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Pancreatic cancer is a malignant disease with extremely poor prognosis. For now, radical resection is the only approach for long-term survival. Therefore, for complete resection of different type of pancreatic neoplasms, quantities of surgical methods have been innovated and applied by scholars and surgeons. Aiming at various situations, amounts of methods and principle have been suggested. Unresectable neoplasms have been challenged day by day. Meanwhile, with progression of technology, minimally invasive techniques have been applied into resection of pancreatic neoplasms. This article mainly reviews the innovation of surgical methods and technology on radical surgery of pancreatic cancer in recent years.
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ObjectiveTo investigate the effect of Shunao Jieyu decoction on intestinal flora in patients with post-stroke depression. MethodSixty patients with post-stroke depression of Qi stagnation， blood stasis， and phlegm obstruction were selected and divided into a treatment group （30 cases， Shunao Jieyu decoction） and a control group （n=30， paroxetine hydrochloride tablets） according to the random number table. All patients were treated correspondingly for eight weeks. The scores of traditional Chinese medicine（TCM） syndrome， Hamilton rating scale for depression（HAMD）， National Institutes of Health stroke scale（NIHSS）， and activities of daily living（ADL）before and after treatment were compared between the two groups. High-throughput sequencing was used to analyze the diversity of fecal flora and the distribution of taxonomical levels in two groups before and after treatment. ResultThe post-treatment TCM syndrome score， HAMD score， and NIHSS score were lower than those before treatment in the same group （P<0.05）， while the post-treatment ADL score was higher than that before treatment （P<0.05）. Compared with the control group after treatment， the treatment group showed decreased TCM syndrome score （P<0.05）. No significant difference was observed in the HAMD score， NIHSS score and ADL score between the two groups after treatment. The total effective rate of the treatment group was 90% （27/30）， which was superior to 66.3% （19/30） of the control group （χ2=5.863， P<0.05）. After treatment， the average values of Chao1 index， Observed species index， Shannon index， Simpson index， and Pielou's evenness index of intestinal flora diversity in the treatment group increased without significant difference， while the average value of the Good's Coverage index remained unchanged in the same group. At the phylum level， the abundance of Bacteroidetes increased. At the family level， the abundance of Bacteroidaceae increased. At the genus level， the abundance of Bacteroidetes increased. ConclusionShunao Jieyu decoction can effectively improve the clinical TCM symptoms of patients with post-stroke depression， relieve neurological impairment， improve the ability of daily living， and change the diversity and abundance of the intestinal flora of patients at different taxonomic levels.
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BACKGROUND@#The past decade has witnessed an ever-increasing momentum of transcatheter aortic valve replacement (TAVR) and a subsequent paradigm shift in the contemporary management of severe aortic stenosis (AS). We conducted a multi-centric TAVR registry based on Chinese patients (the China Aortic valve tRanscatheter Replacement registrY [CARRY]) to delineate the clinical characteristics and outcomes of Chinese patients who underwent TAVR and compare the results between different valve types in different Chinese regions.@*METHODS@#CARRY is an all-comer registry of aortic valve disease patients undergoing TAVR across China and was designed as an observational study that retrospectively included all TAVR patients at each participating site. Seven hospitals in China participated in the CARRY, and 1204 patients from April 2012 to November 2020 were included. Categorical variables were compared using the chi-squared test, and continuous variables were analyzed using a t test or analysis of variance (ANOVA) test. The Kaplan-Meier curve was used to estimate the risk of adverse events during follow-up.@*RESULTS@#The mean age of the patients was 73.8 ± 6.5 years and 57.2% were male. The median Society of Thoracic Surgeon-Predicted Risk of Mortality score was 6.0 (3.7-8.9). Regarding the aortic valve, the proportion of bicuspid aortic valve (BAV) was 48.5%. During the hospital stay, the stroke rate was 0.7%, and the incidence of high-degree atrioventricular block indicating permanent pacemaker implantation was 11.0%. The in-hospital all-cause mortality rate was 2.2%. After 1 year, the overall mortality rate was 4.5%. Compared to patients with tricuspid aortic valve (TAV), those with BAV had similar in-hospital complication rates, but a lower incidence of in-hospital mortality (1.4% vs. 3.3%) and 1 year mortality (2.3% vs. 5.8%).@*CONCLUSIONS@#TAVR candidates in China were younger, higher proportion of BAV, and had lower rates of post-procedural complications and mortality than other international all-comer registries. Given the use of early generation valves in the majority of the population, patients with BAV had similar rates of complications, but lower mortality than those with TAV. These findings further propel the extension of TAVR in low-risk patients.@*TRIAL REGISTRATION@#https://www.chictr.org.cn/ (No. ChiCTR2000038526).
