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Objective:To compare the prognosis of pancreatic head cancer, uncinate process cancer and pancreatic neck cancer patients after undergoing pancreatoduodenectomy.Methods:The clinical data and follow-up data of 71 pancreatic cancer patients undergoing pancreatoduodenectomy in the First Affiliated Hospital of Xinjiang Medical University were analyzed retrospectively, Kaplan Meier method was used to compare the survival of postoperative patients. COX proportional risk model was used to analyze the survival of three groups of tumor.Results:In pancreatic cancer patients, uncinate process cancer and pancreatic neck cancer had more frequent vascular invasion, higher lymph node metastasis rate and lower R 0 resection rate than pancreatic head cancer (all P<0.05). Multivariate COX suggested that vascular invasion ( P=0.018), lymph node metastasis ( P=0.001), tumor site ( P=0.022 in uncinate process, P=0.000 in pancreatic neck) and R 0 resection ( P=0.000) were independent risk factors for prognosis. For pancreatic head cancer the 1-year recurrence rate was 43.8%, 3-year survival rate was 28.1%, median survival time was 20.0 months (95% CI 15.565-24.435). For uncinate process cancer 1-year recurrence rate was 61.5%, 3-year survival rate was 15.4%, median survival time was 14.0 months (95% CI 9.003-18.997) respectively.That was 69.2%, 7.7% and 10.0 months (95% CI 5.303-14.697) respectively for pancreatic neck cancer. Conclusion:Compared with pancreatic head cancer, uncinate process cancer and pancreatic neck cancer are associated with poorer prognosis because of frequent early vascular invasion, low R 0 resection rate and early local recurrence.
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Objective To investigate the effect of open surgical drainage approach for the treatment of walled-off pancreatic necrosis ( WOPN) in severe acute pancreatitis. Methods Clinical data of 154 WOPN patients admitted in the First Affiliated Hospital of Xinjiang Medical University from January 2005 to October 2016 were retrospectively analyzed. Traditional open debridement necrosectomy was performed in 83 patients from January 2005 to October 2012 ( debridement group) , and small abdominal incision with low-position open surgical drainage was performed in 71 patients from October 2012 to October 2016 ( drainage group ) . The clinical outcomes of two groups were analyzed and compared. Results 43 cases (51. 8％) in debridement group had postoperative intraperitoneal reinfection, while there were only 13 cases with postoperative intraperitoneal reinfection (18. 3％) in drainage group;18 cases (21. 7％) in debridement group had surgery-related digestive tract fistula, while there were only 4 cases with surgery-related digestive tract fistula (5. 6％) in drainage group; the differences were statistically significant (χ2 = 18. 55, P=0. 001; χ2 = 11. 35, P=0. 002). 15 patients (18. 1％) in debridement group and only 2 patients (2. 8％) in drainage group died. The mortality in drainage group were obviously lower than that in debridement group, and the difference was statistically significant (χ2 = 9. 07, P<0. 05 ). 62 cases ( 74. 7％) in debridement group and 55 cases (77. 5％) in drainage group were cured directly, respectively. No significant difference was found between two groups. However, 3 cases (3. 6％) in debridement group and 12 cases (16. 9％) in drainage group were cured by the way of small intestinal fistula in the late stage of intubation, and the latter was higher than the former with statistically significant(χ2 =5. 989,P=0. 014). Conclusions Compared with open debridement necrosectomy, the abdominal infection rate, digestive tract fistula rate and mortality of open surgical drainage were all significantly reduced , which may be a better treatment for WOPN.
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Objective The risk of current pancreaticojejunostomy is carefully considered from the perspective of the morphology of remnant pancreas,and we aimed to discuss the clinical outcomes of selecting different pancreaticojejunostomy techniques based on pancreatic morphology.Methods This was a prospective cohort study.The histopathology of remnant pancreatic tissues was categorized into four types based on preoperative radiological images and intraoperative palpation:Type Ⅰ:pancreas with hard texture in palpation,pancreatic atrophy,dilated pancreatic duct larger than 5 mm and remnant pancreatic surface ＜3 cm;Type Ⅱ:pancreas with hard texture in palpation,pancreatic atrophy and mild dilatation of pancreatic duct with the diameter of 3-5 mm and remnant pancreatic surface ＜3 cm;Type Ⅲ:pancreas with slightly hard texture,no atrophy,and normal or slightly dilated pancreatic duct with the diameter of 3-5 mm and remnant pancreatic surface ≥3 cm;Type Ⅳ:pancreas with soft texture,normal morphology and pancreatic duct.Results From January 2008 to August 2017,116 consecutive patients underwent pancreaticoduodenectomy in our center.Among them,10 patients with type Ⅰ underwent classic pancreatic ductal mucosa to mucosa anastomosis.19 patients with type Ⅱ underwent classic end to end invaginated pancreaticojejunostomy.45 patients with type Ⅲ underwent classic end to end invaginated pancreaticojejunostomy with overlapping U sutures;42 patients with type Ⅵ underwent total invaginated pancreaticojejunostomy.The post-operative pancreatic fistula occurred in 6 patients (5.2％) with one patient died.Postoperative bleeding occurred in 10 patients (8.6％),and gastroparesis occurred in 22 patients (19.0％).Overall complication rate was 33.6％.Conclusions Classification of pancreatic morphology based on preoperative radiological images and intraoperative palpation and the selection of corresponding pancreaticojejunostomy technique is theoretically rational and has the advantage of potentially reducing the risk of remnant pancreatic tissue.
