The incidence of PVT was compared between the two groups. Results:A total of 125 patients were included in the study, including 91 males and 34 females, aged 20-59 years. Age, gender, preoperative platelet level, preoperative splenic vein and portal vein width, preoperative coagulation function, preoperative liver function (Child classification), preoperative esophageal and gastric varices, operation time, preoperative bleeding time, preoperative venous blood flow velocity, coagulation function 1 week and 2 weeks after operation between the two groups were not significantly different (all P>0.05). Of 125 patients undergoing splenectomy and pericardial devascularization, PVT was not found in all patients before operation. The incidence of PVT was 39.2% (49/125) within one month after operation. Among the 85 patients in the study group, 28 patients developed PVT, and the incidence of thrombosis was 32.9% (28/85). In the control group, 21 patients developed PVT, and the thrombosis rate was 52.5% (21/40). The difference was significant (χ 2=4.366, P=0.037). After anticoagulant therapy, the incidence of bleeding in the study group was 4.7% (4/85), and that in the control group was 5.0% (2/40), the difference was no significant ( P>0.05). Conclusion:Early anticoagulation (platelet >100×10 9/L) does not increase the risk of postoperative bleeding, but can reduce the incidence of PVT.
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Objective:To study factors influencing postoperative pancreatic fistula rates with a view to prevent postoperation pancreatic fistula from happening.Methods:This is a retrospective study on 281 patients who underwent distal pancreatectomy at the First Affiliated Hospital of China Medical University from March 2011 to April 2018. There were 89 males and 192 females, with the age of (51.01±13.65) years. Univariate and multivariate logistic regression analyses were used to analyze the following factors on the occurrence of pancreatic fistula after operation: gender, age, body mass index(BMI), tumor characteristics, preoperative fasting blood glucose, blood biochemistry, liver function and surgical indications.Results:Of the 281 patients who underwent distal pancreatectomy in this study, 245 (87.2%) did not develop pancreatic fistula / biochemical leakage, while 36(12.8%) patients developed clinically significant pancreatic fistula (B/C grade). Univariate analysis showed the factors which affected the incidence of pancreatic fistula after surgery to include: BMI, preoperative fasting blood glucose, and whether the main pancreatic duct was ligated (all P<0.05). Multivariate logistic regression analysis showed that the independent factors affecting pancreatic fistula incidence after surgery were BMI≥25 kg/m 2 ( OR=2.354, 95% CI: 1.137-4.873, P<0.05), and main pancreatic duct was not ligated ( OR=4.067, 95% CI: 1.191-13.885, P<0.05). Conclusions:A high BMI increased the risk of postoperative pancreatic fistula, while ligation of main pancreatic duct during surgery reduced the risk.
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Objective:To evaluate the clinical effect of Jinghua Weikang capsule in treating peptic ulcer with intermingled heat and cold syndrome.Methods:From January 2016 to December 2018, 90 patients of peptic ulcer with intermingled heat and cold syndrome in Changzhou Hospital of Traditional Chinese Medicine were divided into two groups by the random digital table method, with 45 cases in each group.The control group was treated with rabeprazole capsule, and the observation group were treated with rabeprazole capsule and Jinghua Weikang capsule.The gastroscopic performance, the main individual symptoms and TCM syndrome between the two groups were compared.Results:The gastroscopic performance[42 cases(93.3%) were clinical cured, 1 case(2.2%) was significantly improved, 1 case(2.2%) was improved], TCM syndrome effect[38 cases(84.4%) were clinical cured, 4 cases(8.9%) were significantly improved, 2 cases(4.4%) were improved] in the observation group were significantly better than those in the control group[the gastroscopic performance: 35 cases(77.8%) were clinical cured, 5 cases(11.1%) were significantly improved, 3 cases(6.7%) were improved], TCM syndrome effect: 28 cases(62.2%) were clinical cured, 6 cases(13.3%) were significantly improved, 8 cases(17.8%) were improved]( Z=-2.040, -2.463, all P<0.05). The improvement of TCM symptoms of epigastric pain which could be relieved by warmth and pressure, dry mouth with bitter taste, cool limbs were significantly better than those in the control group(χ 2=6.154, 6.056, 7.174, all P<0.05). Conclusion:Jinghua Weikang capsule can accelerate the repair of gastric mucous of patients with intermingled heat and cold syndrome, improve clinical syndrome, especially these symptoms: stomacha which can be relieved by warmth and pressure, dry mouth with bitter taste, cool limbs.