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Aged , Aged, 80 and over , Humans , Male , Aortic Valve/surgery , Aortic Valve Stenosis/surgery , Registries , Retrospective Studies , Risk Factors , Transcatheter Aortic Valve Replacement/adverse effects , Treatment OutcomeABSTRACT
Objective To observe the clinical efficacy of Recipe for Clearing Heat and Removing Dampness combined with Butyl Flufenamate Ointment for the treatment of facial seborrheic dermatitis. Methods A total of 92 patients with facial seborrheic dermatitis were randomly divided into treatment group and control group,46 cases in each group. The treatment group was treated with oral use of Recipe for Clearing Heat and Removing Dampness combined with external use of Butyl Flufenamate Ointment, and the control group was only treated with external use of Butyl Flufenamate Ointment. The treatment for the two groups covered 4 weeks. Before treatment and on treatment day 7, 14 and 28, scores of clinical symptoms, related skin barrier function indexes,and the serum level of cathepsin S(Cat S)in the two groups were observed. Results(1)On treatment day 14,28,the total effective rate in the treatment group was 84.8％, 89.1％,and that in the control group was 65.2％,71.7％ respectively,the difference being significant(P < 0.05).(2)On treatment day 7,14,28, the scores of clinical symptoms in the two groups were obviously decreased(P < 0.05 compared with those before treatment),and the decrease in the treatment group was superior to that in the control group (P < 0.05).(3) On treatment day 7,14,28,facial sebum secretin,skin water content,and transepidermal water loss(TEWL) of the treatment group were improved to various degrees compared with those of the control group,the differences being significnat(P < 0.05 or P < 0.01).(4)On treatment day 28,serum Cat S of the two groups was markedly decreased(P < 0.01 compared with that before treatment),and the decrease in the treatment group was superior to that in the control group (P < 0.01). Conclusion Recipe for Clearing Heat and Removing Dampness combined with Butyl Flufenamate Ointment exerts certain effect for the treatment of facial seborrheic dermatitis.
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A method for the determination of 15 kinds of nitroaromatics in aqueous samples was developed by dispersive liquid-liquid microextraction and gas chromatography with electron capture detection. A high-density extractant applied in electron capture detector was screened out. The chromatographic conditions, types and dosages of extractants, types and dosages of dispersants, extraction time and the extraction temperature were optimized. The results showed that DB-35 capillary column had the best separation performance for the 15 kinds of nitroaromatics. The nitroaromatics could be separated within 22 min using programmed temperature control as follows: holding at an initial temperature of 80℃ and then heating to 180℃ at a ramping rate of 5℃ / min. For the extraction of 15 kinds of nitroaromatics from 5 mL of aqueous sample, the extraction equilibrium could be reached within 30 s with a high extraction recovery of over 90%when using 100 μL of chlorobenzene as extracting solvent and 400 μL of methanol as disperser solvent. In addition, the enrichment factor could approach a high value of 45. 0 - 48. 8. The sediment collected by centrifugation was injected and analyzed by gas chromatography with electron capture detector. The limits of quantification of the developed method were 0. 03 - 0. 15 μg / L ( S / N = 10). The linear range was from 0. 20 μg / L to 50. 0 μg / L, while the correlation coefficients (R2 ) were more than 0. 998. At the spiked level of 0. 200 μg / L, the relative standard deviations of this method were 3. 3% -8. 9% , the relative recoveries ranged from 86. 0% to 103. 5% . At higher spiked level, the relative standard deviations were less than 5% , and the relative recoveries ranged from 94. 5% to 101. 5% .
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BACKGROUND:Because the geographical environment and diet cause obesity and osteoarthritis in Xinjiang Uygur local patients, the number of patients became more. At present, more and more patients received artificial knee replacement. How to master and further apply the technology of soft tissue balance during artificial knee replacement in patients of different physical fitness and nations becomes the focus of many scholars. OBJECTIVE:To analyze the clinical efficacy of soft tissue balance in Xinjiang Uygur patients with knee valgus in total knee replacement. METHODS:A total of 60 cases (72 knees) with severe knee osteoarthritis with a certain degree of knee valgus were subjected to total knee replacement through anterior lateral approach and individualized soft tissue balance from February 2009 to December 2010. Folow-up mode was the clinic visit. X-ray was used to measure tibiofemoral angle (i.e., the supplementary angle of the included angle between anatomic axis of femur and tibia). Clinical score and functional score of American knee society knee score were applied to assess knee joint function. RESULTS AND CONCLUSION:A total of 57 patients were folowed up for 6-35 months. The tibiofemoral angle decreased from 27.9° preoperatively to 5.6° postoperatively. Clinical score of American knee society knee score elevated from 16.7 points preoperatively to 87.5 postoperatively. Functional score of American knee society knee score elevated from 7.9 points preoperatively to 85.2 postoperatively. Significant differences in preoperative and final folow-up scores were detected (P < 0.01). Valgus deformity was corrected and joint stability was good in 57 patients after replacement. These findings indicate that in patients with severe knee osteoarthritis and valgus deformity, to select individualized treatment of soft tissue balance can effectively correct soft tissue imbalance and get more satisfactory clinical results.
