One anastomosis gastric bypass: recent global advancement / 中华消化外科杂志

Bariatric surgery is effective on obesity, which can significantly improve the metabolic diseases of obesity patients, especially the type 2 diabetes. However, the surgical proce-dures of bariatric and metabolic surgery are still evolving and in progress. One anastomosis gastric bypass (OAGB) is the latest bariatric surgery recognized by the international bariatric and metabolic surgery community. The authors review the relevant literatures at home and abroad, and introduce the development history, surgical skills, clinical efficacy, status quo and adaptability of OAGB.

The role of SnRK2 in the response to stress, the growth and development of plants / 生物工程学报

Sucrose non-fermenting-1-related protein kinase 2 (SnRK2) is a specific Ser/Thr protein kinase in plants. SnRK2 can regulate the expression of downstream genes or transcription factors through phosphorylation of substrates to achieve stress resistance regulation in different tissue parts, and make plants adapt to adverse environment. SnRK2 has a small number of members and a molecular weight of about 40 kDa, and contains a conserved N-terminal kinase domain and a divergent C-terminal regulatory domain, which plays an important role in the expression of enzyme. This review summarized the recent research progresses on the discovery, structure, and classification of SnRK2, and its function in response to various stresses and in regulating growth and development, followed by prospecting the future research direction of SnRK2. This review may provide a reference for genetic improvement of crop stress resistance.

Suprachoroidal injection of sodium hyaluronate in the treatment of 12 patients with rhegmatogenous retinal detachment / 中华眼底病杂志

Objective To observe the retinal reattachment of suprachoroidal injection with sodium hyaluronate in the treatment of rhegmatogenous retinal detachment (RRD).Methods Twelve eyes of 12 patients with RRD diagnosed by the examinations of B-mode ultrasound,binocular indirect ophthalmoscope,OCT and scanning laser ophthalmoscope in West China Hospital of Sichuan University from October 2018 to February 2019 were included in this study.There were 7 males and 5 females,aged from 15 to 66 years,with the mean age of 32.40± 14.81 years.There were 4 eyes with BCVA＜0.1,4 eyes with BCVA 0.1-0.4,4 eyes with BCVA＞0.4.The extent of retinal detachment involves 1 to 4 quadrants.All eyes were injected with sodium hyaluronate via suprachoroidal space under non-contact wide-angle system.Surgery was performed by the same ophthalmologist with extensive surgical experience.During the operation,the retinal hole was handled with scleral freezing and laser photocoagulation.The follow-up was 2 months.The retinal reattachment was observed.Results Of the 12 eyes,6 eyes (50.00％) were anatomically reattached,4 eyes (33.33％) ere partly anatomically reattached with subretinal fluid,2 eyes (16.67％) were not reattached.The holes in 4 eyes of partly anatomically reattached with subretinal fluid were located on the choroidal pad and the holes were closed,in addition,the subretinal fluid gradually absorbed over time.Two eyes failed in retinal reattachment received vitrectomy with silicone oil tamponade or sclera buckling surgery.No severe complications such as endophthalmitis and choroidal hemorrhage were found at follow-up visits.Conclusion Suprachoroidal injection of sodium hyaluronate is an effective and safe treatment for RRD,which can promote retinal reattachment.

Ventilator-associated Pneumonia due to Acute Lung lnjury and Acute Respiratory Distress Syndrome after Severe Injury:High Risk Factors and Clinical Characteristics / 中华医院感染学杂志

OBJECTIVE To explore the incidence rate,pathogen distribution and characteristics of drug resistance of ventilator-associated pneumonia(VAP) patients due to acute lung injury and acute respiratory distress syndrome(ALI/ARDS) after severe injury,and analyze impact factors on VAP.METHODS All 183 cases with ALI/ARDS after severe injury from Jan 2004 to Mar 2008,were admiitted and given mechanic ventilation over 48 hours in our ICU and EICU.RESULTS VAP was found in 98 cases,accounted for 53.56%.Among them,42 were early-onset VAP and the other 56 were late-onset VAP.Altogether 276 pathogens were isolated,and most of them were Pseudomonas aeruginosa,Staphylococci aureus,Klebsiella pneumoniae,Acinetobacter baumannii and Escherichia coli.In 41 cases only one pathogen was isolated,the other 57 cases were with two or above pathogens.The revealed important risk factors were coma,prolonged mechanical ventilation,tracheotomy,antiacid treatment,use of antimicrobial agents and low albumin.CONCLUSIONS The incidence rate of VAP due to ALI/ARDS is high,and most of the isolated pathogens are drug resistant.Mixed infections are found commonly in these cases.