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Objective@#To evaluate the clinical effect of Jinghua Weikang capsule in treating peptic ulcer with intermingled heat and cold syndrome.@*Methods@#From January 2016 to December 2018, 90 patients of peptic ulcer with intermingled heat and cold syndrome in Changzhou Hospital of Traditional Chinese Medicine were divided into two groups by the random digital table method, with 45 cases in each group.The control group was treated with rabeprazole capsule, and the observation group were treated with rabeprazole capsule and Jinghua Weikang capsule.The gastroscopic performance, the main individual symptoms and TCM syndrome between the two groups were compared.@*Results@#The gastroscopic performance[42 cases(93.3%) were clinical cured, 1 case(2.2%) was significantly improved, 1 case(2.2%) was improved], TCM syndrome effect[38 cases(84.4%) were clinical cured, 4 cases(8.9%) were significantly improved, 2 cases(4.4%) were improved] in the observation group were significantly better than those in the control group[the gastroscopic performance: 35 cases(77.8%) were clinical cured, 5 cases(11.1%) were significantly improved, 3 cases(6.7%) were improved], TCM syndrome effect: 28 cases(62.2%) were clinical cured, 6 cases(13.3%) were significantly improved, 8 cases(17.8%) were improved](Z=-2.040, -2.463, all P<0.05). The improvement of TCM symptoms of epigastric pain which could be relieved by warmth and pressure, dry mouth with bitter taste, cool limbs were significantly better than those in the control group(χ2=6.154, 6.056, 7.174, all P<0.05).@*Conclusion@#Jinghua Weikang capsule can accelerate the repair of gastric mucous of patients with intermingled heat and cold syndrome, improve clinical syndrome, especially these symptoms: stomacha which can be relieved by warmth and pressure, dry mouth with bitter taste, cool limbs.
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Objective To establish a patient-derived xenografts (PDX) mouse model of liver cancer (LC) and to explore its role in precision medicine.Methods PDX model was established by subcutaneous implantation of tumor tissues in NCG mice.The morphological structure of tumor tissue was exaimed using HE staining.Fifteen BALB/c nude mice were subcutaneously inoculated with tumor cell suspension from the PDX models.The xenograft mice were randomly divided into 5-fluorouracil (5-FU) group, sorafenib group and negative control group.The tumor volume and body weight of the tumor-bearing mice were measured regularly, the tumor inhibition rate was calculated and the curative effect was evaluated.Results The success rate was 33.3% (6/18) in the establishment of liver cancer PDX mouse model, and the model well retained the characteristics of the primary tumor.In one case of PDX mouse model, the tumor inhibition rates of 5-FU and sorafenib group were 63.7% and 29.6%, with a statistically significant differece between them (P< 0.05), and there was no significant difference between the sorafenib group and negative control group, consistent with clinical observation.Conclusions The PDX mouse model of liver cancer can maintain the histological structure of primary tumor, and can be applied to precision medicine for patients with liver cancer.
