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Objective:To investigate the classification of main pancreatic duct and treatment strategy after linear stapler closure of pancreatic neck in laparoscopic pancreaticoduodenectomy (LPD).Methods:The records of 51 consecutive patients with LPD who were treated by linear staple closure technique of pancreatic neck from February to December 2022 from Binzhou Second People′s Hospital, Shijingshan Campus, Beijing Chaoyang Hospital, Capital Medical University, Rizhao Hepatobiliary-Pancreatic-Splenic Surgery Research Institute, Chaoyang Central Hospital, Shandong Juxian People′s Hospital, Weihai Municipal Hospital, Binzhou Central Hospital, and Affiliated Hospital of Chifeng University were retrospectively reviewed. According to the visibility, position and diameter of the main pancreatic duct at the stump of the pancreas, the type of main pancreatic duct was divided into type I, type Ⅱ, type Ⅲa and type Ⅲb. The number of cases in each main pancreatic duct classification and the corresponding treatment strategies were examined.Results:A total of 51 cases of LPD were successfully completed. Of these patients, the males comprised 56.9%(29/51), and females comprised 43.1%(22/51), with age ranging from 31 to 88 years old. The type of the main pancreatic duct at the stump of the pancreas included 7 cases (13.7%) of type Ⅰ, 39 cases (76.5%) of type Ⅱ, 2 cases (3.9%) of type Ⅲa, and 3 cases (5.9%) of type Ⅲb. Corresponding treatment strategies were adopted according to different main pancreatic duct types, the main pancreatic duct was successfully found, and a support drainage tube was inserted.Conclusion:After linear stapler closure of pancreatic neck, corresponding treatment strategies should be adopted according to the classification of the main pancreatic duct, which would help to improve the success rate of finding the main pancreatic duct and placing a support drainage tube.
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@#Objective To assess the feasibility and safety of ultra-micro 5 mm single-port endoscopic thoracic sympathicotomy in selected patients with primary palmar hyperhidrosis. Methods From March 1, 2018 to February 1, 2021, 90 patients with primary palmar hyperhidrosis who underwent ultra-micro 5 mm single-port endoscopic thoracic sympathicotomy at the Thoracic Surgery Department of the University of Hong Kong-Shenzhen Hospital. There were 47 males and 43 females, with a median age of 26.0 (22.0, 31.0) years. During the operation, T3 and/or T4 thoracic sympathetic nerve chain was transected using an ultra-micro 5 mm single-port incision near the areola or under the axilla. The surgical data of the patients were retrospectively reviewed and analyzed. Results All patients successfully completed the operation without major bleeding during the operation and no conversion to thoracotomy. There was no death or serious complication during the perioperative period. The operation time was 43.0 (23.0, 60.0) min, and the intraoperative blood loss was 2.0 (1.0, 2.0) mL. In the perioperative period, only one patient needed a tiny chest tube indwelling. The symptoms of hyperhidrosis on the hands all disappeared after the operation. The pain score on the postoperative day was 2.0 (2.0, 2.0) points. The hospital stay after surgery was 1.0 (1.0, 1.0) d. In the first month after the operation, the symptoms of hyperhidrosis on the hands were significantly relieved compared with those before the operation. The surgical incisions healed well, the wounds were concealed, and there was no wound infection or poor healing. The patients' satisfaction with the surgical incisions was 100.0%. After the operation, 14 (15.6%) patients had mild compensatory hyperhidrosis, 5 (5.6%) patients had moderate compensatory hyperhidrosis, and no patient had severe compensatory hyperhidrosis. Overall satisfaction rate was 94.0%. Conclusion The clinical application of ultra-micro 5 mm single-port endoscopic thoracic sympathicotomy in selected patients with primary palmar hyperhidrosis is safe and feasible. The surgical wound is extremely small and hidden, the operation time is short, the pain is very slight, and the clinical outcome is good. It can fully meet the patients' pursuit of beauty.
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In order to accurately implant the brain electrodes of carp robot for positioning and navigation, the three-dimensional model of brain structure and brain electrodes is to be proposed in the study. In this study, the tungsten electrodes were implanted into the cerebellum of a carp with the aid of brain stereotaxic instrument. The brain motor areas were found and their three-dimensional coordinate values were obtained by the aquatic electricity stimulation experiments and the underwater control experiments. The carp brain and the brain electrodes were imaged by 3.0 T magnetic resonance imaging instrument, and the three-dimensional reconstruction of carp brain and brain electrodes was carried out by the 3D-DOCTOR software and the Mimics software. The results showed that the brain motor areas and their coordinate values were accurate. The relative spatial position relationships between brain electrodes and brain tissue, brain tissue and skull surface could be observed by the three-dimensional reconstruction map of brain tissue and brain electrodes which reconstructed the three-dimensional structure of brain. The anatomical position of the three-dimensional reconstructed brain tissue in magnetic resonance image and the relationship between brain tissue and skull surface could be observed through the three-dimensional reconstruction comprehensive display map of brain tissue. The three-dimensional reconstruction model in this study can provide a navigation tool for brain electrodes implantation.