Ventilator-associated Pneumonia Following Severe Craniocerebral Trauma and Its Clinical Characteristics / 中华医院感染学杂志

OBJECTIVE To explore the characteristics of the pathogens in ventilator-associated pneumonia (VAP) following severe craniocerebral trauma. METHODS The 220 cases with severe craniocerebral trauma were analyzed retrospectively. RESULTS The incident rate of VAP was 24% in these patients. A total of 169 pathogens were isolated,including 146 ( 86%) strains of bacteria and 23 (14%) fungal isolates. The main Gram-negative bacteria (114 strains) were Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,etc. The Gram-positives (32 strains) were Staphylococcus aureus and twenty-four (75%) of them were meticillin-resistant. CONCLUSIONS The incident rate of VAP is high following severe craniocerebral trauma. Most of the isolated pathogens are drug resistant. These cases have mixed infection occurred commonly. To prevent and treat VAP,we should pay attention to disinfection and aseptic manipulation,and make the rational use of antimicrobial agents.

Stresses in portal venous system of pre-hepatic portal hypertension (PHT) rabbits / 生物医学工程学杂志

Portal hypertension is a common physiopathological change in liver cirrhosis. In this study, rabbits were used and the model of pre-hepatic portal hypertension (PHT) was induced by partial ligation of portal vein in two steps. We measured the diameters of portal vein and small mesenteric vein at different time-points. Then we detected the stress forces induced by blood flow in varicose veins and in portal vein; such forces included hydrostatic pressure, shear stress and circumferential stress. With the increase of the diameter of varicose small mesenteric vein, the hydrostatic pressure and circumferential stress gradually elevated and shear stress descended markedly in both the portal vein and the small mesenteric vein of PHT rabbits, between which there was a positive linear correlation. The findings in our study indicate that the complications of PHT are partially attributable to the environment of lower shear stress and higher circumferential stress in which the blood vessels of portal venous system live.

Change of zero-stress state of portal vein in the rat during the pathogenesis of intrahepatic portal hypertension / 生物医学工程学杂志

A model of intrahepatic portal hypertension was established in SD rats by injection of carbon tetrachloride (CCl4). By observing the opening angle of the portal vein, the zero-stress state of the portal veins was studied at different time during the pathogenesis of intrahepatic portal hypertension. After CCl4 injection, the opening angles of the portal veins were increased, in the tenth week, they were much greater than those in the corresponding controls (P<0.05). The results suggest that during the pathogenesis of portal hypertension, unequal remodeling exists in the portal veins to change its biomechanical properties, and the residual stress and strain of the portal veins in portal hypertensive rats are greater than those in normal controls.

Approximate entropy analysis of fetal heart rate variability and its application in the diagnosis of fetal distress / 生物医学工程学杂志

To introduce approximate entropy (ApEn) in the analysis of fetal heart rate variability (FHRV) and to discuss the relationship between the ApEn values and perinatal outcomes, 67 computerized cardiotocographs were recorded. Approximate entropy and index in time domain were used to analyze FHRV. After childbirth, the neonatal Apgar scores were recorded and umbilical cord arterial blood gas analyses were performed. The results showed the ApEn values of FHRV were correlated with pH, Pco2, Po2, HCO3-, ABE, SO2 and neonatal Apgar scores (r = 0.51, -0.29, 0.49, 0.29, 0.45, 0.56, 0.28, respectively, P < 0.05). The ApEn values for acidotic fetuses (pH less than 7.20) were significantly different from those of normal fetuses (P < 0.01), however the time domain parameters of FHRV were unable to identify the difference. The results suggest that the ApEn values of FHRV are closely related to the fetal hypoxia and acidemia. Thus the ApEn analysis appears to be useful for improving the sensitivity in the diagnosis of fetal distress.