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Objective To discuss how to develop the standardized management of medical research contracts in order to promote the policy-making and compliance of hospital scientific contracts management.Methods Through the literature review from the perspective of classified medical research contracts management,along with the analysis of problems raised in regular daily practice,this paper explored how to effectively improve the scientific research management capacity.Results A series of measures such as updating the contract management system,standardizing the management process,improving professional training and implementing the contract archiving can improve the policy-making and compliance of hospital scientific contracts management.Conclusions Standardized hospital scientific contracts management plays significant roles in protecting the interests of both sides,as well as strengthen cooperation.
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Based on domestic and international studies on Career-Life-Cycle theories,this paper analyzed the scientific research data of doctors to elucidate characters of varied steps in clinical and research practices,trying to construct Research Life-Cycle theory for doctors and provide theoretical references of talent cultivation in hospitals.
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Objective To investigate the clinical value of intraoperative ultrasound guided precise positioning and enucleation of the functional islet cell tumor.Methods The clinical data of 20 patients with functional islet cell tumor who were admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2005 to December 2011 were retrospectively analyzed.The method of precise positioning,surgical approach and prognosis of the patients were reviewed.Results The accurate rates of computed tomography (CT),magnetic resonance imaging (MRI) and transabdominal B ultrasound in detecting the position of the functional islet cell tumors were 12/18,2/6 and 7/13,respectively,and the diameters of the tumors were (1.7 ±0.8)cm,(1.3 ±0.2)cm and (1.9 ±0.9)cm,respectively.The accurate rates of arterial stimulation venous sampling and pancreatic perfusion CT imaging were 100％,and the diameters of the tumor detected were (0.7 ± 0.3) cm and (0.9 ± 0.4) cm.The accurate rate of intraoperative B ultrasound examination was 14/14,and the diameter of the tumor was (1.5 ± 0.6)cm.Routine surgery was carried out on 6 patients,and 2 patients were complicated with grade C pancreatic fistula,and 1 was complicated with grade A pancreatic fistula.Fourteen patients received precise enucleation of islet cell tumor,and 4 patients were complicated with grade A pancreatic fistula.Twenty patients were followed up.The general condition of the patients was good till April 2012,and no death,tumor recurrence and metastasis were detected.Conclusions Combination of pre-and intraoperative imaging positioning could precisely locate functional islet cell tumor.If the distance between the tumor and main pancreatic duct is above 3 mm,precise enucleation of the islet cell tumor should be considered.
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<p><b>OBJECTIVE</b>To observe the effect of Uighur medicine gu-jing-mai-si-ha tablet (GJMSHT) for treatment of premature ejaculation (PE) and to explore part of its mechanism.</p><p><b>METHODS</b>The condition of patients was scored by related questionnaire, and the intravaginal ejaculation latency time (IELT) was observed before and after GJMSHT treatment, with the blood levels of nitric oxide (NO) and prostaglandin F2alpha (PGF2alpha) detected in PE patients as well. The results were compared with those in the control group.</p><p><b>RESULTS</b>After treatment, the scores of PE and IELT, as well as the levels of NO and PGF2alpha, all increased significantly compared to those before treatment in the treated group (P<0.01), while in the control group, all the parameters were insignificantly changed (P>0.05). Therefore, the difference of these parameters between the two groups after treatment all showed statistical significance (P<0.01).</p><p><b>CONCLUSION</b>GJMSHT could treat PE effectively, its mechanism is possibly by strengthening the coordination of the related smooth muscles through increasing the blood levels of NO and PGF2alpha, and the endurance of patients to the cavitary effect of prostatico-urethral pressure, thus postponing the arrival of urgent ejaculatory feeling.</p>
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Adult , Female , Humans , Male , Dinoprost , Blood , Drugs, Chinese Herbal , Pharmacology , Therapeutic Uses , Ejaculation , Nitric Oxide , Blood , Sexual Dysfunction, Physiological , Drug Therapy , TabletsABSTRACT
Objective: To study the mechanism of inhibitory ef fect of ginsenoside Rg3 on tumor growth. Methods: The chick chor ioallantoic membrane(CAM) test and Lewis lung carcinoma model were used to inves tigate the inhibitory effect of Rg3 on tumor angiogenesis. Results: Rg3(0.1 or 0.5 mmol/L) obviously inhibited angiogenesis in the CAM. Treatmen t with Rg3 in vivo obviously inhibited Lewis lung carcinoma growth with the inhibition ratio from 23% to about 47%. We also observed that the angiogenesis in implanted Lewis lung carcinoma tissue decreased obviously after treated wit h Rg3 (5, 10, 20 mg/kg). Conclusion: Rg3 can obviously inhibit t he growth of Lewis lung cancer, the inhibitory effect partially due to the effec t of Rg3 inhibiting neovascularization induced by malignant tumor.
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Objective: To study the mechanism of inhibitory ef fect of ginsenoside Rg3 on tumor growth. Methods: The chick chor ioallantoic membrane(CAM) test and Lewis lung carcinoma model were used to inves tigate the inhibitory effect of Rg3 on tumor angiogenesis. Results: Rg3(0.1 or 0.5 mmol/L) obviously inhibited angiogenesis in the CAM. Treatmen t with Rg3 in vivo obviously inhibited Lewis lung carcinoma growth with the inhibition ratio from 23% to about 47%. We also observed that the angiogenesis in implanted Lewis lung carcinoma tissue decreased obviously after treated wit h Rg3 (5, 10, 20 mg/kg). Conclusion: Rg3 can obviously inhibit t he growth of Lewis lung cancer, the inhibitory effect partially due to the effec t of Rg3 inhibiting neovascularization induced by malignant tumor.