Subject(s)
Animals , Brain/diagnostic imaging , Carps , Electrodes , Electrodes, Implanted , Imaging, Three-Dimensional , Magnetic Resonance ImagingABSTRACT
OBJECTIVE@#To investigate the relationship between serum 25(OH) vitamin D and liver fat content in nonalcoholic fatty liver disease (NAFLD).@*METHODS@#A total of 120 patients with NAFLD admitted in our hospital between June and August, 2017 were enrolled and divided into 4 groups with different serum 25 (OH) vitamin D levels: >75 nmol/L (group A, =25), 50-75 nmol/L (group B, =35), 25-50 nmol/L (group C, =32), and < 25 nmol/L (group D, =28). For all the patients, serum 25 (OH) vitamin D level was measured by ELISA, and liver fat content was determined using in-phase opposed-phase TWI sequences. The measurement data were compared among the 4 groups to assess the association between serum 25(OH) vitamin D level and liver fat content.@*RESULTS@#The liver fat content appeared to be higher in group B (28.66±6.45%) and group C (38.74±11.47%) than in group A (22.79 ± 6.10%), but the difference was not statistically significant (>0.05); the liver fat content in group D (54.79 ± 5.28%) was significantly higher than that in the other 3 groups (>0.05). Liver fat content increased significantly as serum 25(OH) vitamin D level decreased, showing an inverse correlation between them in these patients ( < 0.05, =-0.125).@*CONCLUSIONS@#In patients with NAFLD, a decreased serum 25(OH) vitamin D level is associated with an increased liver fat content, suggesting the value of serum 25(OH) vitamin D as a predictor of NAFLD.
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Humans , Liver , Pathology , Non-alcoholic Fatty Liver Disease , Blood , Pathology , Vitamin D , BloodABSTRACT
To solve the problem of precise positioning of carp brain tissue coordinates, it is proposed in this paper for a method for transforming the coordinates of magnetic resonance imaging of carp brain tissue into the coordinates of electrode implantation using a brain stereotaxic apparatus. In this study, the 3.0T magnetic resonance imaging instrument was used to scan the carp brain. We independently established the three-dimensional positioning coordinate system of the brain, the three-dimensional coordinate assistance system of skull surface and the three-dimensional coordinate assistance system in brain tissue. After two coordinate transformations, the magnetic resonance image coordinates of the brain electrodes implantation sites were converted into the three-dimensional stereotactic coordinate system to guide the electrodes implantation. The experimental groups were divided into two groups, A and B. Group A was the group of magnetic resonance imaging apparatus combining with the brain stereotaxic apparatus, and group B was the group of brain atlas combining with the brain stereotaxic apparatus. Each group had 20 tails of carps ( = 20). This two methods were used to implant the electrodes into the cerebellar motor area. The underwater experiments of the carp robots were carried out to test the two methods. The results showed that the accuracy of the implanted electrodes were 90% in group A and 60% in group B. The success rate of group A was significantly higher than that of group B ( < 0.05). Therefore, the new method in this paper can accurately determine the coordinates of carp brain tissue.
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Objective To analyze the choice preferences and factors influencing the long-term care (LTC)of disabled elderly in Beijing and to provide a reference for the development of aging service industry based on the present supply situations. Methods This cross-sectional study included the sociodemographic and disability information and the need for LTC.Statistical analysis was performed using the chi-square test and multivariate logistic regression analysis. Results About 75.5% (1 169) of respondents preferred household-based LTC,whereas only 0.8%(12)preferred community-based LTC.In a single factor analysis,gender,age,educational level,living conditions,marital status,income,medical and pension insurances,chronic diseases,vision,hearing,sense of taste and touch,and self-evaluation of health had statistically significant difference (χ2= 35.19, 195.58, 295.21, 245.88, 10.89, 30.33, 230.62, 277.87, 77.09, 51.07, 131.03, 124.50, 23.18, and 37.51,respectively, P<0.05). Multivariate analysis showed that educational level, marital status, medical and pension insurances, self-evaluation of health were correlated with household-based LTC,(odds ratio and 95%confidence interval,0.69(0.54-0.89),51.61(21.55-123.59), 0.29(0.09-0.94),0.40(0.22-0.73),and 0.63(0.45-0.88),respectively).Conclusions The services in the old-age caring industry have become inevitably diverse, and many factors affect the choice of LTC. Therefore,LTC insurance and community-based care should be established to meet the needs of the elderly.
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OBJECTIVE:To investigate clinical efficacy and safety of conjugeted estrogen tablets combined with Salmon calci-tonin acetate injection and Alendronate sodium tablets in the treatment of osteoporosis in postmenopausal. METHODS:148 post-menopausal women with osteoporosis were randomly divided into observation group(78 cases)and control group(70 cases). Con-trol group was given Salmon calcitonin acetate injection hypodermically or intramuscularly,100 IU each time,once a day in first week,every two days in second week,every three days in third week,21 times of consecutive injection as a treatment course;Alendronate sodium tablet,70 mg each time,once a week,3 months as a treatment course. Based on control group,observation group was additionally given conjugeted estrogen tablets,0.625 mg each time,qd,for consecutive 3 weeks,drug withdrawal for one week,and then continued to taking drug,for 3 months in total. Clinical efficacy of 2 groups were observed as well as BGP, bone metabolism index as human collagen type Ⅰ N-terminal peptide (NTX) and ALP,bone density and ADR before and after treatment. RESULTS:After treatment,total effective rate of observation group was 94.87%,which was significantly higher than 78.57% in control group,with statistical significance(P0.05);various ADR disappeared after drug withdrawal. CONCLUSIONS:Conjugeted estrogen tablets combined with Salmon calcitonin acetate injection and Alendronate sodium tablets can effectively relieve bone pain,regulate bone metabolism,increase bone density and induce slight ADR in postmenopausal with osteoporosis.