Pulse pressure and mean pressure relationship of intracranial pressure and lumbar cerebrospinal fluid pressure / 生物医学工程学杂志

Intracranial pressure fluctuates due to heart beat, respiration, neuro-regulation, etc. Traditional intracranial pressure study focuses on the static pressure and related factors, putting emphasis on mean intracranial pressure, while paying little attention to the pulse components. This study was composed of two parts: animal experiment and theoretical analysis. The animal experiment was performed on 14 mongrel dogs, studying the variation of intracranial pressure wave form under different intracranial pressure level. The dogs were installed epidurally with latex sacculus to establish models of increased intracranial pressure. The degree of intracranial pressure and volume could be altered by changing the volume of fluid in the sacculus. During the process, pressure transducers were arranged to monitor and record the variations of the pressure of intracranial ventricle and lumbar subarachnoid cavity. The result demonstrated that, with the continual increase of intracranial pressure, intracranial pulse pressure increased correspondingly, showing a linear relationship with the change of intracranial pressure. After the sacculus was emptied and reinfused, the slope of the linear relationship was determined to be greater than the former slope. The same result was obtained in the lumbar cerebrospinal fluid pressure. Therefore, the lumbar cerebrospinal fluid pressure is consistent with the intracranial pressure. Intracranial pulse pressure is in linear relationship with mean pressure, and the slope of their linear relationship predicts the perform of intracranial autoregulation.

Hand-assisted laparoscopic splenectomy plus portozygos disconnection procedure for patients with portal hypertension / 中国内镜杂志

[Objective] To explore the techniques of hand-assisted laparoscopic splenectomy plus portozygos disconnection procedure. [Methods] 18 patients with portal hypertension were operated by hand-assisted laparoscopic splenectomy plus portozygos disconnection. [Results] The operations were completed successfully. The mean operative time was 180(150～260) minutes, the mean blood loss estimated was 540(200～2 000) mL, the mean weight of spleen was 910 (500～2000) g and the mean length of hospital stay was 9.7 (8～18) days after operation. All patients had recovered rapidly and suffered less pain and only 5 patients needed analgesic. The mean recovery time of the bowel function was 52(24～74) hours. The hand incisions healed well, and only one occurred complications and another suffered death. [ Conclusions ] Hand-assisted laparoscopic splenectomy plus portozygos disconnection procedure is to be feasible and safe, and has the merits of minimally invasive surgery.

Power spectral analysis on heart rate variability of hypoxaemia in fetal lambs / 生物医学工程学杂志

To analyze the effect of hypoxaemia on heart rate variability (HRV) in fetal lambs by means of power spectrum, the intrauterine surgical operations were performed at 116-125 gestational days in 7 lambs. Arterial catheter was inserted in the fetal femoral artery and sent to aorta abdominalis, and blood pressure was recorded continually on tape recorder. The microspheres were injected via the arterial catheter to block the micrangium of placenta, thus making an animal model of fetal hypoxaemia. The fetal blood sample was drawn through the catheter for blood gas analysis. In terms of the heart beat variability power spectral density, there were four consistent components, namely very low (VL, 0.01-0.025 cycle/beat), low (L, 0.025-0.125 cycle/beat), middle (M, 0.125-0.2 cycle/beat), and high (H, 0.2-0.5 cycle/beat). Integrated peaks in the power spectrum were compared before and after administration of microsphere. The spectral power in the L frequency components was significantly increased (0.07 +/- 0.01 vs. 0.21 +/- 0.03, P<0.01), and the spectral power in the H frequency components was significantly reduced (0.53 +/- 0.1 vs. 0.27 +/- 0.05, P<0.05). There was no significant difference in M and VL. The times of microsphere injection were related to fetal blood pH (r=0.585, p<0.01), PCO2 (r=0.5, p<0.05) and PO2 (r=0.75, P<0.01). The results clearly demonstrate the association between change of power spectrum of heart rate variability and the effect of hypoxia of the fetus in labour.