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Objective To investigate the relationships of peripheral blood levels of interleukin 6 receptor (IL-6R),a disintegrin and metalloprotease with thrombospondin type 1 motifs (ADAMTS-1) and high sensitive C reactive protein (hs CRP) with Gensini score and Ambrose classification in patients with coronary heart disease,and to investigate the correlations of IL-6R,ADAMTS-1 and hsCRP levels with unstable coronary atherosclerotic plaques.Methods 328 patients undergoing coronary angiography were admitted,and 272 patients were diagnosed as coronary heart disease including 105 cases with acute myocardial infarction (AMI),126 cases with unstable angina peetoris (UA) and 41 cases with stable angina pectoris (SA).The 56 cases with no coronary artery stenosis were selected as control group.We detected the levels of IL-6R,ADAMTS 1 and hs-CRP in all patients,and then evaluated their Gensini scores by coronary angiography,and appraised the character of the plaque by Ambrose classification.Results The serum levels of IL 6R and ADAMTS-1 were higher in AMI and UA groups than in SA and normal control groups (all P＜0.05).The level of hsCRP was higher in AMI group than in UA,SA and control groups (all P＜0.05).The levels of IL-6R,ADAMTS 1 and hs-CRP were higher in complex lesion group evaluated by Ambrose classification than in simple lesion group and normal control group (all P＜0.05).ADAMTS-1 level was higher in simple lesion group than in normal control group (P＜0.05).The level of IL 6R was positively correlated with ADAMTS-1 levels (r=0.70,P＜0.05),while the serum IL-6R,ADAMTS-1 and hsCRP levels had no relationship with Gensini score in patients with coronary heart disease (all P＞ 0.05).Conclusions The IL-6R,ADAMTS-1 and hs-CRP levels can be the indexes for evaluating the plaque stability in patients with coronary heart disease,but have no relationships with the severity of coronary artery stenosis.
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Objective To determine the role of human serum albumin therapy in the post-operative management of patients with hepatocellular carcinoma (HCC) associated with cirrhosis.Methods Between January 2011 and December 2012,we treated 171 consecutive cirrhotic patients with HCC.88 patients were treated with 5％ human serum albumin for 48 hours followed by 20％ human serum albumin in the post-operative period (the observer group) ; 81 patients were only treated with 20％ human serum albumin during the same time duration (the control group).The prognosis,complications,average amount of human serum albumin and plasma used as well as the in-hospital stay were observed.Results There were no deaths or major complications in either of these 2 groups.After treatment,the observer group was lower than the control group in the amount of intravenous fluid infused,the volume of peritoneal drainage,the amount of human serum albumin and plasma used as well as the mean post-operative hospitalization days (P ＜ 0.05).At the same time,the daily urine output,the central venous pressure and the mean arterial pressure within 48 hours after surgery were higher in the observer group than the control group.Furthermore the observer group had a smoother post-operative recovery in liver function,and the difference was significant between the two groups (P ＜ 0.05).Conclusion Not only did treatment with 5 ％ and 20％ human serum albumin gave the advantages of a more stable blood circulation,better organ perfusion and improved liver function recovery but it also reduced the amount of consumption of human serum albumin and plasma and shortened the hospital stay.
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[Objective] To observe the anti - aging effects and explore the mechanism of Qibao Meiran Pellet (QMP) and its modified prescriptions, including QMP with qi - invigorating and spleen - strengthening herbs, with kidney -nourishing herbs or with blood - activating and purgative herbs. [ Methods ] Ten - month - old model rats were established by D - galactose. Serum free radical levels and immune indexes in QMP group and various modified QMP groups were observed. [ Results ] QMP increased the activity of superoxide dismutase ( SOD). QMP combined with kidney - nourishing herbs or blood - activating and purgative herbs decreased the serum level of malondialdehyde (MDA) and increased the activities of glutathione peroxidase (GSH - Px) and SOD. Meanwhile, QMP combined with kidney -nourishing herbs increased interleukin - 2 activities. [ ConclusionJ QMP, mainly composed of herbs for nourishing liver and spleen, can delay the aging of rats, and spleen - strengthening herbs and blood - activating and purgative herbs also play an important role in the delay of aging. Furthermore, it is suggested that the anti - aging effect of herbal medicine is related to the sex.
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Objective To make a accurate, simple method for determination which is suitable for application in basic level units to test nitrate nitrogen in drinking water. Methods Based on the principle that catalyzed by the Cu2+, NO3- is reduced by hydrazine sulfate into NO2-, then it reacts on sulfanilamide in hydrochloric acid to produce a diazo compound, the latter reacts on NEDD to produce a rose dye. Results The maximum wave-length of the was 555 nm, the molar absorption coefficient was 6.5?106L/(mol?cm), RSD were 0.55%-2.07%, the rates of recovery were 91.3%-109.6%. Beer's law was obeyed in the range of 40-320 ?g/L(1-8 ?g /25 ml). Conclusion This method is simple, rapid, accurate and suitable for application in basic level units to determine nitrate nitrogen in drinking water.