Prediction of postoperative pancreatic fistula using a nomogram based on the updated definition

PURPOSE: The International Study Group on Pancreatic Fistula's definition of postoperative pancreatic fistula (POPF) has recently been updated. This study aimed to identify risk factors for POPF in patients having pancreaticoduodenectomy (PD) and to generate a nomogram to predict POPF.METHODS: Data on 298 patients who underwent PD from March 2012 to October 2017 was retrospectively reviewed and POPF statuses were redefined. A nomogram was constructed using data from 220 patients and validated using the remaining 78 patients. Independent risk factors for POPF were identified using univariate and multivariate analyses. A predictive nomogram was established based on the independent risk factors and was compared with existing models.RESULTS: Texture of the pancreas, size of the main pancreatic duct, portal vein invasion, and definitive pathology were the identified risk factors. The nomogram had a C-index of 0.793 and was internally validated. The nomogram performed better (C-index of 0.816) than the other most cited models (C-indexes of 0.728 and 0.735) in the validation cohort. In addition, the nomogram can assign patients into low- (less than 10%), intermediate- (10% to 30%), and high-risk (equal or higher than 30%) groups to facilitate personalized management.CONCLUSION: The nomogram accurately predicted POPF in patients having PD.

Subacute toxicity and chemical analysis of Tibetan medicine Oxytropis falcata / 中国中药杂志

Four different extracts of Oxytropis falcata, including the aerial aqueous extract, and the underground aqueous extract, the aerial lipophilic extract, and the underground lipophilic extract were prepared and then administrated orally to mice at the maximum dose (50 g x kg(-1) x d(-1) calculated by raw material) for fifteen days respectively. Compared with the control group, which was administrated of 1.0% tween-80, the treatment groups did not show significant differences in appearance and behavior. However, the organcoefficient, blood biochemical indicator and pathological section results showed that the lipophilic extracts of the aerial and underground parts of O. flacata showed mild injury to the liver of mice, while the aerial and underground aqueous extracts and the underground lipophilic extract showed mild toxicity to the kidney of male mice. Chemical analysis showed that the lipophilic extracts of the aerial and underground parts, especially aerial lipophilic extract, consisted of large amount of flavonoid aglycones with little amount of polysaccharides and proteins, while the aqueous extracts contained much polysaccharides and proteins with almost no flavonoid aglycones detected.

Chemical constituents from whole plants of Carduus acanthoides / 中国中药杂志

Fourteen compounds were isolated from wholeplants of Carduus acanthoides by various chromatographic techniques including column chromatography over HP-20 macroporous resin, MCI gel, silica gel, Sephadex LH-20 and ODS and reversed-phase HPLC. Their structures were identified as salidroside (1), 2-(3,4-dihydroxyphenyl)-ethyl-O-beta-D-glucopyranoside (2), 3,5-di-hydroxyphenethyl alcohol-3-O-beta-D-glucopyranoside (3), p-coumaric acid (4), 3-hydroxy-1-(4-hydroxy-3-methoxyphenyl) propan-1-one (5), 3-hydroxy-1-(4-hydroxy-3,5-dimethoxyphenyl) propan-1-one (6), syringin (7), p-hydroxybenzaldehyde (8), salicylic acid (9), tachioside (10), vanillic acid-4-O-beta-D-glucopyranoside (11), syringic aldehyde (12), 2,6-dimethoxy-4-hydroxyphenol-1-O-beta-D-glucopyranoside (13), and 2, 6-dimethoxy-p-hydroquinone-4-0-P-D-glucopyranoside (14) on the basis of spectroscopic data analysiS. All compounds were isolated from the genus Carduus for the first time except for compounds 4 and 7.

Assessment of ¹⁸⁸Re marked anti MHC class II antibody by peripheral blood mononuclear cells stimulated by donor alloantigen / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Previous studies showed that anti MHC-II monoclone antibody (MAb) only had partial inhibiting effect of alloreactive mixed lymphocyte reaction (MLR) in vitro and it was unsteady and non-persistent. The aim of this research was to determine whether radioactive isotope (188)Re marked MHC-II antibody could benefit the allograft acceptance in transplantation as compared to normal MHC-II antibody.</p><p><b>METHODS</b>188Re was incorporated to 2E9/13F (ab')(2) which is against swine MHC class II antigen (MAb-(188)Re). Porcine peripheral blood mononuclear (PBMC) cells were examined for proliferation and cytokine mRNA expression after stimulation with MHC-II MAb or MAb-(188)Re.</p><p><b>RESULTS</b>The proliferative response of recipient PBMCs in mixed lymphocyte reaction (MLR) to donor alloantigen showed that the stimulation index of MAb-(188)Re group was significantly lower than the MHC-II MAb group and control (P < 0.05). mRNA expression of interleukin 2, interferon Υ and tumor necrosis factor α (type 1 cytokines) was lower in MAb-(188)Re group than the MHC-II MAb group, while interleukin 10 (type 2 cytokines) was higher in MAb-(188)Re group in the first 24 hours.</p><p><b>CONCLUSION</b>MAb-(188)Re could help the graft acceptance by inhibiting T cell proliferation, lowering the expression of type 1 cytokines and elevating the type 2 cytokines produced by PBMC.</p>