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BACKGROUND: Common complication of traditional joint replacement is hip joint dislocation and large head joint implant can effectively solve this problem. OBJECTIVE: To investigate the preliminary efficacy of large head metal-on-metal implants for patients undergoing total hip arthroplasty. DESIGN, TIME AND SETTING: Prospective cohort study. The patients were selected from Department of Joint Surgery, Xinjiang Hospital of Traditional Chinese Medicine between February 2007 and January 2008. PARTICIPANTS: A total of 65 patients (71 hips) undergoing large head metal-on-metal implantation in Xinjiang Hospital of Traditional Chinese Medicine were selected, including 21 females and 44 males with an average age of 54.6 years (ranging 19 to 77 years). Of them, there were 28 cases of necrosis of the femoral head, 24 of hip osteoarthritis, 9 of femoral neck fracture and 4 of acetabular dysplasia. METHODS: According to age, sex, cause of disease and preoperative joint function, the patients were divided into traditional prosthesis (n=30, 33 hips, metal-on-polyethylene implant) and large head M-O-M group (n=35, 38 hips, ASR/XL prosthesis, DePuy, Motech, Warsaw, IN, USA). MAIN OUTCOME MEASURES: The pre and postoperative Harris scores for the hip, range of motion, periprosthetic radiolucency, leg-length inequality and complications were recorded and compared. RESULTS: All patients were followed-up. The traditional group was followed up for 20 months (ranging 13-28 months), and the large head M-O-M group was followed up for 17 months (ranging 10-26 months). The mean Harris score was 89 points (ranging 59-98) in traditional group, and 94 points (ranging 71-100) in large head M-O-M group (P=0.014). The range of motion of hip was improved, and the large head M-O-M group (34?) was superior to traditional group (26?, P=0.004) at 6 months after surgery; the range of motion was improved 27? in traditional group and 37? in large head M-O-M group (P=0.009) over 1 year of follow up. The leg-length inequality was 4 mm (2-11 mm) in large head M-O-M group and 7 mm (5-16 mm) in traditional group (P=0.005). Both groups exhibited periprosthetic radiolucency (≤1 mm, 2 cases in traditional group and 3 cases in large head M-O-M group). One patient in the traditional group suffered dislocation. CONCLUSION: The large head M-on-M implants in total hip arthroplasty has excellent short-term effects on patients compared with traditional prosthesis. They offer the more stability and better restoration of hip articulation function and biomechanical reconstruction.
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<p><b>AIM</b>To investigate the inhibitory effect of recombinant human endostatin (rhEndostatin) on endothelia cell proliferation and tumor growth.</p><p><b>METHODS</b>MTT assay was applied to examine the anti-proliferation of rhEndostatin on human embryo umbilical cord vascular endothelial cell ECV304 and human cancer cell HCT-8, BGC803 and EJ. Xenotrasplanted nude mice models with human cancer and experimental implanted tumor mice model were used to evaluate rhEndostatin's antitumor activity.</p><p><b>RESULTS</b>rhEndostatin was shown to inhibit the proliferation of ECV304 cells and the IC50 is about 7 x 10(-6) g.L-1. No inhibition was observed in HCT-8, BGC803 and EJ cells at 1 x 10(-4) g.L-1 rhEndostatin. rhEndostatin was shown to inhibit human xenograft in nude mice with human gastric cancer BGC803 and breast cancer B37 when administered subcutaneously at 5, 10, 20 mg.kg-1.d-1 for 24 days in a dose-dependent manner. Mouse hepatoma H22 was also suppressed when given rhEndostatin subcutaneously 20 mg.kg-1.d-1 for 9 days, but it showed no inhibitory effect on Lewis lung carcinoma and B16 melanoma.</p><p><b>CONCLUSION</b>These results indicate that rhEndostatin can inhibit the growth of xenotransplanted human tumors in nude mice and certain murine tumor. The action mechanisms may be that it can inhibit endothelial cell proliferation, thereby inhibiting the formation of new blood vessel in tumor, leading the tumor to stop grow.</p>