Effects of Recombinant Human IGF-1 on Kidney in Diabetic Rats / 复旦学报（医学版）

PurposeTo observe the effects of rhIGF-1 on kidney in diabetic rats. MethodsUsing biochemistry, radioimmunoassay, molecular biology (RT-PCR). Results(1) 24 h UAER,24 h uriary volume in rhIGF-1 group is lower than that of diabetic control group; (2) The level of sertan IGF-1 ,kidney IGF-1 and IGF-1 mRNA in diabetic control group is lower than that of normal control group;The level of serum IGF-1 in rhIGF-1 group is higher than that of diabetic control group;no differences were found in the levels of kidney IGF-1 and kidney IGF-1 mRNA between diabetic control group and rhIGF-1 group; (3) The level of serum GH in diabetic control group is higher than that of normal control group; The level of serum GH in rhIGF-1 group is lower than that of diabetic control group; (4) rhIGF-1 might have some protective effects on diabetic nephropathy via electron microscope. ConclusionsrhIGF-1 doesn't increase the damage of diabetic kidney tissue.

Relationship between the variation of cerebrospinal fluid pulse pressure and cerebral perfusion pressure during the process of increasing intracranial pressure / 临床神经病学杂志

Objective To investigate the relationship between the variation of cerebrospinal fluid pulse pressure and that of intracranial perfusion pressure during the process of increasing intracranial pressure.Methods Fourteen dogs were installed epidurally with latex sacculus to establish models of increased intracranial pressure. The degree of intracranial pressure and volume could be altered by changing the volume of fluid in the sacculus. During the process, pressure transducers were arranged to monitor and record the systematic blood pressure and the variation of the pressure of cerebral ventricle and lumbar subarachnoid space.Results With the continual increasement of intracranial pressure, the cerebral perfusion pressure decreased, and the cerebrospinal fluid pulse pressure correspondingly increased. A positive linear relationship between the variation of intracranial pressure and that of cerebrospinal fluid pulse pressure and a negative linear relationship between the variation of cerebral perfusion pressure and that of cerebrospinal fluid pulse pressure were found.Conclusion During the experimental process of increased intracranial pressure, with the decrease of cerebral perfusion pressure , the cerebrospinal fluid pulse pressure increases. The relationship of variations between them shows a negative linear one. It seems that in the circumstances when the autoregulation of cerebral vessel is injured, the variations of cerebrospinal fluid pulse pressure may produce some useful information as to the changes of intracranial blood flow.

Influence of parenteral nutrition via portal vein on insulin and glucagon in liver regeneration / 肠外与肠内营养

Objectives:To investigate the influence of PN via portal vein on insulin and glucagon in liver regeneration. Methods:The rabbits were randomly devided into control group( n =5),PN via portal vein group(group Ⅰ, n =10) and PN via central vein group(group Ⅱ, n =10).The PN was performed for 6 days after partial hepatectomy.The concentration of serum insulin and glucagon in portal and perpheral vein were analysed with radioimmunoassay. Results:The concentration of serum insulin was increased in group Ⅰ and group Ⅱ,and it was increased significantly( P 0.05),but it was increased significantly in portal vein blood in group Ⅰ( P

Radical resection of rectal carcinoma by laparoscopic versus open approach / 中国普通外科杂志

Objective To study the feasibility and curative effect of laparoscopic radical resection of rectal carcinoma. Methods Sixty-two cases were enrolled in this study between Feb 2003 and Mar 2005, including 32 cases undergoing laparoscopic radical resection (19 Dixon and 13 Miles) , and 30 cases undergoing open radical resection (22 Dixons and 8 Miles). Results The mean operation time of laparoscopic group was 195 min, and open group was 156 min (P 0. 05 ). The GI and urination function of laparoscopic group recovered faster than open group ( evacuated was 2. 7 days vs. 3. 7 days, P

Experimental study of low frequency component of intracranial pressure fluctuation during intracranial hypertension / 临床神经病学杂志

Objective To study the changes of low-frequency-component of intracranial pressure (ICP) fluctuation during intracranial hypertension. Methods 15 healthy mongrel dogs were used to make models of intracranial hypertension by arranging latex sacculus epidurally.The different amount of normal that was injected into latex sacculus led to fluctuation of ICP and alteration of intracranial volume. The pressures in ventricle and lumbar spinal canal were recorded continuously by baroceptor, and the changes of low-frequency-component of ICP fluctuation were studied by frequency-spectrum analysis. Results After increase of intracranial pressure and volume,pulse wave (M wave) with its frequency at 0.1～0.2 Hz showed continually. Conclusion Emerge of M wave may reflect some decrease of intracranial compliance and the beginning of volume compensation failure.