Two en-kaurene diterpenoids from Tibetan medicine Caryopteris toroetii / 中国中药杂志

<p><b>OBJECTIVE</b>To study the chemical constituents of Tibetan medicine Caryopteris toroetii.</p><p><b>METHOD</b>The crude drug was extracted with 95% EtOH and isolated by repeated chromatographic methods. The structures of the isolated compounds were elucidated on the basis of spectral analysis.</p><p><b>RESULT</b>Two en-kaurene diterpenoid compounds: oridonin (1) and nodosin (2), were obtained from C. toroetii and their 1H and 13C-NMR data in CD3OD were reported for the first time.</p><p><b>CONCLUSION</b>The en-kaurene diterpenoid compounds were obtained from genus Caryopteris for the first time.</p>

Studies on chemical constituents of Tibetan medicine Caryopteris toroetii / 中国中药杂志

<p><b>OBJECTIVE</b>To study the chemical constituents of the Tibetan medicine Caryopteris toroetii.</p><p><b>METHOD</b>The crude drug was extracted with 95% EtOH and isolated by repeatedly chromatographic methods. The structures of the isolated compounds were elucidated by spectral analysis.</p><p><b>RESULT</b>Six compounds were yielded and identified as: phenethyl cinnamide (1), 1-hydroxy-2, 3, 4, 5-tetramethoxy-xanthone (2), 1-hydroxy-2, 3, 5-trimethoxy-xanthone (3), (2S)-5-hydroxy-7-methoxyflavanone (4), 2', 4'-dihydroxydihydrochalcone (5) and rutin (6).</p><p><b>CONCLUSION</b>All the above compounds were obtained from C. toroetii for the first time.</p>

Studies on glycosides from Gentiana veitchiorum / 中国中药杂志

<p><b>OBJECTIVE</b>To study the chemical constituents of Gentiana veitchiorum.</p><p><b>METHOD</b>The chemical constituents were isolated by chromatography and identified by spectral data.</p><p><b>RESULT</b>Five glycosides, loganic acid (1), gentiopicroside (2), isoorientin 3'-methyl ether (3), isovitexin (4), isoorientin (5) were isolated and identified.</p><p><b>CONCLUSION</b>Compounds 1-5 were isolated from this plant for the first time.</p>

Influence of CO2 pneumoperitoneum on intracellular pH and signal transduction in cancer cells / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECT</b>The authors studied the influence of CO(2) pneumoperitoneum on intracellular pH and signal transduction arising from cancer cell multiplication in laparoscopic tumor operation.</p><p><b>METHOD</b>They set up a simulation of pneumoperitoneum under different CO(2) pressure, and then measured the variation of intracellular pH (pHi) at different time and the activity of protein kinase C (PKC) and protein phosphatase 2a (PP2a) at the end of the pneumoperitoneum. After 1 week, the concentration of cancer cells in the culture medium was calculated.</p><p><b>RESULT</b>When the pressure of CO(2) pneumoperitoneum was 0, 10, 20, 30 mmHg respectively, the average pHi was 7.273, 7.075, 6.783, 6.693 at the end of the pneumoperitoneum; PKC activity was 159.4, 168.5, 178.0, 181.6 nmol/(g.min) and PP2a was 4158.3, 4066.9, 3984.0, 3878.5 nmol/(g.min) respectively. After 1 week, the cancer cells concentration was 2.15 x 10(5), 2.03 x 10(5), 2.20 x 10(5), 2.18 x 10(5) L(-1).</p><p><b>CONCLUSION</b>CO(2) pneumoperitoneum could promote acidosis in cancer cells, inducing the activation of protein kinase C and deactivation of protein phosphatase 2a, but it could not accelerate the mitosis rate of the cancer cells.</p>